臨床外科70巻5号

2015年05月発行

特集 外科医が知っておくべき がん薬物療法の副作用とその対策

症状別対策マニュアル

皮膚障害

著者： 安西紘幸¹ 野澤宏彰¹ 渡邉聡明¹

所属機関： ¹東京大学医学部附属病院腫瘍外科

ページ範囲：P.590 - P.594

文献概要

【ポイント】
◆化学療法による皮膚障害は身体的，精神的苦痛を伴いQOLの低下を招くため治療法を熟知する必要がある．
◆カペシタビンによる手足症候群は予防と早期対処（全身療法，局所療法，薬剤の減量・休薬）が重要である．
◆分子標的薬は早期から様々な症状を伴う皮膚障害を起こす一方で，抗腫瘍効果との相関が報告されている．

参考文献

1）Lévy E, Piedbois P, Buyse M, et al：Toxicity of fluorouracil in patients with advanced colorectal cancer：effect of administration schedule and prognostic factors. J Clin Oncol 16：3537-3541, 1998

2）Schüller J, Cassidy J, Dumont E, et al：Preferential activation of capecitabine in tumor following oral administration to colorectal cancer patients. Cancer Chemother Pharmacol 45：291-297, 2000

3）Nagore E, Insa A, Sanmartin O：Antineoplastic therapy-induced palmar plantar erythrodysesthesia（' hand-foot'）syndrome. Incidence, recognition and management. Am J Clin Dermatol 1：225-234, 2000

4）Zhang RX, Wu XJ, Wan DS, et al：Celecoxib can prevent capecitabine-related hand-foot syndrome in stage Ⅱ and Ⅲ colorectal cancer patients：result of a single-center, prospective randomized phase Ⅲ trial. Ann Oncol 23：1348-1353, 2012

5）Saif MW, Elfiky AA：Identifying and treating fluoropyrimidine-associated hand-and-foot syndrome in white and non-white patients. J Support Oncol 5：337-343, 2007

6）Lacouture ME：Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer 6：803-812, 2006

7）Rowinsky EK, Schwartz GH, Gollob JA, et al：Safety, pharmacokinetics, and activity of ABX-EGF, a fully human anti-epidermal growth factor receptor monoclonal antibody in patients with metastatic renal cell cancer. J Clin Oncol 22：3003-3015, 2004

8）Wagner LI, Lacouture ME：Dermatologic toxicities associated with EGFR inhibitors：the clinical psychologist's perspective. Impact on health-related quality of life and implications for clinical management of psychological sequelae. Oncology（Williston Park）21（11 Suppl 5）：34-36, 2007

9）Douillard JY, Siena S, Cassidy J, et al：Randomized, phase Ⅲ trial of panitumumab with infusional fluorouracil, leucovorin, and oxaliplatin(FOLFOX4)versus FOLFOX4 alone as first-line treatment in patients with previously untreated metastatic colorectal cancer：the PRIME study. J Clin Oncol 28：4697-4705, 2010

10）Peeters M, Price TJ, Cervantes A, et al：Randomized phase Ⅲ study of panitumumab with fluorouracil, leucovorin, and irinotecan （FOLFIRI） compared with FOLFIRI alone as second-line treatment in patients with metastatic colorectal cancer. J Clin Oncol 28：4706-4713, 2010