EGFRI-associated health-related quality of life by severity of skin toxicity in metastatic colorectal cancer patients re
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ORIGINAL ARTICLE
EGFRI-associated health-related quality of life by severity of skin toxicity in metastatic colorectal cancer patients receiving epidermal growth factor receptor inhibitor target therapy Ting-Yu Chiang 1 & Hung-Chih Hsu 2,3 & Sui-Whi Jane 4,5,6,7 & Shu-Ching Chen 4,6,7,8 Received: 16 May 2019 / Accepted: 17 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The purposes of this study were to assess the levels of symptom distress, body image, and epidermal growth factor receptor inhibitors(EGFRI)-associatedhealth-relatedqualityoflife(QoL);identifythefactorsrelatedtoEGFRI-associatedhealth-relatedQoL;and examine the differences in EGFRI-associated health-related QoL by grade of skin toxicity in mCRC patients receiving target therapy. Methods This cross-sectional study examined mCRC patients who received cetuximab-based target therapy from the oncology and CRC inpatient and outpatient departments of a medical center in northern Taiwan. Structured questionnaires were used to measure patients’ symptom distress, body image, and EGFRI-associated health-related QoL. Results Of the 111 mCRC patients studied, 79.2% reported acneiform eruption and 52.2% reported paronychia. The most common symptoms were dry skin and itching. Poor EGFRI-associated health-related QoL was associated with more symptom distress, more negative body image, a higher cumulative dose of target therapy, and being married; these factors explained 66.6% of the variance in EGFRI-associated health-related QoL. Conclusion Patient-specific skin care and emotional support are needed to relieve distressful dermatological symptoms and emotional distress during and post-treatment for mCRC. Keywords Colorectal cancer . Molecular targeted therapy . Cetuximab . Body image . Skin toxic . Health-related quality of life
Sui-Whi Jane and Shu-Ching Chen contributed equally to this work.
Introduction
* Shu-Ching Chen [email protected]
Colorectal cancer (CRC) is a serious disease threatening human health. In 2012, there were approximately 136.1 million new CRC cases, making it the third most common cancer and also the fourth leading cause of death worldwide [1]. In Taiwan, CRC is a leading cancer diagnosis, with 15,579 new cases diagnosed in 2016, and the third leading cause of death [2]. Approximately, 18% of those diagnosed with CRC are at stage IV, and chemotherapy plus target therapy is the major treatment for metastatic CRC (mCRC). The important combined chemotherapy regimens are folinic acid, fluorouracil, and oxaliplatin (FOLFOX) and folinic acid, fluorouracil, and irinocetan (FOLFIRI) combined with cetuximab [3]. Skin toxicity is one of the most common adverse effects of the use of epidermal growth factor receptor inhibitors (EGFRI), such as the above [4]. Patients receiving target therapy experience acne-like rashes as a symptom of skin toxicity during and after treatment, which present as an acneiform rash, erythema, xerosis,
1
Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoy
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