Grading Recommendations of Spazzapan et al for Nail Toxicity Associated with Weekly Chemotherapeutic Regimens

Description

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

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Description

Specialty

ICD-10