대장암 환자에서 oxaliplatin으로 유발된 peripheral neuropathy의 발현율 및 임상약사의 환자상담을 통한 부작용 감소 효과

Abstract

Background : The major adverse effect of oxaliplatin-based chemotherapy (FOLFOX4) for colon cancer patients mainly has been reported as acute and chronic peripheral neuropathy (PN). This study was for analyzing PN incidence in patients treated with oxaliplatin and for examining change of adverse effects by pharmacist. Method : Oncology specialty pharmacist joined the colon cancer cooperation team in January,2008. She monitored the adverse effects of FOLFOX4 and provided consultation for patients. PN adverse effect was analyzed from 61 patients of colon cancer on FOLFOX4 from May, 2007 to August, 2008. There were 33 patients before March, 2008 when doctors and nurses monitored adverse effects and 28 patients after March, 2008 when pharmacist consulted with the patients. Results : Regardless of chemotherapy cycles and characteristic of acuteness, PN occurred in 60of 61 patients (98%) on oxaliplatin, and Grade1/2/3/4 was 246 cases (58.6%)/ 22(5.3%)/ 1(0.2%)/none of 471 cases with toxicity assessment. Among 61 patients with first incidence of PN, the patients experienced PN in 1st phase was 11 (18%), after 2nd to 5th cycles was 39 (65%), after 6th cycles was 10(16%) patients. Progressing rates over grade 2 occurred in 14 (23%) of 60 patients. The progression occurred at mean 4.6th±2.7 Cycles in 11 (33%) of 32 patients before pharmacist consultation and at mean 8th±0.9 Cycles in 3 (10%) of 28 patients after pharmacist consultation. Conclusion : Pharmacist consultation improved patient’s awareness of adverse effects and helped them to reduce exposure to risk related to adverse effects. It could influence the progression of PN symptoms though the incidence rate was not reduced.