台北中医医学杂志

97.07 中医药治疗第四期大肠癌EGFR 抑制剂所致皮疹病例报告
中医药治疗第四期大肠癌EGFR 抑制剂所致皮疹病例报告
A Case Report of Traditional Chinese Medicine Alleviating Skin Rash Subsequent
to EGFR Inhibitors
何佳颖 王品涵*
长庚纪念医院中医部中医内科
【摘要】
仅管近年来医疗制药技术有突破性发展,转移性大肠直肠癌预後仍差。目前主流第一线治疗为Epidermal growth factor receptor inhibitor(EGFR 抑制剂)Cetuximab 合并FOLFIRI 治疗能有效阻止疾病恶化,特别是对无法手术的肝脏转移患者有显着助益。然而研究统计有相当大比例的病患在接受此疗法後会产生皮肤相关副作用,这些皮肤不良反应产生机制与EGFR 作用的抑制有关,但确切的病理生理学仍有待证实。
本病例报告为47 岁第四期升结肠大肠癌合并肝脏转移病患,使用EGFR 抑制剂Cetuximab 配合FOLFIRI 治疗,因药物副作用产生严重皮疹,搔痒难忍影响生活品质而求诊中医诊治。在服用中药清热解毒、养阴清热药二个月控制後,皮疹症状及睡眠品质皆获得良好改善,病人得以持续接受西医抗癌疗程。我们希望藉由此个案说明中医药治疗第四期升结肠大肠癌使用EGFR 抑制剂治疗後副作用皮疹之临床疗效。
【关键词】第四期大肠癌、EGFR 抑制剂副作用、中药治疗
 
Chia-Ying HoPin-Han Wang*
Department of Chinese Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
【Summary】
The prognosis of metastatic colorectal cancer remains poor despite advances made in recent years. The combination of cetuximab and FOLFIRI is currently the first-line treatment, proven by studies to be the best solution in reducing the risk of progression of metastatic colorectal cancer. Nevertheless, patients who underwent the treatment have a substantial risk of developing high-grade skin rash and other skin-related discomforts. These skin effects appear to be mechanism-based linked to the inhibition of EGFR action but the exact pathophysiology remains elusive. Left untreated these dermatological side-effects could represent a threat to patient compliance and therefore effective management is mandatory. Our study aim to find solution from perspective of Tradition Chinese Medicine.
We report a 47-year-old man with metastatic colorectal cancer who suffers from skin rash following concurrent treatment of cetuximab and FOLFIRI. The skin rash seriously exacerbate his quality of life. Thus, he turned himself to traditional Chinese Medicine for a continuous treatment of eight weeks and the discomfort abated. This study endeavor in discussion of the role of Traditional Chinese medicine in resolving side-effects from EGFR inhibitors.
【Keywords】Colon cancer, EGFR, Chinese medication treatment