Introduction. In clinical practice many non-pharmacological interventionsare used to manage the side-effects of antineoplastic therapy, but formost of them nurses don’t know the effectiveness. The aim of this literaturereview is to define the level of scientific evidence of the non-pharmacologicalinterventions currently available to control nausea, vomiting, mucositis,diarrhoea, fatigue, the hand/foot syndrome, acneiform rashes produced bydrugs used for treatment of colorectal cancer, in particular 5-FU/LV, CPT-11, Oxaliplatin, Bevacizumab/Cetuximab and Xeloda.Methods. A search was conducted on the Cochrane Library, Medlineand Cinahl databases until May 2008, selecting systematic reviews and,when these were missing, the best quality clinical studies, that evaluatedthe effectiveness of non-pharmacological interventions to manage themain side effects of anticancer therapy used in colorectal cancer. Levels ofevidence, according to those set forth by the Oxford Centre for EvidenceBased Medicine (2001), were applied for each intervention.Results. A lack of scientific evidence was found for almost all ofthe non-pharmacological interventions studied. Non-pharmacologicalinterventions aimed at controlling nausea and vomiting induced bychemotherapy, such as muscle relaxation training an the employmentof guided imagination, do not replace the pharmacological approachand further research is necessary to define their true efficacy. The onlynon-pharmacological intervention that proved to be effective in managingmucositis was oral cryotherapy during bolus infusion of 5-FU; otherindications, such as basic oral care, needs to be supported by further studies.There were no studies that analyzed effective non-pharmacologicalinterventions for the management of chemotherapy-induced diarrhoea,hand/foot syndrome, acneiform rashes and peripheral neuropathy. Incontrast fatigue has been studied in-depth: physical exercise has shownto reduce fatigue, but some interventions such as progressive musclerelaxation and the use of nutritional supplements have been studied inresearches of poor quality.

Scientific Evidence for Non-Pharmacological Management of the Main Side-Effects of Antineoplastic Drugs in Colorectal Cancer Patients. [Evidenze scientifiche per la gestione non farmacologica dei principali effetti collaterali della terapia antineoplastica nei pazienti con cancro colon-rettale]

Gualandi R;Piredda M;Rocci L;De Benedictis A;Matarese M;Tartaglini D;De Marinis MG
2009-01-01

Abstract

Introduction. In clinical practice many non-pharmacological interventionsare used to manage the side-effects of antineoplastic therapy, but formost of them nurses don’t know the effectiveness. The aim of this literaturereview is to define the level of scientific evidence of the non-pharmacologicalinterventions currently available to control nausea, vomiting, mucositis,diarrhoea, fatigue, the hand/foot syndrome, acneiform rashes produced bydrugs used for treatment of colorectal cancer, in particular 5-FU/LV, CPT-11, Oxaliplatin, Bevacizumab/Cetuximab and Xeloda.Methods. A search was conducted on the Cochrane Library, Medlineand Cinahl databases until May 2008, selecting systematic reviews and,when these were missing, the best quality clinical studies, that evaluatedthe effectiveness of non-pharmacological interventions to manage themain side effects of anticancer therapy used in colorectal cancer. Levels ofevidence, according to those set forth by the Oxford Centre for EvidenceBased Medicine (2001), were applied for each intervention.Results. A lack of scientific evidence was found for almost all ofthe non-pharmacological interventions studied. Non-pharmacologicalinterventions aimed at controlling nausea and vomiting induced bychemotherapy, such as muscle relaxation training an the employmentof guided imagination, do not replace the pharmacological approachand further research is necessary to define their true efficacy. The onlynon-pharmacological intervention that proved to be effective in managingmucositis was oral cryotherapy during bolus infusion of 5-FU; otherindications, such as basic oral care, needs to be supported by further studies.There were no studies that analyzed effective non-pharmacologicalinterventions for the management of chemotherapy-induced diarrhoea,hand/foot syndrome, acneiform rashes and peripheral neuropathy. Incontrast fatigue has been studied in-depth: physical exercise has shownto reduce fatigue, but some interventions such as progressive musclerelaxation and the use of nutritional supplements have been studied inresearches of poor quality.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12610/7304
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