外用中药成功治疗克唑替尼所致手足综合征2例

Successful treatment of hand-foot syndrome caused by crizotinib with external use of traditional Chinese medicine:report of 2 cases

2例患者(例1女,60岁;例2男,62岁)均因间变性淋巴瘤激酶基因阳性非小细胞肺癌给予口服靶向药物克唑替尼治疗(剂量分别为250 mg、2次/d和500 mg、1次/d)。2例患者均于治疗半年后出现双手皮肤反应,继续治疗,皮肤损伤加重。例1表现为双手、前臂和颈部大片红色斑块,表皮轻度肥厚、伴脱屑,有明显触痛;例2表现为双手指尖、手掌皮肤皲裂、溃疡、糜烂,伴明显疼痛。2例患者均予由生黄芪、红花、紫草、老鹳草、当归组成的复方中药颗粒剂泡洗治疗,分别于4周和5周后症状明显改善。

Two patients(patient 1,a 60-year-old female;patient 2,a 62-year-old male)received oral targeted drug crizotinib(250 mg twice daily and 500 mg once daily,respectively)for anaplastic lymphoma kinase-positive non-small cell lung cancer.Both patients developed skin reactions of their hands after half a year of treatment,which were aggravated as the treatment continued.Symptoms of patient 1 presented as large red patches on the hands,forearms,and neck,with mild epidermis hypertrophy and desquamination,accompanied by obvious tenderness.Symptoms of patient 2 presented as chapped,ulcerated,and erosive skin on the fingertips and palms,accompanied by obvious pain.The 2 patients were given soaking treatment with compound granules of traditional Chinese medicine consisting of raw Astragalus,Carthamus,Radix Arnebiae,Geranium,and Radix Angelicae Sinensis,and their symptoms were obviously improved after 4 and 5 weeks,respectively.