Bourgeois J F, Gourgou S, Kramar A, Lagarde J M, Guillot B
Montpellier I University and Centre Régional de Lutte Contre le Cancer Val d'Aurelle, Montpellier Cedex, France.
Skin Res Technol. 2008 Feb;14(1):71-6. doi: 10.1111/j.1600-0846.2007.00263.x.
BACKGROUND/PURPOSE: Cutaneous fibrosis is the quite mandatory sequela after a breast cancer treated by radiotherapy and it induces more or less important functional troubles. The LPG technique is a technique of mechanical massage that allows skin mobilization by folding/unfolding. The aim of this study was to evaluate the changes on irradiated skin before and after LPG treatment by clinical and skin replica analysis.
Twenty women, 43-55 years old, who had been treated from 6 to 16 months before, for breast cancer with a conservative surgery and radiotherapy, had been enrolled in the trial. They were divided into two groups after randomization: the first group was LPG treated three times a week for 1 month; the second group was only placed under medical supervision. The clinical criteria studied were systematically studied before (T0), at the end of treatment (T1) and 1 month after the end of treatment (T2): pain, itching, skin dryness, erythema, skin infiltration, feeling of tightness and of induration of the skin. Softening of the skin was assessed at T1 and T2. Cutaneous replica was performed on the internal upper 1/4 of each breast with silicone material before, after and 1 month later after the end of the treatment. After polymerization, the replica was stored and then blindly analyzed by image analysis software. The following parameters were systematically measured: average skin roughness, average of wrinkles' depth and residual length, wrinkle number and the space between them.
Clinically, the LPG treatment induced a decrease of erythema (10% of the patients vs. 40% before treatment), a decrease of pain and pruritus (10% vs. 20% and 40%, respectively) and a decrease of the feeling of induration of the skin (10% of the patients vs. 70% before treatment). Furthermore, a skin-softening sensation was noted by seven patients vs. one in the control group. Replica shows an increase of roughness and of furrow depth without any change in the residual length and an increase in the space between the wrinkles, whose number decreases.
This study confirms the impact of the clinical sequelae induced on skin after radiotherapy and shows improvement of the clinical signs after treatment by the LPG technique. The latter induces changes of micro relief, suggesting a softening effect on the skin. These preliminary results have to be confirmed on a more important group of patients.
背景/目的：皮肤纤维化是乳腺癌放疗后必然出现的后遗症，会或多或少引发严重的功能问题。LPG技术是一种机械按摩技术，通过折叠/展开实现皮肤活动。本研究旨在通过临床和皮肤复制品分析评估LPG治疗前后受照射皮肤的变化。
招募了20名年龄在43至55岁之间的女性，她们在6至16个月前接受了乳腺癌保乳手术及放疗。随机分为两组：第一组每周接受3次LPG治疗，共1个月；第二组仅接受医学观察。在治疗前（T0）、治疗结束时（T1）和治疗结束后1个月（T2）系统研究临床标准：疼痛、瘙痒、皮肤干燥、红斑、皮肤浸润、紧绷感和皮肤硬结感。在T1和T2评估皮肤软化情况。在治疗前、治疗结束后及治疗结束后1个月，用硅酮材料在每个乳房的内上1/4处制作皮肤复制品。聚合后，保存复制品，然后用图像分析软件进行盲法分析。系统测量以下参数：平均皮肤粗糙度、皱纹深度平均值和残留长度、皱纹数量及其间距。
临床上，LPG治疗使红斑减少（患者比例从治疗前的40%降至10%）、疼痛和瘙痒减轻（分别从20%和40%降至10%）、皮肤硬结感减轻（患者比例从治疗前的70%降至10%）。此外，7名患者有皮肤软化感，而对照组只有1名。复制品显示粗糙度和皱纹深度增加，残留长度无变化，皱纹间距增加，皱纹数量减少。
本研究证实了放疗后皮肤临床后遗症的影响，并表明LPG技术治疗后临床症状有所改善。LPG技术引起微观表面变化，表明对皮肤有软化作用。这些初步结果有待在更多患者群体中得到证实。
