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Abstract：
Background: Pediatric oncology patients receive multiple modalities of therapy to treat their malignancies. These modalities have the potential for acute toxicity and late effects. In the last decade, a new modality known as targeted biological therapy, has become an integral part of treatment for pediatric cancers. As targeted therapy use has increased, adverse events specific to these targeted agents have emerged, requiring a new effort focused on providing education to patients and families regarding how best to report, monitor, and manage these adverse events. Method: A clinical question was developed to guide the systematic literature review. Anaplastic lymphoma kinase (ALK) and mitogen-activated protein kinase kinase (MEK) inhibitors were selected for review due to their frequency of use in pediatric oncology. The search was conducted to identify relevant articles published between January 1, 2000 and May 5, 2020. Articles were screened by two team members for inclusion/exclusion criteria using the web-based systematic review tool, Rayyan. Results: Twenty-seven articles met the eligibility criteria for inclusion and were evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation criteria. Adverse events for ALK and MEK inhibitors included manifestations of the gastrointestinal, hematologic, dermatologic, musculoskeletal, neurological, cardiovascular, and ocular systems. Recommendations for patient/family education were made for ALK and MEK inhibitors based on the reported adverse events. Conclusions: Adverse events of ALK and MEK inhibitors differ from the more common adverse events experienced with conventional treatment modalities used in pediatric oncology. It is important for nurses to include information regarding potential adverse events in patient/family education for children receiving these targeted agents.
摘要：
背景：小儿肿瘤患者接受多种治疗方式来治疗其恶性肿瘤。这些方式具有急性毒性和后期效应的潜力。在过去的十年里，一种被称为靶向生物治疗的新模式，已经成为儿科癌症治疗不可或缺的一部分。随着靶向治疗的使用增加，这些靶向药物特有的不良事件已经出现，需要一项新的努力，专注于向患者和家庭提供关于如何最好地报告的教育，监视器,并管理这些不良事件。方法：建立临床问题，指导系统文献复习。间变性淋巴瘤激酶（ALK）和丝裂原活化蛋白激酶激酶（MEK）抑制剂因其在儿科肿瘤学中的使用频率而被选择进行审查。进行搜索是为了识别2000年1月1日至2020年5月5日之间发表的相关文章。文章由两名团队成员使用基于网络的系统审查工具筛选纳入/排除标准，Rayyan.结果：27篇文章符合纳入资格标准，并使用建议分级进行评估，评估,发展,和评价标准。ALK和MEK抑制剂的不良事件包括胃肠道表现，血液学，皮肤病学,肌肉骨骼，神经学,心血管,和眼部系统。根据报告的不良事件，建议对ALK和MEK抑制剂进行患者/家庭教育。结论：ALK和MEK抑制剂的不良事件与儿科肿瘤学中使用的常规治疗方式所经历的更常见的不良事件不同。对于护士来说，重要的是在接受这些靶向药物的儿童的患者/家庭教育中纳入有关潜在不良事件的信息。
