题名

頭頸癌常見化療藥物及副作用之照護

并列篇名

Common Chemotherapy Drugs and Care for Side Effects in Head and Neck Cancer

DOI

10.6647/CN.202409_31(3).0003

作者

楊家豪(Chia-Hao Yang);曾淑卿(Shu-Ching Tseng)

关键词

頭頸癌 ; 化學治療副作用 ; 化學治療護理照護 ; head and neck cancer ; chemotherapy side effects ; chemotherapy nursing care

期刊名称

彰化護理

卷期/出版年月

31卷3期(2024 / 09 / 01)

页次

6 - 12

内容语文

繁體中文;英文

中文摘要

頭頸癌為台灣十大癌症之一,其累積個案數逐年攀升,而化學藥物治療為頭頸癌常見治療之一,破壞癌細胞的同時,健康的細胞也會受到影響,身體機能也會隨之下降,當患者面對疾病本身的不適加上治療帶來痛苦,其生活品質也會越來越差,影響治療意願,此時護理人員扮演者照護及陪伴的角色,應該對其化療藥物及副作用有充分的認識,協助病人緩解化學治療帶來的不適感,預防併發症的發生,將病人的傷害降到最小,使其對治療充滿信心。本文提及頭頸癌常見的誘導型化學治療及合併放射治療的化學治療藥物,包含鉑金類(如:Cisplatin、Carboplatin…等)、紫杉醇類(如:Paclitaxel、Docetaxel…等)、抗代謝藥物嘧啶類(如:5-Fluorouracil,簡稱5-FU)及標靶類藥物(如:Cetuximab…等),說明其治療機轉並詳述常見副作用噁心、嘔吐、嗜中性白血球低下症、周邊神經病變、皮膚紅疹及口腔炎等照護,希望藉此提升臨床護理人員對於頭頸癌常見化療藥物的認識,提高頭頸癌患者化療後的護理照護品質。

英文摘要

Head and neck cancer ranks among the top ten cancers in Taiwan, with an increasing number of cases each year. Chemotherapy is a standard treatment for this type of cancer, yet it not only targets cancer cells but also impacts healthy cells, potentially diminishing overall bodily functions. Patients often endure the discomfort of the disease alongside the side effects of treatment, which can significantly affect their quality of life and willingness to continue therapy. In such challenging times, nurses play a pivotal role in providing care and support. It is crucial for them to possess a comprehensive understanding of chemotherapy drugs and their side effects. This knowledge enables nurses to help patients manage discomfort, prevent complications, and minimize harm, thereby fostering confidence in the treatment process. This article explores commonly used chemotherapy drugs for head and neck cancer, including platinum-based agents like cisplatin and carboplatin, taxanes such as paclitaxel and docetaxel, 5-fluorouracil (5-FU), and the targeted therapy cetuximab. It delves into their mechanisms of action and provides detailed guidance on managing common side effects such as nausea, vomiting, neutropenia, peripheral neuropathy, rash, and oral mucositis. By enhancing clinical nurses' knowledge of these chemotherapy drugs, this article aims to elevate the standard of nursing care provided to patients undergoing treatment for head and neck cancer, ultimately improving their post-chemotherapy experience.

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. Boccia, R., Glaspy, J., Crawford, J., & Aapro, M. (2022). Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed? The Oncologist, 27(8), 625-636. https://doi.org/10.1093/oncolo/oyac074
    連結:
  2. Bou-Assaly, W., & Mukherji, S. (2010). Cetuximab (erbitux). American Journal of Neuroradiology, 31(4), 626-627.https://doi.org/10.3174/ajnr.A2054
    連結:
  3. Burgess, J., Ferdousi, M., Gosal, D., Boon, C., Matsumoto, K., Marshall, A., Mak, T., Marshall, A., Frank, B., & Malik, R. A. (2021). Chemotherapy-Induced Peripheral Neuropathy: Epidemiology, Pathomechanisms and Treatment. Oncology and therapy, 9(2), 385-450.https://doi.org/10.1007/s40487-021-00168-y
    連結:
  4. Cidon, E. U. (2018). Chemotherapy induced oral mucositis: prevention is possible. Chinese clinical oncology, 7(1), 6-6.https://doi.org/10.21037/cco.2017.10.01
    連結:
  5. Gupta, K., Walton, R., & Kataria, S. P. (2021). Chemotherapy-Induced Nausea and Vomiting: Pathogenesis, Recommendations, and New Trends. Cancer Treatment and Research Communications, 26, 100278. https://doi.org/https://doi.org/10.1016/j.ctarc.2020.100278
    連結:
  6. Klastersky, J., De Naurois, J., Rolston, K., Rapoport, B., Maschmeyer, G., Aapro, M., & Herrstedt, J. (2016). Management of febrile neutropaenia: ESMO clinical practice guidelines. Annals of Oncology, 27, v111-v118.https://doi.org/
    連結:
  7. Klein, I., & Lehmann, H. C. (2021). Pathomechanisms of Paclitaxel-Induced Peripheral Neuropathy. Toxics, 9(10), 229.https://doi.org/10.3390/toxics9100229
    連結:
  8. Lai, J.-I., Chao, T.-C., Liu, C.-Y., Huang, C.-C., & Tseng, L.-M. (2022). A systemic review of taxanes and their side effects in metastatic breast cancer. Frontiers in Oncology, 12, 940239.https:doi.org/10.3389/fonc.2022.940239
    連結:
  9. Longley, D. B., Harkin, D. P., & Johnston, P. G. (2003). 5-fluorouracil: mechanisms of action and clinical strategies. Nature reviews cancer, 3(5), 330-338.https://doi.org/10.1038/nrc1074
    連結:
  10. Machiels, J.-P., Leemans, C. R., Golusinski, W., Grau, C., Licitra, L., & Gregoire, V. (2020). Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS–ESMO–ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 31(11), 1462-1475.https://doi.org/10.1016/j.annonc.2020.07.011
    連結:
  11. Mesia, R., Iglesias, L., Lambea, J., Martínez-Trufero, J., Soria, A., Taberna, M., Trigo, J., Chaves, M., García-Castaño, A., & Cruz, J. (2021). SEOM clinical guidelines for the treatment of head and neck cancer (2020). Clinical and Translational Oncology, 23(5), 913-921.https://doi.org/10.1007/s12094-020-02533-1
    連結:
  12. Oun, R., Moussa, Y. E., & Wheate, N. J. (2018). The side effects of platinum-based chemotherapy drugs: a review for chemists. Dalton transactions, 47(19), 6645-6653.https://doi.org/
    連結:
  13. Pinto, C., Barone, C. A., Girolomoni, G., Russi, E. G., Merlano, M. C., Ferrari, D., & Maiello, E. (2011). Management of skin toxicity associated with cetuximab treatment in combination with chemotherapy or radiotherapy. Oncologist, 16(2), 228-238. https://doi.org/10.1634/theoncologist.2010-0298
    連結:
  14. Razvi, Y., Chan, S., McFarlane, T., McKenzie, E., Zaki, P., DeAngelis, C., Pidduck, W., Bushehri, A., Chow, E., & Jerzak, K. J. (2019). ASCO, NCCN, MASCC/ESMO: a comparison of antiemetic guidelines for the treatment of chemotherapy-induced nausea and vomiting in adult patients. Supportive Care in Cancer, 27(1), 87-95.https://doi.org/
    連結:
  15. Rottenberg, S., Disler, C., & Perego, P. (2021). The rediscovery of platinum-based cancer therapy. Nature Reviews Cancer, 21(1), 37-50. https://doi.org/10.1038/s41568-020-00308-y
    連結:
  16. Saif, M. W., & Kim, R. (2007). Incidence and management of cutaneous toxicities associated with cetuximab. Expert Opinion on Drug Safety, 6(2), 175-182. https://doi.org/10.1517/14740338.6.2.175
    連結:
  17. Smith, T. J., Bohlke, K., Lyman, G. H., Carson, K. R., Crawford, J., Cross, S. J., Goldberg, J. M., Khatcheressian, J. L., Leighl, N. B., Perkins, C. L., Somlo, G., Wade, J. L., Wozniak, A. J., & Armitage, J. O. (2015). Recommendations for the Use of WBC Growth Factors: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol, 33(28), 3199-3212. https://doi.org/10.1200/jco.2015.62.3488
    連結:
  18. Vodenkova, S., Buchler, T., Cervena, K., Veskrnova, V., Vodicka, P., & Vymetalkova, V. (2020). 5-fluorouracil and other fluoropyrimidines in colorectal cancer: Past, present and future. Pharmacology & therapeutics, 206, 107447.https://doi.org/
    連結:
  19. Loprinzi, C. L., Lacchetti, C., Bleeker, J., Cavaletti, G., Chauhan, C., Hertz, D. L., Kelley, M. R., Lavino, A., Lustberg, M. B., & Paice, J. A. (2020). Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: ASCO guideline update.
  20. Pfister, D. G., Spencer, S., Adelstein, D., Adkins, D., Anzai, Y., Brizel, D. M., Bruce, J. Y., Busse, P. M., Caudell, J. J., & Cmelak, A. J. (2020). Head and neck cancers, version 2.2020, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network, 18(7), 873-898.
  21. Štulhofer Buzina, D., Martinac, I., Ledić Drvar, D., Čeović, R., Bilić, I., & Marinović, B. (2016). Adverse Reaction to Cetuximab, an Epidermal Growth Factor Receptor Inhibitor. Acta Dermatovenerol Croat, 24(1), 70-72.
  22. The American Cancer Society medical and editorial content team. (2020a, September 10, 2020). Managing Nausea and Vomiting at Home. American Cancer Society. Retrieved May 28 from https://www.cancer.org/cancer/managing-cancer/side-effects/eating-problems/nausea-and-vomiting/managing.html
  23. The American Cancer Society medical and editorial content team. (2020b, December 10, 2020). Skin Rash. American Cancer Society Retrieved May 29 from https://www.cancer.org/cancer/managing-cancer/side-effects/hair-skin-nails/skin-rash.html
  24. The American Cancer Society medical and editorial content team. (2021, September 24, 2021). Mouth Sores and Pain. American Cancer Society. Retrieved May 29 from https://www.cancer.org/cancer/managing-cancer/side-effects/eating-problems/mouth-sores.html
  25. The American Cancer Society medical and editorial content team. (2024a, March 29, 2024). Peripheral Neuropathy. American Cancer Society. Retrieved May 28 from https://www.cancer.org/cancer/managing-cancer/side-effects/pain/peripheral-neuropathy.html
  26. The American Cancer Society medical and editorial content team. (2024b, February 13, 2024). Preventing Infections in People with Cancer. American Cancer Society. Retrieved May 28 from https://www.cancer.org/cancer/managing-cancer/side-effects/infections/preventing-infections-in-people-with-cancer.html