標靶治療藥物相關皮膚併發症的臨床表徵與處置

Clinical Signs and Management of Targeted Therapeutic Drugs Related Cutaneous Complications

江建平(Chien-Ping Chiang) ； 周繡玲(Hsiu-Ling Chou) ； 陳宇欽(Yeu-Chin Chen)

《腫瘤護理雜誌》 9卷2期 (2009/12) Pp. 1-11

https://doi.org/10.6880/TJON.200912_9(2).01

摘要

隨著腫瘤治療的進步，標靶治療藥物在近十年來已逐漸被廣泛使用於治療癌症病患。這些新興藥物雖然較傳統化療的副作用少，然而還是有許多包含對皮膚毒性的併發症相繼被發現，影響到病人的生活品質，甚至繼續接受標靶治療的意願。這些常見的副作用包括痤瘡樣疹，指甲變化（如：指甲內嵌與甲溝炎），乾燥、搔癢，手足症候群，毛髮改變（如：落髮與眉毛、睫毛過長）等等。在開始標靶治療前期衛教病人對相關皮膚副作用的認識，治療期間積極地介入治療與護理，同時請腫瘤科主治醫師適時調整藥物劑量等三大原則是治療這些副作用的關鍵。當然身為第一線的醫護人員對於何種藥物常發生那些種類的皮膚副作用也要熟悉，對於改善副作用的方法也要多加利用。期望這篇文獻有助於護理人員在照顧這類病人時，有更新的知識與技巧來幫助病人，使得癌症病人的日常活動與生活品質在接受標靶治療時仍可兼顧。

關鍵字

標靶治療藥物 ； 皮膚併發症 ； 痤瘡樣疹 ； 手足症候群 ； 甲溝炎

並列摘要

With the advances in cancer therapy, targeted therapeutic agents have been increasingly and widely used in the treatment of cancer patients in the past 10 years. Although these new drugs have fewer side effects than conventional chemotherapeutic agents, there are still many cutaneous complications affecting the patient's quality of life, and even leading to discontinue treatment. These common side effects include acneiform eruption, nail changes (such as: ingrowing nail, paronychia), xerosis, pruritus, hand-foot syndrome, hair changes (such as: hair loss and the eyelash trichomegaly), etc. Three key points to treat these side effects comprise early intervention of health education upon awareness of these side effects, active treatment and supportive care during the course of targeted therapy, as well as timely adjustment of drug doses by clinical oncologists. First-line health care workers should be familiar with the various types of cutaneous side-effects and the ways to improving them. It is expected that this article will help nursing staff to understand the updated knowledge of targeted therapy and learn the skills to help patients who undergo effective cancer treatment without compromising normal daily activities and quality of life.

並列關鍵字

targeted therapeutic agents ； cutaneous complications ； acneiform eruption ； handfoot syndrome ； paronychia