癌症患者免疫相关皮肤不良反应预防及管理的证据总结

Evidence summary for the prevention and management of immune-related cutaneous adverse events in cancer patients

目的:系统检索、评价并提取总结国内外关于癌症患者免疫相关皮肤不良反应预防及管理的相关证据。方法:依据“6S”金字塔模型,自上而下系统检索相关网站和数据库中关于癌症患者免疫相关皮肤不良反应预防及管理的文献,检索时限为2013年1月1日至2023年12月31日。对纳入的文献进行质量评价后提取证据并整合。结果:共纳入16篇文献,其中指南7篇、临床决策1篇、专家共识6篇、系统评价2篇,从多学科团队、基线评估、皮肤日常管理、早期诊断、症状处理、随访监测、健康教育7个方面形成了28条证据。结论:本研究总结了癌症患者免疫相关皮肤不良反应预防及管理的相关证据,可以为临床医护人员制定皮肤不良反应管理策略提供参考,但对患者开展临床实践时仍需要结合临床实际情况和患者个体需求选择适宜的证据。

Objective:To retrieve,evaluate and summarize the latest evidence on the prevention and management for immune-related cutaneous adverse events in cancer patients.Methods:Based on the 6S pyramid model,literatures on the prevention and management of immune-related cutaneous adverse events in cancer patients were systematically searched.The retrieval period was from January 1,2013 to December 31,2023.Evidence was extracted and integrated after quality evaluation of the included studies.Results:A total of 16 articles were finally included,containing 7 guidelines,1 clinical decision,6 expert consensuses and 2 systematic reviews.In total,28 pieces of evidence including 7 aspects were summarized,namely multidisciplinary team,baseline assessment,daily cutaneous management,early diagnosis,symptom management,followup monitoring,and health education.Conclusion:The study summarized the evidence for the prevention and management of immune-related cutaneous adverse events in cancer patients,which can provide a reference for clinicians to formulate reasonable management strategies.However,it is still necessary to choose appropriate evidence based on the actual clinical situation and patients'individual needs in clinical practice.