题名

A Correlational Study of Skin Toxicity and Quality of Life in Patients With Advanced Lung Cancer Receiving Targeted Therapy

DOI

10.1097/jnr.0000000000000339

作者

Jui-Chun CHAN;Yun-Hsiang LEE;Chien-Ying LIU;Hui-Hsuan SHIH;Pei-Kwei TSAY;Woung-Ru TANG

关键词

lung cancer ; skin toxicity ; targeted therapy ; quality of life

期刊名称

The Journal of Nursing Research

卷期/出版年月

27卷6期(2019 / 12 / 01)

页次

1 - 9-003

内容语文

英文

中文摘要

Background: Oral targeted therapy is increasingly used worldwide to treat patients with advanced lung cancer. The adverse skin toxicity that is associated with treatment with epidermal growth factor receptor inhibitors often results in acneiform rash, dry skin (xerosis), pruritus, and paronychia, which may cause discomfort in patients and affect their quality of life. Purpose: This study was designed to explore changes in skin toxicity and quality of life (measured overall by three subscales) as well as the correlation between skin toxicity and overall quality of life over a 3-month period for patients with advanced lung cancer receiving oral targeted therapy. Methods: This study used a longitudinal research design. Baseline data were collected before initiating targeted therapy. Data for the effects of targeted therapy on skin toxicity and quality of life were collected at 2, 4, 8, and 12 weeks after therapy initiation. Data on skin toxicity were collected using the Common Terminology Criteria for Adverse Events Version 4.03, and quality of life was measured using the Chinese version of the Functional Assessment of Cancer Therapy-Epidermal Growth Factor Receptor Inhibitor-18 questionnaire. Demographic and clinical data were analyzed using descriptive statistics, and Spearman's rank correlation coefficient was used to measure the correlation between skin toxicity and quality of life. Results: Thirty-two patients participated in this study. The symptoms of skin toxicity that increased over the 3-month study period included xerosis and paronychia, whereas acneiform rash and pruritus fluctuated during this period. Over the study period, more than 70% of the participants exhibited symptoms of skin toxicity. Skin toxicity was the greatest and quality of life was the lowest, respectively, at the end of the study. All of the symptoms of skin toxicity were significantly correlated with quality of life, although each varied over time (r = .36-.61, p < .05). Conclusions/Implications for Practice: The results of this study indicate that healthcare providers should consider the impact of skin toxicity on quality of life in patients with advanced lung cancer who are receiving oral targeted therapy. These findings may be used to design interventional measures for skin and medical care to improve quality of life in patients with advanced lung cancer.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Chang, L. L.,Chu, C. Y.,Chiang, S. C.,Sheu, L. C.,Huang, K. C.,Chou, W. S.,Hou, H. H.(2015)。Clinical practice guideline: Prevention and management of targeted therapy related skin toxicities。The Journal of Oncology Nursing,15(Suppl.),47-80。
    連結:
  2. Dai, Y. L.,Yang, C. T.,Chen, K. H.,Tang, S. T.(2017).Changes in and determinants of quality of life in patients with advanced non-small-cell lung cancer undergoing initial chemotherapy.The Journal of Nursing Research,25(3),203-215.
    連結:
  3. Chan, A.,Cameron,M. C.,Garden, B.,Boers-Doets, C. B.,Schindler, K.,Epstein, J. B.,Lacouture, M. E.(2015).A systematic review of patient-reported outcome instruments of dermatologic adverse events associated with targeted cancer therapies.Supportive Care in Cancer,23(8),2231-2244.
  4. Chan, A.,Tan, E. H.(2011).How well does the MESTT correlate with CTCAE scale for the grading of dermatological toxicities associated with oral tyrosine kinase inhibitors?.Support Care in Cancer,19(10),1667-1674.
  5. Chan, J. C.,Liao, Y. C.,Lee, Y. H.,Lai, Y. H.(2014)。Clinical care of lung cancer patients with body image changes after targeted therapy。The Journal of Nursing,61(4),90-96。
  6. Clabbers, J. M. K.,Boers-Doets, C. B.,Gelderblom, H.,Stijnen, T.,Lacouture, M. E.,van der Hoeven, K. J. M.,Kaptein, A. A.(2016).Xerosis and pruritus as major EGFRI-associated adverse events.Support Care in Cancer,24(2),513-521.
  7. Health Promotion Administration, Ministry of Health and Welfare, Taiwan, ROC. (2018). Taiwan cancer registry annual report, 2016. Retrieved from https://www.hpa.gov.tw/Pages/ashx/File.ashx?FilePath=~/File/Attach/10227/File_11644.pdf
  8. Jacobsen, P. B.,Davis, K.,Cella, D.(2002).Assessing quality of life in research and clinical practice.Oncology,16(9, Suppl. 10),133-139.
  9. Jatoi, A.,Nguyen, P. L.(2008).Do patients die from rashes from epidermal growth factor receptor inhibitors? A systematic review to help counsel patients about holding therapy.The Oncologist,13(11),1201-1204.
  10. Lacouture, M. E.(2013).Dermatologic principles and practice in oncology: Conditions of the skin, hair, and nails in cancer patients.Hoboken, NJ:Wiley-Blackwell.
  11. Lacouture, M. E.,Anadkat, M. J.,Bensadoun, R. J.,Bryce, J.,Chan, A.,Epstein, J. B.,Murphy, B. A.(2011).Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities.Support Care in Cancer,19(8),1079-1095.
  12. Langer, C. J.(2013).Epidermal growth factor receptor inhibition in mutation-positive non-small-cell lung cancer: Is afatinib better or simply newer?.Journal of Clinical Oncology,31(27),3303-3306.
  13. Lenz, E. R.,Pugh, L. C.,Milligan, R. A.,Gift, A.,Suppe, F.(1997).The middle-range theory of unpleasant symptoms: An update.Advances in Nursing Science,19(3),14-27.
  14. Li, T.,Perez-Soler, R.(2009).Skin toxicities associated with epidermal growth factor receptor inhibitors.Targeted Oncology,4(2),107-119.
  15. Lin, J. Y..Taipei City, Taiwan, ROC.,National Taiwan University.
  16. Ministry of Health and Welfare, Taiwan, ROC. (2018). 2017 statistics of causes of death. Retrieved from https://www.mohw.gov.tw/dl-47804-eb15eaf5-ddfc-40b3-8217-fbbf75508e88.html
  17. Mok, T. S.,Wu, Y. L.,Thongprasert, S.,Yang, C. H.,Chu, D. T.,Saijo, N.,Fukuoka, M.(2009).Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma.The New England Journal of Medicine,361(10),947-957.
  18. National Cancer Institute. (2010). Common Terminology Criteria for Adverse Events(CTCAE) Version 4.03. Retrieved from https://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/CTCAE_4.03.xlsx
  19. National Health Insurance Administration, Taiwan, ROC. (2019). National Health Insurance drug prescription regulations, Chapter 9: Antineoplastic drugs. Retrieved from http://www.nhi.gov.tw/Content_List.aspx?n=E70D4F1BD029DC37&topn=3FC7D09599D25979(Original work published in Chinese)
  20. Passaro, A.,Di Maio, M.,Del Signore, E.,Gori, B.,de Marinis, F.(2014).Management of nonhematologic toxicities associated with different EGFR-TKIs in advanced NSCLC: A comparison analysis.Clinical Lung Cancer,15(4),307-312.
  21. Petrelli, F.,Borgonovo, K.,Cabiddu, M.,Lonati, V.,Barni, S.(2012).Relationship between skin rash and outcome in non-small-cell lung cancer patients treated with anti-EGFR tyrosine kinase inhibitors: A literature-based meta-analysis of 24 trials.Lung Cancer,78(1),8-15.
  22. Raymond, E.,Faivre, S.,Armand, J. P.(2000).Epidermal growth factor receptor tyrosine kinase as a target for anticancer therapy.Drugs,60(1, Suppl.),15-23.
  23. Ricciardi, S.,Tomao, S.,de Marinis, F.(2009).Toxicity of targeted therapy in non-small-cell lung cancer management.Clinical Lung Cancer,10(1),28-35.
  24. Rosell, R.,Carcereny, E.,Gervais, R.,Vergnenegre, A.,Massuti, B.,Felip, E.,Paz-Ares, L.(2012).Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): A multicentre, open-label, randomised phase 3 trial.The Lancet Oncology,13(3),239-246.
  25. Tischer, B.,Huber, R.,Kraemer, M.,Lacouture, M. E.(2017).Dermatologic events from EGFR inhibitors: The issue of the missing patient voice.Supportive Care in Cancer,25(2),651-660.
  26. Wagner, L. I.,Berg, S. R.,Gandhi, M.,Hlubocky, F. J.,Webster, K.,Aneja, M.,Lacouture, M. E.(2013).The development of a Functional Assessment of Cancer Therapy (FACT) questionnaire to assess dermatologic symptoms associated with epidermal growth factor receptor inhibitors (FACT-EGFRI-18).Supportive Care in Cancer,21(4),1033-1041.
  27. Wagner, L. I.,Rosenbaum, S. E.,Gandhi, M.,Webster, K.,Aneja, M. S.,Cella, D.,Lacouture, M. E.(2010).Development of a functional assessment of chronic illness therapy questionnaire to assess dermatology-related quality of life in patients treated with EGFR inhibitors: FACT-EGFRI.Journal of Clinical Oncology,28(15, Suppl.),9046.
  28. Wu, Y. L.,Zhou, C.,Hu, C. P.,Feng, J.,Lu, S.,Huang, Y.,Geater, S. L.(2014).Afatinib versus cisplatin plus gemcitabine for first-line treatment of Asian patients with advanced non-small-cell lung cancer harbouring EGFR mutations (LUX-Lung 6): An open-label, randomised phase 3 trial.The Lancet Oncology,15(2),213-222.
  29. Zhou, C.,Wu, Y. L.,Chen, G.,Feng, J.,Liu, X. Q.,Wang, C.,You, C.(2011).Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-celllung cancer (OPTIMAL,CTONG-0802): Amulticentre, open-label, randomised, phase 3 study.The Lancet Oncology,12(8),735-742.
被引用次数
  1. 游竹君(2020)。接受不同代標靶藥物之晚期肺癌病人於皮膚不良事件、自我照顧能力與情緒狀態之探討。臺灣大學護理學研究所學位論文。2020。1-126。