Association between Subjective Evaluation of Skin Toxicities and Quality of Life in Patients with Lung Cancer Undergoing Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor Treatment: A Pilot Study for Developing Skin Toxicity Assessment

摘要

Purposes: Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) exert satisfactory therapeutic effects in lung cancer patients. However, the resultant skin toxicity can deteriorate patients’ quality of life (QoL). Differences exist in skin toxicity evaluation between patients and clinicians. We aimed to clarify the association between the subjective evaluation of skin toxicities and QoL in lung cancer patients and to establish a document of scale development in the subjective evaluation of skin toxicity. Methods: We used self-administered questionnaires to evaluate 12 lung cancer patients receiving EGFR-TKI treatment. Indices of QoL were generated using the Functional Assessment of Cancer Therapy-Lung and Hospital Anxiety and Depression Scale, and a subjective evaluation questionnaire concerning skin toxicity was completed. The data were collected immediately before treatment initiation and at 4 weeks post treatment. Results: In the subjective evaluation of skin toxicity, four patients (33.3%) were classified as ≥Grade 2 (painful group), experiencing painful pruritus at the emergence site of the skin rash or xerosis. In this group, the QoL scores of physical and emotional aspects declined after treatment. Conversely, patients in the painless group (Grade 0 - 1) demonstrated an improved emotional QoL following treatment (p = 0.028). Conclusions: Lung cancer patients suffering from painful skin toxicity tended to show a decline in the physical and emotional aspects of QoL following EGFR-TKI treatment. The skin toxicity questionnaire was useful from the point of view of a subjective evaluation and could be a powerful assessment tool in future clinical settings with further modification.