Impact of dermatologic adverse reactions on QOL in oncologic patients: results from a single-center prospective study

Rom J Intern Med. 2018 Jun 1;56(2):96-101. doi: 10.2478/rjim-2018-0002.

Abstract

Introduction: Skin toxicity in patients receiving novel therapeutic cancer agents has become a very important marker in determining drug activity, but it can also severely impact their quality of life. About half of the patients receiving this type of oncologic treatment will develop cutaneous reactions, that is why adequate understanding and management of these side effects is very important for drug adherence and patients' quality of life.

Materials and methods: We conducted a prospective study of consecutive patients who received oncologic treatment in our institution and presented with dermatologic side effects. The severity of skin toxicity was assessed using the DLQI score and patients were prospectively followed to evaluate response to therapy. Univariate analysis of factors influencing the impact of skin toxicity on patient QOL was conducted.

Results: 52 patients were enrolled in the study. Patients who developed grade 3 and 4 skin toxicity had a higher DLQI score, with a greater impact on quality of life, but with better clinical outcome at 3 months follow-up, based on RECIST. Patients with moderate or severe cutaneous AE were more likely to achieve complete or partial response to therapy than those with mild AE (16/33 vs. 3/19, p = 0.035). Interestingly, female patients had a significantly poorer quality of life than male patients as assessed by the DLQI score (7.28 ± 7 vs. 3.7 ± 3.6, p = 0.038).

Conclusion: Cutaneous side effects are often encountered in cancer patients and their severity can be a surrogate marker for a positive clinical tumor response to therapy.

Keywords: EGFR tyrosine kinase inhibitor; chemotherapy; exanthema; quality of life; toxicity.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Antineoplastic Agents / adverse effects*
  • Drug Eruptions / drug therapy
  • Drug Eruptions / etiology*
  • ErbB Receptors / antagonists & inhibitors
  • Exanthema / chemically induced
  • Exanthema / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Prospective Studies
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Quality of Life*
  • Severity of Illness Index
  • TOR Serine-Threonine Kinases / adverse effects
  • Vitamin K 1 / therapeutic use
  • Vitamins / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Antineoplastic Agents
  • Vitamins
  • Vitamin K 1
  • ErbB Receptors
  • Protein-Tyrosine Kinases
  • TOR Serine-Threonine Kinases