ゲフィチニブ(イレッサ^【○!R】)内服により皮膚症状の出現をみた19例の臨床的検討  [in Japanese] Cutaneous Side Effects in 19 Lung Cancer Patients Treated with Gefitinib (Iressa^【○!R】)  [in Japanese]

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Abstract

2002年10月から2004年2月までの1年5カ月の間, 山口県立中央病院で肺癌治療のためゲフィチニブ(イレッサ<sup>®</sup>)を内服した24症例について皮膚病変の有無とその性状について検討した。皮膚症状が出現した症例は24例中19例で全体の79.2%であり, そのうち皮膚科を紹介されたのは15例(78.9%)であった。急性肺障害・間質性肺炎やその疑いでゲフィチニブの内服が中止となった症例は4例, 肝機能障害のため休薬した症例は3例, さらに皮膚症状のみで内服を中止した症例は3例であった。皮膚症状としてはざ瘡様発疹が11例(57.9%)と最も多く, 乾皮症・皮脂欠乏性湿疹8例(42.1%), 脂漏性皮膚炎6例(31.6%), 爪囲炎・爪囲肉芽腫形成5例(26.3%)の順に多くみられた。ゲフィチニブを服用する患者は進行期の肺癌患者であり, 有効例では本剤を継続服用できるか否かが予後を大きく左右する。それゆえ, 副作用として最も頻度の高い皮膚病変を十分にコントロールし, 少なくとも皮膚病変のために内服が中止されることがないようにすることが重要と考えた。その意味において, ゲフィチニブの用量の調節や投与法の工夫が有効であることが示唆された。

We investigated 24 patients with non-small cell lung cancer who were treated with Gefitinib (Iressa<sup>TM</sup>) from October 2003 to February 2004 in Yamaguchi Prefectural Center Hospital. A variety of cutaneous manifestations were seen in 19 of 24 (79.2%) patients, and 15 patients were referred to the dermatological division for skin treatment. We had to discontinue Gefitinib therapy in 4, 3, and 3 patients due to pulmonary dysfunction which included definitive or suspected interstitial pneumonitis, liver dysfunction, and cutaneous side effects, respectively. The most common cutaneous reaction to Gefitinib therapy was the development of an acneiform follicular eruption (57.9%). Additional dermatological side effects included xerosis (42.1%), seborrheic dermatitis (31.6%), and paronychia (26.3%). It is now generally accepted that Gefitinib is one of the most effective agents for advanced lung cancer. To continue treatment with this agent, therefore, might improve the prognosis. In maintaining this treatment, it is important to successfully control the cutaneous side effects that are the most common adverse effects of this drug. To achieve this aim, a lower dose or a modification of the dosage, such as intermittent administration, should be considered to lessen these side effects.

Journal

  • The Nishinihon Jourrnal of Dermatology  

    The Nishinihon Jourrnal of Dermatology 66(6), 602-607, 2004-12-01 

    Western Division of Japanese Dermatological Association

References:  9

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Codes

  • NII Article ID (NAID)
    10018999337
  • NII NACSIS-CAT ID (NCID)
    AN00183881
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869784
  • NDL Article ID
    7295774
  • NDL Source Classification
    ZS39(科学技術--医学--皮膚科学・泌尿器科学)
  • NDL Call No.
    Z19-69
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
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