Department of Radiation Oncology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, TRC 2 West 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Radiat Oncol. 2013 Jan 24;8:19. doi: 10.1186/1748-717X-8-19.
Proton therapy can result in clinically significant radiation dermatitis. In some clinical scenarios, such as lung or breast cancer, the risk of severe radiation dermatitis may limit beam arrangement and prescription doses. Patients undergoing proton therapy for prostate cancer commonly develop mild radiation dermatitis. Herein, we report the outcomes of two prostate cancer patients whose radiation dermatitis appears to have been substantially diminished by transparent film dressings (Beekley stickers).
This is a descriptive report of the skin toxicity observed in two patients undergoing proton therapy for prostate cancer at a single institution in 2011. A phantom dosimetric study was performed to evaluate the impact of a transparent film dressing on a beam's spread out Bragg peak (SOBP).
Two patients with low risk prostate cancer were treated with proton therapy to a total dose of 79.2Gy (RBE) in 1.8 Gy (RBE) fractions using two opposed lateral beams daily. Both patients had small circular (2.5 cm diameter) transparent adhesive markers placed on their skin to assist with daily alignment. Patient 1 had markers in place bilaterally for the entirety of treatment. Patient 2 had a marker in place for three weeks on one side and six weeks on the other. Over the course of therapy, both men developed typical Grade 1 radiation dermatitis (asymptomatic erythema) on their hips; however, in both patients, the erythema was substantially decreased beneath the markers. Patient 2 demonstrated less attenuation and thus greater erythema in the skin covered for three weeks compared to the skin covered for six weeks. The difference in skin changes between the covered and uncovered skin persisted for at least 1 month. A phantom study of double scattered beam SOBP with and without the marker in the beam path showed no gross dosimetric effect.
Transparent adhesive markers appear to have attenuated radiation dermatitis in these two patients without affecting the SOBP. One patient may have exhibited a dose-response effect. The reproducibility and underlying mechanisms are unclear. However, the potential to leverage this effect to improve proton-related radiation dermatitis in other clinical scenarios is intriguing. Exploratory animal studies are underway.
质子治疗可能导致临床显著的放射性皮炎。在某些临床情况下，如肺癌或乳腺癌，严重放射性皮炎的风险可能会限制束排列和处方剂量。接受前列腺癌质子治疗的患者通常会出现轻度放射性皮炎。在此，我们报告了两名前列腺癌患者的结果，他们的放射性皮炎似乎通过透明膜敷料（Beekley 贴纸）显著减轻。
这是对 2011 年在一家机构接受前列腺癌质子治疗的两名患者的皮肤毒性观察的描述性报告。进行了体模剂量学研究，以评估透明膜敷料对射束扩展布拉格峰（SOBP）的影响。
两名低危前列腺癌患者接受质子治疗，总剂量为 79.2Gy（RBE），分 1.8Gy（RBE）分次，每天使用两个对侧横向射束。两名患者的皮肤上均有小圆形（直径 2.5cm）透明粘性标记物，以协助日常对准。患者 1 在整个治疗过程中双侧均有标记物。患者 2 在一侧放置标记物 3 周，另一侧放置标记物 6 周。在治疗过程中，两名男性的臀部均出现典型的 1 级放射性皮炎（无症状红斑）；然而，在这两名患者中，标记物下方的红斑明显减轻。患者 2 在皮肤覆盖 3 周的部位显示出较小的衰减，因此红斑比皮肤覆盖 6 周的部位更为明显。覆盖和未覆盖皮肤之间的皮肤变化差异至少持续 1 个月。在带有和不带有标记物的双散射射束 SOBP 体模研究中，没有明显的剂量学影响。
透明粘性标记物似乎减轻了这两名患者的放射性皮炎，而不会影响 SOBP。一名患者可能表现出剂量反应效应。这种重复性和潜在机制尚不清楚。然而，利用这种效应改善其他临床情况下质子相关放射性皮炎的潜力是很有吸引力的。正在进行探索性动物研究。
