A Clinicoepidemiological Study on Various Mucocutaneous Adverse Reactions of Anti-Cancer Drugs in Cancer Patients
Creators
- 1. Assistant Professor, Department of Skin and VD, SCB Medical College and Hospital, Cuttack
- 2. Ex. P.G, Department of Skin and VD, SCB Medical College and Hospital, Cuttack
- 3. Professor, HOD, Department of Skin and VD, SCB Medical College and Hospital, Cuttack
- 4. Professor, Department of Skin and VD, SCB Medical College and Hospital, Cuttack
- 5. Professor, Department of Radiation Oncology, AHPGIC, Cuttack
- 6. Senior Resident, Department of General Surgery, SCB Medical College and Hospital, Cuttack
Description
Background: Cutaneous adverse reactions are the most commonly associated adverse effects with chemotherapy next to hematological toxicity. Chemotherapy is evolving with a tendency towards increasing the use of newer targeted agents. This has resulted in changing patterns of cutaneous adverse effects. Aims: We aim to study clinicoepidemiological aspect of various mucocutaneous adverse reactions due to anti-cancer drugs in cancer patients. Objectives: 1. Estimate occurrence of mucocutaneous adverse reactions among cancer pts on anticancer drugs. 2. To see the pattern, duration & latency of mucocutaneous reactions due to anticancer agents. 3. Study the association of cutaneous adverse reactions with various chemotherapy drugs or combination regimens. 4. Assess severity of various mucocutaneous adverse reactions using standardised criteria. Methods: This was a cross sectional observational study carried out in dermatology department, SCB Medical college & AHPGIC, Cuttack during June 2020 to November 2021. Inclusion Criteria: We included cancer patients who developed at least one mucocutaneous reactions after starting chemotherapy during our study period & gave consent to participate in our study. Exclusion Criteria: Cancer cases who were on prior or concurrent radiotherapy, those who developed mucocutaneous reactions prior to starting chemotherapy & those who did not consent to participate were excluded. The obtained information was analysed retrospectively using SPSS software & results were represented using tables & statistical diagrams. Results: Out of 200 cases, 131 were female & 69 were male. Overall, Breast cancer(37.5%) was the most common indication for chemotherapy followed by rectal cancer & cervical cancer. However, among males Ca Rectum was most common indication for chemotherapy followed by stomach & lungs cancers. Combination regimens were most frequently used. The dermatological manifestations observed include hair changes (alopecia) in 73% cases, followed by skin changes (acral pigmentation, infusion site reactions, hand foot syndrome, Flagellate dermatitis, Supravenous Pigmentation, skin rash, acneiform eruptions, Xerosis etc) in 72% cases, nail changes (nail Pigmentation, Onycholysis, etc) in 56% & mucosal changes (Mucosal pigmentation, painful mucositis) in 14% cases respectively. Limitations: Since most of chemotherapy consisted of combination regimens, it was difficult to imply specific drug in causal association. Due to the cross-sectional nature of our study with limited study period, cases could not be followed up properly. Conclusion: Mucocutaneous adverse reactions of cancer chemotherapy can be mostly diagnosed by detailed history taking & physical examination. Many of the observed side effects are reversible changes, yet their inappropriate management might sometimes affect quality of treatment such as dose reduction or stoppage of drugs. A multidisciplinary approach including oncologist & dermatologist to prevent its occurrence or else limit its progression with appropriate timely management & proper counselling thereby improving the quality of patient care.
Abstract (English)
Background: Cutaneous adverse reactions are the most commonly associated adverse effects with chemotherapy next to hematological toxicity. Chemotherapy is evolving with a tendency towards increasing the use of newer targeted agents. This has resulted in changing patterns of cutaneous adverse effects. Aims: We aim to study clinicoepidemiological aspect of various mucocutaneous adverse reactions due to anti-cancer drugs in cancer patients. Objectives: 1. Estimate occurrence of mucocutaneous adverse reactions among cancer pts on anticancer drugs. 2. To see the pattern, duration & latency of mucocutaneous reactions due to anticancer agents. 3. Study the association of cutaneous adverse reactions with various chemotherapy drugs or combination regimens. 4. Assess severity of various mucocutaneous adverse reactions using standardised criteria. Methods: This was a cross sectional observational study carried out in dermatology department, SCB Medical college & AHPGIC, Cuttack during June 2020 to November 2021. Inclusion Criteria: We included cancer patients who developed at least one mucocutaneous reactions after starting chemotherapy during our study period & gave consent to participate in our study. Exclusion Criteria: Cancer cases who were on prior or concurrent radiotherapy, those who developed mucocutaneous reactions prior to starting chemotherapy & those who did not consent to participate were excluded. The obtained information was analysed retrospectively using SPSS software & results were represented using tables & statistical diagrams. Results: Out of 200 cases, 131 were female & 69 were male. Overall, Breast cancer(37.5%) was the most common indication for chemotherapy followed by rectal cancer & cervical cancer. However, among males Ca Rectum was most common indication for chemotherapy followed by stomach & lungs cancers. Combination regimens were most frequently used. The dermatological manifestations observed include hair changes (alopecia) in 73% cases, followed by skin changes (acral pigmentation, infusion site reactions, hand foot syndrome, Flagellate dermatitis, Supravenous Pigmentation, skin rash, acneiform eruptions, Xerosis etc) in 72% cases, nail changes (nail Pigmentation, Onycholysis, etc) in 56% & mucosal changes (Mucosal pigmentation, painful mucositis) in 14% cases respectively. Limitations: Since most of chemotherapy consisted of combination regimens, it was difficult to imply specific drug in causal association. Due to the cross-sectional nature of our study with limited study period, cases could not be followed up properly. Conclusion: Mucocutaneous adverse reactions of cancer chemotherapy can be mostly diagnosed by detailed history taking & physical examination. Many of the observed side effects are reversible changes, yet their inappropriate management might sometimes affect quality of treatment such as dose reduction or stoppage of drugs. A multidisciplinary approach including oncologist & dermatologist to prevent its occurrence or else limit its progression with appropriate timely management & proper counselling thereby improving the quality of patient care.
Files
IJPCR,Vol15,Issue5,Article144.pdf
Files
(7.7 MB)
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Additional details
Dates
- Accepted
-
2023-05-10
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue5,Article144.pdf
- Development Status
- Active
References
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