RESUMO
BACKGROUND: Despite growing interest in cutaneous adverse events (CAEs) and their management in patients with cancer, they are often underreported and there are no extensive data on their impact on quality of life (QoL). Healthcare professionals should consider this issue in order to minimize its negative impact on QoL and improve patient outcomes. This study evaluates the impact of CAEs on QoL in outpatients receiving anticancer drugs and aims to determine the differences in QoL between conventional chemotherapy versus targeted therapies. METHODS: A total of 114 cancer patients with CAEs were included in this observational, cross-sectional study. Patient-reported outcomes instruments (Functional Assessment of Cancer Therapy - General, Dermatology Life Quality Index, and Skindex-16) were used. RESULTS: Mean scores in QoL indices were 65.3±13.4, 8.4±5, and 30.8±16.9 in Functional Assessment of Cancer Therapy - General, Dermatology Life Quality Index, and Skindex-16, respectively. The CAEs that had the greatest impact on dermatologic-related QoL were hand-foot skin reaction, rash, palmo-plantar erythrodysesthesia, and papulopustular eruption. No significant differences in QoL indices according to the type of treatment (conventional chemotherapy versus targeted therapy) were observed. CONCLUSIONS: CAEs, and particularly hand-foot toxicities, rashes, and papulopustular eruptions, can have an impact on QoL in outpatients receiving anticancer drugs as evaluated with three different patient-reported outcomes instruments. No differences in QoL related to CAEs were observed between conventional chemotherapy and targeted therapy.
RESUMO
BACKGROUND: The introduction of oral antineoplastic agents in therapeutics has caused a change in the treatment strategy against cancer. The objective of this study was to analyze the adherence in patients to treatment with capecitabine, their adverse events, and the overall health status of patients, as well as the relationship of these factors with adherence. METHOD: An observational, prospective study at 7 months, in a cohort of patients on capecitabine treatment, including treatment initiations and continuations, regardless of diagnosis or indication. The data collected were: demographic variables (age, gender), diagnostic (breast cancer, colorectal cancer, gastric cancer, off-label), adherence (tablet count, Morisky test,Sackett test), safety (assessment of adverse events, clinical evaluation by the oncologist) and quality of life (performance status, SF-12 test). DATA SOURCES: electronic clinical records (IANUS®), dispensing program for outpatients (SILICON®) and interviews with patients. RESULTS: There were 111 evaluable patients, with a mean age of 66.7 years (range 32-86), ECOG PS 1 in 76.6%. Adherence level: 78.4% (81.7% in the initiation sub-group vs. 72.5% in the continuation sub-group). Adverse events: skin toxicity (33.33%), asthenia (25.22%), gastrointestinal toxicity (24.32%) and neurological toxicity (24.32%), mostly G1.Health status, SF-12 test: subjective evaluation as "good" in 33.30% of cases. Conclusions: The low level of adherence in the continuation sub-group can be associated with the duration of treatment, toxicities, clinical evolution, and perception of their health status. It is necessary to conduct individualized monitoring in this group of patients in order to obtain a favorable clinical response.
Introducción: La introducción en la terapéutica de antineoplásicos orales ha provocado un cambio en la estrategia de tratamiento frente al cáncer. El objetivo de este trabajo fue analizar la adherencia en pacientes en tratamiento con capecitabina, los acontecimientos adversos y el estado general de salud de los pacientes, así como la relación de estos factores con la adherencia.Método: Estudio observacional prospectivo, de siete meses de duración, en una cohorte de pacientes en tratamiento con capecitabina, incluyendo los inicios y las continuaciones de tratamiento, independientemente del diagnóstico o la indicación. Se registraron variables demográficas (edad, sexo), de diagnóstico (cáncer de mama, colon-recto, gástrico, off-label), deadherencia (recuento de comprimidos, test de Morisky, de Sackett), de seguridad (valoración de acontecimientos adversos, evaluación clínica del oncólogo) y calidad de vida (performance status, test SF-12). Fuentes de datos: historia clínica electrónica (IANUS®), programa de dispensación a pacientes externos (Silicon ®) y entrevistas al paciente. Resultados: 111 pacientes evaluables, media de edad de 66,7 años (rango 32-86), ECOG PS 1 en el 76,6%. Nivel de adherencia: 78,4% (subgrupo inicio 81,7% vs. continuación 72,5%). Acontecimientos adversos: toxicidad cutánea (33,33%), astenia (25,22%), toxicidad gastrointestinal (24,32%) y neurológica (24,32%), en su mayoría G1. Estado de salud, test SF-12: valoración subjetiva "buena" en el 33,30%. Conclusiones: El bajo nivel de adherencia en el subgrupo de continuación puede relacionarse con la duración del tratamiento, las toxicidades, la evolución clínica y la percepción de su estado de salud. Es necesario un seguimiento individualizado en este grupo de pacientes para obtener una respuesta clínica favorable.