open access
Subjective evaluation of skin toxicity and quality of life in patients undergoing anti-cancer treatment at the Department of Cancer Chemotherapy
Affiliations- Chemotherapy Clinic, Oncology Department, Medical University of Lodz Nicolaus Copernicus Multidisciplinary Center for Oncology and Traumatology, 62 Pabianicka St, 93–513 Lodz, Poland
open access
Abstract
Introduction: Skin complications are a frequent side effect of oncological treatment, which may impair patients’ quality of life. The aim of this study is a subjective assessment of skin toxicity and life quality during anticancer treatment.
Material and methods: We analysed patients with malignant cancer, receiving conventional chemotherapy, molecularly targeted drugs, or both, between January 2019 and February 2020, for at least six weeks. The researchers’ questionnaire assessed the type and intensity of skin toxicity, its impact on the emotional state and life quality. Subjective needs concerning education about the potential toxicity of treatment and dermatological care were analysed. Global quality of life was assessed using the EORTC QLQ-C30 scale.
Results: We analysed 78 patients, aged 27–78 years (41 men; 37 women). Twelve patients received anti- EGFR antibody. Skin toxicity influence on emotional state and life quality was assessed by age, gender, duration and type of therapy. Skin complications were reported by 95% of patients, 53% confirmed the influence of skin toxicity on emotional state and 32% on everyday functioning. The inverse correlation between life quality and skin lesions’ severity was found (correlation coefficient = 0,33, p < 0,0001). 31% of patients were willing to have a dermatologist in the team of leading doctors. 28% reported a total lack of possible skin side effects information. 82% declared total skin toxicity acceptance in case of the good effect of anti-cancer therapy.
Conclusions: Dermal toxicity negatively affects various areas of patient functioning. Improvement can be made by proper education of patients, effective prevention and treatment.
Abstract
Introduction: Skin complications are a frequent side effect of oncological treatment, which may impair patients’ quality of life. The aim of this study is a subjective assessment of skin toxicity and life quality during anticancer treatment.
Material and methods: We analysed patients with malignant cancer, receiving conventional chemotherapy, molecularly targeted drugs, or both, between January 2019 and February 2020, for at least six weeks. The researchers’ questionnaire assessed the type and intensity of skin toxicity, its impact on the emotional state and life quality. Subjective needs concerning education about the potential toxicity of treatment and dermatological care were analysed. Global quality of life was assessed using the EORTC QLQ-C30 scale.
Results: We analysed 78 patients, aged 27–78 years (41 men; 37 women). Twelve patients received anti- EGFR antibody. Skin toxicity influence on emotional state and life quality was assessed by age, gender, duration and type of therapy. Skin complications were reported by 95% of patients, 53% confirmed the influence of skin toxicity on emotional state and 32% on everyday functioning. The inverse correlation between life quality and skin lesions’ severity was found (correlation coefficient = 0,33, p < 0,0001). 31% of patients were willing to have a dermatologist in the team of leading doctors. 28% reported a total lack of possible skin side effects information. 82% declared total skin toxicity acceptance in case of the good effect of anti-cancer therapy.
Conclusions: Dermal toxicity negatively affects various areas of patient functioning. Improvement can be made by proper education of patients, effective prevention and treatment.
Keywords
skin toxicity, quality of life, systemic treatment, monoclonal antibodies, epidermal growth factor receptor
About this articleTitle
Subjective evaluation of skin toxicity and quality of life in patients undergoing anti-cancer treatment at the Department of Cancer Chemotherapy
Journal
Issue
Article type
Original article
Pages
99-107
Published online
2021-06-30
Page views
497
Article views/downloads
493
DOI
Bibliographic record
Medical Research Journal 2021;6(2):99-107.
Keywords
skin toxicity
quality of life
systemic treatment
monoclonal antibodies
epidermal growth factor receptor
Authors
Kinga Krawiec
Izabela Janicka
Jakub Woźniak
Sylwia Dębska-Szmich
Magdalena Krakowska
Urszula Czernek
Piotr Potemski
References (30)- Biswal SG, Mehta RD. Cutaneous adverse reactions of chemotherapy in cancer patients: A clinicoepidemiological study. Indian J Dermatol. 2018; 63(1): 41–46.
- Hackbarth M, Haas N, Fotopoulou C, et al. Chemotherapy-induced dermatological toxicity: frequencies and impact on quality of life in women's cancers. Results of a prospective study. Support Care Cancer. 2008; 16(3): 267–273.
- Lee J, Lim J, Park JS, et al. The impact of skin problems on the quality of life in patients treated with anticancer agents: A cross-sectional study. Cancer Res Treat. 2018; 50(4): 1186–1193.
- Lee JJ, Kroshinsky D, Hoang MP. Cutaneous reactions to targeted therapy. Am J Dermatopathol. 2017; 39(2): 67–82.
- Rosen AC, Case EC, Dusza SW, et al. Impact of dermatologic adverse events on quality of life in 283 cancer patients: a questionnaire study in a dermatology referral clinic. Am J Clin Dermatol. 2013; 14(4): 327–333.
- Sibaud V. Dermatologic reactions to immune checkpoint inhibitors: skin toxicities and immunotherapy. Am J Clin Dermatol. 2018; 19(3): 345–361.
- Rossi A, Fortuna MC, Caro G, et al. Chemotherapy-induced alopecia management: Clinical experience and practical advice. J Cosmet Dermatol. 2017; 16(4): 537–541.
- Capriotti K, Capriotti JA, Lessin S, et al. The risk of nail changes with taxane chemotherapy: a systematic review of the literature and meta-analysis. Br J Dermatol. 2015; 173(3): 842–845.
- Yokomichi N, Nagasawa T, Coler-Reilly A, et al. Pathogenesis of hand-foot syndrome induced by PEG-modified liposomal Doxorubicin. Hum Cell. 2013; 26(1): 8–18.
- Kowalska M, Kowalik A, Góźdź S. Dermatologic adverse events associated with chemotherapy and targeted anticancer therapy. Dermatology Review. 2016; 103(2): 127–138.
- Sibaud V, Lebœuf NR, Roche H, et al. Dermatological adverse events with taxane chemotherapy. Eur J Dermatol. 2016; 26(5): 427–443.
- Van Cutsem E, Köhne CH, Láng I, et al. Cetuximab plus irinotecan, fluorouracil, and leucovorin as first-line treatment for metastatic colorectal cancer: updated analysis of overall survival according to tumor KRAS and BRAF mutation status. J Clin Oncol. 2011; 29(15): 2011–2019.
- Joly-Tonetti N, Ondet T, Monshouwer M, et al. EGFR inhibitors switch keratinocytes from a proliferative to a differentiative phenotype affecting epidermal development and barrier function. BMC Cancer. 2021; 21(1): 5.
- Peeters M, Oliner KS, Price TJ, 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. 2010; 28(31): 4706–4713.
- Sodergren SC, Copson E, White A, et al. Systematic review of the side effects associated with anti-HER2-targeted therapies used in the treatment of breast cancer, on behalf of the EORTC quality of life group. Target Oncol. 2016; 11(3): 277–292.
- Mortimer J, Jung J, Yuan Y, et al. Skin/nail infections with the addition of pertuzumab to trastuzumab-based chemotherapy. Breast Cancer Res Treat. 2014; 148(3): 563–570.
- Gandhi M, Oishi K, Zubal B, et al. Unanticipated toxicities from anticancer therapies: survivors' perspectives. Support Care Cancer. 2010; 18(11): 1461–1468.
- Barrios DM, Phillips GS, Freites-Martinez A, et al. Outpatient dermatology consultations for oncology patients with acute dermatologic adverse events impact anticancer therapy interruption: a retrospective study. J Eur Acad Dermatol Venereol. 2020; 34(6): 1340–1347.
- Nikolaou V, Voudouri D, Tsironis G, et al. Cutaneous toxicities of antineoplastic agents: data from a large cohort of Greek patients. Support Care Cancer. 2019; 27(12): 4535–4542.
- Iwamoto S, Ooki A, Morita S, et al. A prospective Phase II study to examine the relationship between quality of life and adverse events of first-line chemotherapy plus cetuximab in patients with KRAS wild-type unresectable metastatic colorectal cancer: QUACK trial. Cancer Med. 2018; 7(9): 4217–4227.
- Siena S, Tabernero J, Bodoky G, et al. Quality of life during first-line FOLFOX4±panitumumab in wild-type metastatic colorectal carcinoma: results from a randomised controlled trial. ESMO Open. 2016; 1(2): e000041.
- Koukakis R, Gatta F, Hechmati G, et al. Skin toxicity and quality of life during treatment with panitumumab for RAS wild-type metastatic colorectal carcinoma: results from three randomised clinical trials. Qual Life Res. 2016; 25(10): 2645–2656.
- Unger K, Niehammer U, Hahn A, et al. Treatment of metastatic colorectal cancer with cetuximab: influence on the quality of life. Z Gastroenterol. 2013; 51(8): 733–739.
- Peeters M, Siena S, Van Cutsem E, et al. Association of progression-free survival, overall survival, and patient-reported outcomes by skin toxicity and KRAS status in patients receiving panitumumab monotherapy. Cancer. 2009; 115(7): 1544–1554.
- Romito F, Giuliani F, Cormio C, et al. Psychological effects of cetuximab-induced cutaneous rash in advanced colorectal cancer patients. Support Care Cancer. 2010; 18(3): 329–334.
- Frith H, Harcourt D, Fussell A. Anticipating an altered appearance: women undergoing chemotherapy treatment for breast cancer. Eur J Oncol Nurs. 2007; 11(5): 385–391.
- Lacouture ME, Anadkat M, Jatoi A, et al. Dermatologic toxicity occurring during anti-EGFR monoclonal inhibitor therapy in patients with metastatic colorectal cancer: A systematic review. Clin Colorectal Cancer. 2018; 17(2): 85–96.
- Guerrero AM, Zhu GA, Kwong B. 155 Retrospective analysis of inpatient dermatology consultations for cancer patients. Journal of Investigative Dermatology. 2016; 136(5): S28.
- Duffour J, Thézenas S, Dereure O, et al. Inter-observer agreement between dermatologists and oncologists in assessing dermatological toxicities in patients with metastatic colorectal cancer treated by cetuximab-based chemotherapies: a pilot comparative study. Eur J Cancer. 2010; 46(18): 3169–3174.
- Phillips GS, Freites-Martinez A, Hsu M, et al. Inflammatory dermatoses, infections, and drug eruptions are the most common skin conditions in hospitalized cancer patients. J Am Acad Dermatol. 2018; 78(6): 1102–1109.