Cutaneous Adverse Events of Targeted Anticancer Therapy: A Review of Common Clinical Manifestations and Management

比起化學治療造成的全身性副作用，抗癌標靶藥物更易引起皮膚反應，而這些副作用常發生在影響外觀甚鉅的部位。常見的皮膚反應有上皮細胞生長因子受體抑制劑引發的丘疹樣膿泡型紅疹，乾燥搔癢，以及甲溝炎；血管上皮細胞生長因子受體抑制劑還會引起手足症候群，除此之外也會發現黏膜及毛髮的變化。這些副作用除了會減低病人使用標靶治療的意願，也可能使臨床醫師須調整標靶藥物的劑量，甚至導致治療中斷。對於病人生活品質及心理社會學上都造成不等程度的影響。然而值得注意的是，這些皮膚反應的發生，可能代表標靶藥物在此類病患是有作用的。皮膚反應的處理可分成預防性及反應性的處理。使用系統性抗生素及外用類固醇藥膏可能某種程度預防副作用的發生或減緩其症狀。所有接受標靶藥物治療的病人都建議做好防曬；使用滋潤保養品則可有效減輕手足症候群的症狀。

關鍵字

標靶治療；皮膚反應；上皮細胞生長因子受體；酪胺酸激酶抑制劑

並列摘要

Targeted anticancer therapies, unlike the traditional cytotoxic chemotherapies which lead to systemic toxicities, frequently cause cutaneous adverse events that are symptomatic and manifest in cosmetically sensitive areas. The most common dermatologic toxicities related to epidermal growth factor receptor (EGFR) inhibitors are papulopustular eruption, xerosis, pruritus and paronychia. Vascular endothelial growth factor receptor (VEGFR) inhibitors usually cause hand-foot skin reaction. Reports of dermatologic side effects such as abnormalities of hair growth and mucosal changes also increased.These events may contribute to poor adherence, dose interruption and discontinuation of the regimens. In addition, psychosocial discomfort causing reduction in the quality of life does occur. However, the presence and severity of cutaneous adverse events has shown to have positive correlation with treatment response.The management of these side effects can be categorized into prophylaxis and reactive treatment. Systemic antibiotics and topical corticosteroid could possibly prevent or alleviate symptoms caused by EGFR inhibitors. The prevention of sun exposure is recommended to all patients on targeted therapy, and emollients and lubricants can be used to relieve and improve the hand-foot skin reaction.

並列關鍵字

targeted therapy ； dermatologic toxicities ； epidermal growth factor receptor ； tyrosine kinase inhibitor

國際替代計量

Cutaneous Adverse Events of Targeted Anticancer Therapy: A Review of Common Clinical Manifestations and Management

全文下載

主題瀏覽