非小细胞肺癌患者免疫治疗致皮肤毒性的调查研究

Longitudinal study of skin toxicity caused by immunotherapy in patients with non-small cell lung cancer

目的调查非小细胞肺癌患者免疫治疗致皮肤毒性情况,为制定针对性护理措施提供参考。方法选取110例非小细胞肺癌患者,在首次免疫治疗后的第1~21天持续追踪其皮疹和瘙痒的发生情况及严重程度。结果首个免疫治疗周期后患者皮疹发生率31.82%,瘙痒症发生率为18.18%,皮疹、瘙痒以1~2级为主。不同性别、过敏史、TNM分期、化疗史的免疫治疗患者皮疹发生率比较,差异有统计学意义;不同过敏史、TNM分期、化疗史的免疫治疗患者瘙痒发生率比较,差异有统计学意义(P<0.05,P<0.01)。结论非小细胞肺癌患者初次免疫治疗后,皮肤毒性发生率及严重程度不高,但仍需积极干预,尤其重视女性、有过敏史、化疗史及肿瘤晚期患者,以提高患者的治疗依从性。

Objective To investigate the skin toxicity caused by immunotherapy in patients with non-small cell lung cancer(NSCLC),so as to provide reference for the development of targeted nursing measures.Methods A total of 110 non-small cell lung cancer patients were selected and their rashes and pruritus were followed up from the first day to the 21 st day into the first immunotherapy cycle.Results In the first immunotherapy cycle,the incidence rate was 31.82%for rash,and 18.18%for pruritus,with the skin lesions being graded between level 1 and 2.The incidence rate of skin rash in patients on immunotherapy varied significantly by different genders,allergy history,TNM stages and chemotherapy history;the incidence rate of pruritus in immunotherapy patients varied significantly by allergy history,TNM stages and chemotherapy history(P<0.05,P<0.01).Conclusion The incidence rate and severity of skin toxicity is low and mild after the initial immunotherapy of NSCLC.Still the patients are in need of active intervention,especially for those who are female,have allergy or chemotherapy history,and have advanced stage cancer.