上皮生長因子接受體抑制劑相關皮膚毒性之照護

Management of EGFR Inhibitors Associated Dermatological Toxicities

陳秋慧(Chiu-Hui Chen)

《腫瘤護理雜誌》 9卷2期 (2009/12) Pp. 13-22

https://doi.org/10.6880/TJON.200912_9(2).02

摘要

近年來上皮生長因子接受體抑制劑(epidermal growth factor receptor inhibitor, EGFRI)已逐漸被廣泛應用於癌症治療。EGFRI並不會造成類似化學治療之嚴重副作用，卻可能導致皮膚乾燥、搔癢、痤瘡樣皮疹、指甲病變以及毛髮生長的異常。不僅造成病人生理上的不適，引發情緒上的痛苦，更可能中斷病人的治療，影響治療的效果。雖然目前對於如何處理EGFRI所導致之皮膚毒性，尚未出現一個共識，處理方式仍可因其症狀的特性及嚴重度而有所不同。護理人員在預防及處理皮膚毒性的過程中扮演著重要的角色。主要照護措施包括早期的衛教，以協助病人了解皮膚副作用，並正確執行日常皮膚照護；早期發現皮膚症狀，並依醫囑給予適當藥物使用，以減輕其嚴重度，預防續發性的感染；以及持續的心理支持與鼓勵。

關鍵字

上皮細胞生長因子接受體抑制劑 ； 痤瘡樣皮疹 ； 皮膚毒性

並列摘要

In recent years, epidermal growth factor receptor inhibitors (EGFRI) have been used for the treatment of a variety of cancer diseases. EGFRI do not induce severe adverse effects as chemotherapy does. However, the unique dermatological toxicities including xerosis, pruritus, and acneiform eruptions as well as change of nail and hair growth not only cause physical and psychological distresses, but also interrupt treatment and lead to poor responses to the treatment. So far, there is no consensus regarding treatment modalities of the dermatologic toxicities of EGFRI. It mainly depends on the characteristics and grading of the symptoms. The role of nursing staff is essential in prevention and management of the toxicities during the course of treatment with EGFRI. Strategies of care include early health education to ensure that patient understand the side effects, regular skin care, early detection of the symptoms and provision of medications according to doctor’s order, as well as continuous emotional support.

並列關鍵字

epidermal growth factor receptor inhibitor EGFRI ； acneiform eruption ； dermatological toxicities