Spazzapan et al described nail toxicity associated with weekly taxanes (paclitaxel) in women with metastatic breast cancer. This can have a significant impact on the patient's quality of life. The authors are from the Centro di Riferimento Oncologico in Aviano and the University of Trieste in Italy.
The current Common Toxicity Criteria (above, shown below) recognizes Grades 0 to 2 in toxicity.
Nail Changes |
Grade |
normal |
0 |
discoloration or ridging or pitting |
1 |
partial or complete loss of nails |
2 |
pain in nailbeds |
2 |
Weekly chemotherapy with taxanes can result in severe changes in the nails that may result in cause the patient to discontinue therapy. The authors recommend extending the CTC to reflect the impact on a patient's quality of life.
Nail Changes |
Impact on Quality of Life |
Grade |
normal |
NA |
0 |
discoloration or pigmentation |
NA |
1 |
ridging or pitting |
NA |
1 |
partial loss of nails |
not interfering with function |
2 |
partial loss of nails |
significant interference with function |
3 |
pain in nailbeds |
not interfering with function |
2 |
pain in nailbeds |
significant interference with function |
3 |
complete loss of nails |
NA |
3 |
where:
• Partial loss of nails = onycholysis
• Ridging of nails = koilonychia
Specialty: Hematology Oncology, Dermatology
ICD-10: ,