National University of Singapore, Yong Loo Lin School of Medicine, 21 Lower Kent Ridge Road, Singapore.
Radiat Oncol. 2011 Jan 24;6:9. doi: 10.1186/1748-717X-6-9.
To determine the usefulness of ultrasonography in the assessment of post radiotherapy skin changes in postmastectomy breast cancer patients.
Patients treated for postmastectomy radiotherapy in National University Hospital (NUH) and Tan Tock Seng Hospital (TTSH), Singapore between January 2004- December 2005 was recruited retrospectively. Ultrasound scan was performed on these Asian patients who had been treated to a total dose of 46-50 Gy with 1 cm bolus placed on the skin. The ultrasound scans were performed blinded to the RTOG scores, and the skin thickness of the individually marked points on the irradiated chest wall was compared to the corresponding points on the non-irradiated breast.
The mean total skin thickness inclusive of the epidermis and the dermis of the right irradiated chest wall was 0.1712 mm (± 0.03392 mm) compared with the contra-lateral non-irradiated breast which was 0.1845 mm (± 0.04089 mm; p = 0.007). The left irradiated chest wall had a mean skin thickness of 0.1764 mm (± 0.03184 mm) compared with the right non-irradiated breast which was 0.1835 mm (± 0.02584 mm; p = 0.025). These independent t-tests produced a significant difference of reduced skin thickness on the right irradiated chest wall, p = 0.007 (p < 0.05) and left irradiated chest wall p = 0.025 (p < 0.025) in comparison to the non-irradiated skin thickness investigating chronic skin reactions. Patients with grade 2 acute skin toxicity presented with thinner skin as compared to patients with grade 1 (p = 0.006).
This study has shown that there is a statistically significant difference between the skin thicknesses of the irradiated chest wall and the contra-lateral non-irradiated breast and a predisposition to chronic reactions was found in patients with acute RTOG scoring of grade1 and grade 2.
为了确定超声检查在评估乳腺癌根治术后放疗后皮肤变化中的作用。
回顾性招募了 2004 年 1 月至 2005 年 12 月在新加坡国立大学医院（NUH）和陈笃生医院（TTSH）接受乳腺癌根治术后放疗的患者。对这些接受了 46-50 Gy 总剂量放疗且在皮肤上放置了 1 cm 厚的 bolus 的亚洲患者进行了超声扫描。超声扫描是在不知道 RTOG 评分的情况下进行的，并且将照射胸壁上各个标记点的皮肤厚度与非照射侧乳房上的相应点进行了比较。
右侧照射胸壁的表皮和真皮总皮肤厚度平均值为 0.1712mm（±0.03392mm），而对侧未照射的乳房为 0.1845mm（±0.04089mm；p=0.007）。左侧照射胸壁的皮肤厚度平均值为 0.1764mm（±0.03184mm），而右侧未照射的乳房为 0.1835mm（±0.02584mm；p=0.025）。这些独立的 t 检验表明，右侧照射胸壁的皮肤厚度显著减少，p=0.007（p<0.05），左侧照射胸壁 p=0.025（p<0.025），与非照射侧皮肤厚度相比，存在慢性皮肤反应的差异。急性皮肤毒性 2 级患者的皮肤厚度较 1 级患者薄（p=0.006）。
这项研究表明，照射胸壁的皮肤厚度与对侧未照射乳房的皮肤厚度之间存在统计学上的显著差异，并且在急性 RTOG 评分 1 级和 2 级的患者中发现了慢性反应的倾向。
