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Asian Nursing Research May 2024Radiation-induced dermatitis (RD) is a common side-effect of therapeutic ionizing radiation that can severely affect patient quality of life. This study aimed to develop...
PURPOSE
Radiation-induced dermatitis (RD) is a common side-effect of therapeutic ionizing radiation that can severely affect patient quality of life. This study aimed to develop a risk prediction model for the occurrence of RD in patients with cervical carcinoma undergoing chemoradiotherapy using electronic medical records (EMRs).
METHODS
Using EMRs, the clinical data of patients who underwent simultaneous radiotherapy and chemotherapy at a tertiary cancer hospital between 2017 and 2022 were retrospectively collected, and the patients were divided into two groups: a training group and a validation group. A predictive model was constructed to predict the development of RD in patients who underwent concurrent radiotherapy and chemotherapy for cervical cancer. Finally, the model's efficacy was validated using a receiver operating characteristic curve.
RESULTS
The incidence of radiation dermatitis was 89.5% (560/626) in the entire cohort, 88.6% (388/438) in the training group, and 91.5% (172/188) in the experimental group. The nomogram was established based on the following factors: age, the days between the beginning and conclusion of radiotherapy, the serum albumin after chemoradiotherapy, the use of single or multiple drugs for concurrent chemotherapy, and the total dose of afterloading radiotherapy. Internal and external verification indicated that the model had good discriminatory ability. Overall, the model achieved an area under the receiver operating characteristic curve of .66.
CONCLUSIONS
The risk of RD in patients with cervical carcinoma undergoing chemoradiotherapy is high. A risk prediction model can be developed for RD in cervical carcinoma patients undergoing chemoradiotherapy, based on over 5 years of EMR data from a tertiary cancer hospital.
Topics: Humans; Female; Uterine Cervical Neoplasms; Middle Aged; Chemoradiotherapy; Retrospective Studies; Adult; Aged; Radiodermatitis; Risk Assessment; Nomograms; Risk Factors
PubMed: 38723775
DOI: 10.1016/j.anr.2024.04.012 -
Nan Fang Yi Ke Da Xue Xue Bao = Journal... Oct 2023To observe the therapeutic effect of metformin on pathological pain in mice with radiation dermatitis and explore the underlying mechanism.
OBJECTIVE
To observe the therapeutic effect of metformin on pathological pain in mice with radiation dermatitis and explore the underlying mechanism.
METHODS
Thirty-two male adult ICR mice were randomized into normal control group, radiation dermatitis model group, metformin treatment (200 mg/kg) group and gabapentin (100 mg/kg) group (=8).In the latter two groups, metformin treatment was administered after modeling via intraperitoneal injection and gabapentin by gavage on a daily basis for 16 days; the mice in the control group and model group received intraperitoneal injection of normal saline.After the last administration, radiation dermatitis was graded in each group.Mechanical withdraw threshold (MWT) and thermal withdrawal latency (TWL) of the mice were tested one day before and at 1, 4, 8, 12 and 16 days after modeling.Western blotting was used to measure the protein expression levels of p38MAPK, p-p38MAPK, NF-κB p65 and p-NF-κB p65 in the L-L spinal cord, and the concentrations of IL-1β, IL-6 and TNF-α in the spinal cord tissue were determined with ELISA.
RESULTS
Compared with those in the control group, the mice in the other 3 groups showed obvious symptoms of radiation dermatitis after modeling (<0.05), which were significantly alleviated by treatment with metformin (<0.05).The mice in the model group exhibited significant decreases in MWT and TWL (<0.05), which were improved by treatment with metformin and gabapentin (<0.05).Compared with those in the model group, the levels of p-p38MAPK, p-NF-κB p65, IL-1β, IL-6 and TNF-α in the spinal cord were significantly decreased in the mice after metformin treatment (<0.05).
CONCLUSION
Metformin can significantly ameliorate pathological pain symptoms in mice with radiation dermatitis possibly by inhibiting the activation of p38MAPK/NF-κB signaling pathway.
Topics: Animals; Male; Mice; Gabapentin; Interleukin-6; MAP Kinase Signaling System; Mice, Inbred ICR; NF-kappa B; Pain; Tumor Necrosis Factor-alpha; Metformin; Radiation Injuries, Experimental; Radiodermatitis
PubMed: 37933660
DOI: 10.12122/j.issn.1673-4254.2023.10.22 -
Alternative Therapies in Health and... Nov 2023Acute radiodermatitis is a type of skin injury caused by tumor radiotherapy. Compound Dahuang Baiji spray (CDBS) is a traditional Chinese medicine spray made from...
Acute radiodermatitis is a type of skin injury caused by tumor radiotherapy. Compound Dahuang Baiji spray (CDBS) is a traditional Chinese medicine spray made from Dahuang and Baiji decoction. In the present study, we aimed to investigate the effects and mechanisms of CDBS on radiation dermatitis. We analyzed the main components of CDBS using High Performance Liquid Chromatography (HPLC). Through network pharmacology prediction, the target of Dahuang and Baiji was identified as arachidonate 5-lipoxygenase (ALOX5), associated with inflammation. Therefore, we constructed radiodermatitis rat models and treated them with CDBS for 14 d. Skin samples were collected from the rats' injured skin tissues, and pathological changes, oxidative stress indicators, inflammatory cytokines, and ALOX5 expression were detected using techniques such as HE staining, blood parameters analysis, ELISA, Real-time qPCR, and Western blot. The characteristic appearances of radiodermatitis were observed in different rat groups which indicated that the skin injury score in the model group was at grade II and was at grade I in the CDBS group. In addition, the HE results showed that CDBS reduced the necrosis of collagen fibers and inflammatory cell infiltration in the dermis of the radiodermatitis rats. Moreover, compared to the model group, CDBS significantly decreased leukocytes, lymphocytes, and neutrophils in the blood, as well as levels of IL-2, LTB4, 5-LO, NO, and ALOX5 expression in rat blood. Our findings suggest the therapeutic effect of CDBS on radiodermatitis by downregulating ALOX5 to inhibit inflammation, potentially serving as a radiodermatitis therapy.
PubMed: 37971445
DOI: No ID Found -
Medicine Aug 2023Acute radiodermatitis is a significant complication of cancer radiotherapy, and platelet-based therapies are emerging as potential new treatments.
INTRODUCTION
Acute radiodermatitis is a significant complication of cancer radiotherapy, and platelet-based therapies are emerging as potential new treatments.
MAIN SYMPTOMS AND IMPORTANT CLINICAL FINDINGS
In this report, we present the case of a patient with head and neck cancer undergoing radiotherapy combined with the monoclonal antibody cetuximab. After 4 weeks of this treatment, the patient developed cutaneous radiation dermatitis. Despite receiving standard treatment with corticosteroids and emollient cream, the lesion did not improve.
MAIN DIAGNOSIS
cutaneous radiation dermatitis on head and neck cancer patient.
THERAPEUTIC INTERVENTIONS
Topical application of platelet gel was initiated on the wound. From the second week of radiotherapy to the 4th week, homologous platelet-rich plasma was applied on the dermatitis using a bandage, 4 times a day.
OUTCOMES
The topical treatment with homologous platelet gel resulted in complete healing of the radiodermatitis, including restoration of the epidermis, reepithelialization, and reduction in associated pain.
CONCLUSION
homologous platelet gel might be an alternative to standard treatment of radiation dermatitis.
Topics: Radiodermatitis; Cetuximab; Antineoplastic Agents, Immunological; Combined Modality Therapy; Humans; Male; Aged; Squamous Cell Carcinoma of Head and Neck; Oropharyngeal Neoplasms; Blood Platelets; Gels; Complementary Therapies
PubMed: 37653754
DOI: 10.1097/MD.0000000000034779 -
Advances in Radiation Oncology Mar 2024The current standard-of-care management of locally advanced triple negative breast cancer (TNBC) is based on neoadjuvant chemo-immunotherapy with pembrolizumab, surgery,...
PURPOSE
The current standard-of-care management of locally advanced triple negative breast cancer (TNBC) is based on neoadjuvant chemo-immunotherapy with pembrolizumab, surgery, radiation therapy (RT), and adjuvant pembrolizumab. However, the safety of combining pembrolizumab with adjuvant breast RT has never been evaluated. This study evaluated the tolerance profile of concurrent pembrolizumab with adjuvant RT in patients with locally advanced TNBC.
METHODS AND MATERIALS
This bicentric ambispective study included all the patients with early and locally advanced TNBC who received neoadjuvant chemo-immunotherapy with pembrolizumab and adjuvant RT as part of their treatment. The tolerance profile of adjuvant RT was evaluated and compared in patients who received concurrent pembrolizumab and in patients for whom pembrolizumab was withheld.
RESULTS
Fifty-five patients were included between July 2021 and March 2023. Twenty-eight patients received adjuvant RT with concurrent pembrolizumab (RT+P group), and 27 patients had pembrolizumab withheld while receiving adjuvant RT (RT-only group). Two patients developed grade ≥3 toxicity (1 grade 3 pain in the RT+P group and 1 grade 3 radiodermatitis in the RT-only group), and there were no differences in terms of toxicity between the RT-only and the RT+P groups. No cardiac or pulmonary adverse event was reported during RT. With a median follow-up of 12 months (10-26), no patient relapsed.
CONCLUSIONS
In this study of limited size, the authors did not find a difference between the RT-only and RT+P groups in terms of toxicity. More studies and longer follow-up may add to the strength of this evidence.
PubMed: 38495034
DOI: 10.1016/j.adro.2023.101384 -
Journal of Breast Cancer Apr 2024Pencil-beam scanning (PBS) is a modern delivery technique used in proton beam therapy (PBT) to reduce normal tissue reactions. No dosimetric correlation between...
PURPOSE
Pencil-beam scanning (PBS) is a modern delivery technique used in proton beam therapy (PBT) to reduce normal tissue reactions. No dosimetric correlation between dermatitis and PBS has been reported for breast cancer. The current study aimed to investigate the factors associated with grade 2 or higher dermatitis in patients with breast cancer undergoing PBT using PBS.
METHODS
The medical data of 42 patients with breast cancer who underwent adjuvant radiotherapy between December 2019 and September 2023 were reviewed. All patients received hypofractionated radiotherapy (HFRT), either 26 Gy (relative biological effectiveness [RBE])/five fractions or 40.05 or 43.5 Gy (RBE)/15 fractions, for the whole breast/chest wall with or without nodal irradiation. The duration of acute radiation dermatitis was defined as within 90 days from the start of radiotherapy. The Kaplan-Meier method and Cox proportional hazards model were used for univariate and multivariate analyses of the actuarial rates of grade 2-3 dermatitis.
RESULTS
Twenty-two (52.4%) and 20 (47.6%) patients were diagnosed with grade 1 and 2 dermatitis, respectively. Multivariate analysis revealed a clinical target volume (CTV) ≥ of 320 cc ( = 0.035) and a skin dose of D ≥ 38.3 Gy (RBE) ( = 0.009) as independent factors of grade 2 dermatitis. The 10-week cumulative grade 2 dermatitis rates were 88.2%, 39.4%, and 8.3% ( < 0.001) for patients with both high, either high, and neither high CTV and D, respectively.
CONCLUSION
To the best of our knowledge, this is the first study on dosimetric correlations for dermatitis in patients with breast cancer who underwent hypofractionated PBT using PBS. In the era of HFRT, skin dose modulation using PBS may reduce the incidence of dermatitis.
PubMed: 38769685
DOI: 10.4048/jbc.2024.0012 -
Revista Gaucha de Enfermagem 2024To evaluate the skin characteristics and quality of life of patients with breast cancer undergoing radiotherapy.
OBJECTIVE
To evaluate the skin characteristics and quality of life of patients with breast cancer undergoing radiotherapy.
METHOD
Cross-sectional study conducted with 60 women. The classification scales of skin changes resulting from exposure to ionizing radiation (RTOG) and the validated versions in Portuguese of those that classified skin types (Fitzpatrick), symptoms (RISRAS) and quality of life (DLQI) were applied. in the period between December 2021 and October 2022. For data analysis, Fisher's Exact Test, Chi-Square and Asymptotic General Independence Test were used.
RESULTS
100% of patients had skin irritation. As the treatment progressed and the radiodermatitis appeared or worsened, there was a tendency for the intensity of signs and symptoms to increase, such as: sensitivity, discomfort or pain, itching, burning and heat, dry and wet desquamation, which may have impacted the quality of life and reflected in other aspects, such as: shopping activities or outings (p=0.0020), social activities or leisure activities (p=0.0420).
CONCLUSION
Radiodermatitis is a common condition that affects women with breast cancer undergoing radiotherapy, skin characteristics and quality of life of patients affected during this treatment.
Topics: Female; Humans; Radiodermatitis; Quality of Life; Cross-Sectional Studies; Breast Neoplasms; Pruritus
PubMed: 38359280
DOI: 10.1590/1983-1447.2024.20230062.en -
Renal Failure Dec 2023
Topics: Humans; Radiodermatitis; Kidney Neoplasms; Hair; Acute Kidney Injury
PubMed: 37264782
DOI: 10.1080/0886022X.2023.2213778 -
Biomedical Optics Express Sep 2023Whilst radiotherapy (RT) is widely used for cancer treatment, radiodermatitis caused by RT is one most common severe side effect affecting 95% cancer patients. Accurate...
Whilst radiotherapy (RT) is widely used for cancer treatment, radiodermatitis caused by RT is one most common severe side effect affecting 95% cancer patients. Accurate radiodermatitis assessment and classification is essential to adopt timely treatment, management and monitoring, which all depend on reliable and objective tools for radiodermatitis grading. We therefore, in this work, reported the development and grading performance validation of a low-cost (∼2318.2 CNY) algorithms-based hyperspectral imaging (aHSI) system for radiodermatitis assessment. The low-cost aHSI system was enabled through Monte Carlo (MC) simulations conducted on multi-spectra acquired from a custom built low-cost multispectral imaging (MSI) system, deriving algorithms-based hyper-spectra with spectral resolution of 1 nm. The MSI system was based on sequentially illuminated narrow-band light-emitting diodes (LEDs) and a CMOS camera. Erythema induced artificially on healthy volunteers was measured by the aHSI system developed, with algorithms-based hyper-spectra and skin layer resolved physiological parameters (i.e., the blood volume fraction (BVF) and the oxygen saturation of hemoglobin in blood, et. al.) derivation using MC simulations. The MC simulations derived BVF and the oxygen saturation of hemoglobin in blood showed significant (P < 0.001, analysis of variance: ANOVA) increase with erythema. Further 1D-convolution neural network (CNN) implemented on the algorithms-based hyper-spectra leads to an overall classification accuracy of 93.1%, suggesting the great potential of low-cost aHSI system developed for radiodermatitis assessment.
PubMed: 37791251
DOI: 10.1364/BOE.500067 -
PloS One 2024Radiation dermatitis (RD) is a prevalent and difficult-to-manage consequence of radiation therapy (RT). A variety of interventions have been proven effective in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Radiation dermatitis (RD) is a prevalent and difficult-to-manage consequence of radiation therapy (RT). A variety of interventions have been proven effective in preventing and treating RD. However, the optimal approach remains unclear. This network meta-analysis (NMA) conducted a comparison and ranking of the effectiveness and patient-reported outcomes (PROs) of the interventions currently utilized in RD.
METHODS
PubMed, Web of Science, Embase, and Cochrane Library were searched to identify pertinent randomized controlled trials (RCTs) focused on the prevention and treatment of RD. The primary outcome measures included the incidence of grade≥2 RD (i.e., percentage of moist desquamation) and RD score. The secondary outcome measures encompassed patients' subjective assessment scores of pains, itching and burning sensations.
RESULTS
Our meta-analysis encompassed 42 studies and 4884 participants. Regarding the primary outcomes, photobiomodulation treatment (PBMT) ranked first in surface under curve cumulative ranking area (SUCRA:0.92) for reducing the incidence of grade≥2 RD. It demonstrated a significant difference when compared to Trolamine (OR 0.18,95%CrI 0.09-0.33) and Xonrid® (OR 0.28,95%CrI 0.12-0.66). Mepitelfilm (SUCRA: 0.98) achieved the highest rank in reducing the RD score, demonstrating superiority over StrataXRT® (MD -0.89, 95% CrI -1.49, -0.29). Henna (SUCRA: 0.89) demonstrated the highest effectiveness in providing pain relief, with a significant difference compared to Hydrofilm (MD -0.44, 95% CrI -0.84, -0.04) and Mepitelfilm (MD -0.55, 95% CrI -0.91, -0.19). Hydrofilm (SUCRA: 0.84) exhibited the fewest itching sensations, demonstrating superiority over Mepitelfilm (MD -0.50, 95% CrI -0.84, -0.17). No statistically significant difference was observed among various interventions in the assessment of burning sensations.
CONCLUSION
PBMT and Mepitelfilm demonstrated better efficacy in reducing the incidence of grade≥2 RD and RD score, respectively. In terms of PROs, Henna and Hydrofilm had fewer complaints in pain and itching sensations, respectively. However, studies with larger sample size on different interventions are warranted in the future.
TRIAL REGISTRATION
PROSPERO registration number CRD42023428598.
Topics: Humans; Network Meta-Analysis; Radiodermatitis; Randomized Controlled Trials as Topic; Pain; Pruritus
PubMed: 38598529
DOI: 10.1371/journal.pone.0298209