drug-induced-skin-…

Study Purpose

To discuss the affect of 0.1% VitK1 cream on cetuximab-induced skin toxicity in patients with colorectal cancer

Intervention Characteristics/Basic Study Process

Routine nursing was implemented for all patients. The experimental group also received VitK1 cream smeared on the face, neck, chest, back, and nail edges three times on the day of cetuximab infusion at 9 am, 3 pm, and 9 pm.

Sample Characteristics

N = 60 (30 experimental, 30 control)
AGE = 20 years or older
MALES: 86.7% (experimental), 66.7% (control); FEMALES: 13.3% (experimental), 33.3% (control)
KEY DISEASE CHARACTERISTICS: Patients with colorectal cancer
OTHER KEY SAMPLE CHARACTERISTICS: Patients who were hospitalized and receiving cetuximab-containing therapy for the first time. No one with prior skin disease or diabetes was included.

Setting

SITE: Single site
SETTING TYPE: Inpatient
LOCATION: The First Affiliated Hospital of Zhengzhou University (January 2013–October 2014)

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment
APPLICATIONS: Elder care

Study Design

Randomized, controlled clinical trial

Measurement Instruments/Methods

Common Terminology Criteria for Adverse Events (CTCAE), version 3.0

Results

Dry skin, itchy skin, acne-like rash, skin dehiscence, and paronychia were evaluated in both groups after four cycles of cetuximab therapy (56 days) using the Common Toxicity Criteria, version 3.0, assessment scale. No grade 4 results were observed in either group. No significant differences existed in acne-like rash, paronychia, or dehiscence in either group. A significant difference existed in skin dryness and itch, favoring the experimental group. All patients had skin toxicities. No reports of discomfort were received from the experimental group, receiving VitK1 cream.

Conclusions

The VitK1 cream appeared to reduce skin dryness and itching.

Limitations

Small sample (< 100)
Risk of bias (no blinding)
Risk of bias (no random assignment)
Findings not generalizable
Convenience sampling
Results consistent with studies from outside of China where VitK1 cream was available
Need further discussion

Nursing Implications

Reducing or improving the existence of skin toxicities from cetuximab therapies allows patients to stay on therapies without an extreme decrease in quality of life. VitK1 cream had not been available in China; therefore, this study used the compounding of this cream with specific directions. Safeguarding the production of emollients and creams from compounding pharmacies has met recent scrutiny. Nurses need to ensure consistency with medical interventions when able. Providing for symptom management options, such as VitK1 cream, should promote patient adherence to therapy and improve outcomes. Few interventions have been shown effective for the prevention and management of skin toxicities. Further research is needed.