Department of Oncology, Karolinska University Hospital, 171 76 Stockholm, Sweden; Department of Learning, Informatics, Management and Education, Karolinska Institutet, 171 77 Stockholm, Sweden.
Breast. 2013 Oct;22(5):634-8. doi: 10.1016/j.breast.2013.07.047. Epub 2013 Aug 13.
Risk factors for severe acute radiation skin reactions (ARSR) have been described with conflicting results. The aim of this study was to identify risk factors for the development of severe ARSR in women undergoing adjuvant radiotherapy (RT) for breast cancer. 390 women were assessed at the first and final RT sessions and at followup. ARSR were measured by the Radiation Therapy Oncology Group/The Organization for Research and Treatment of Cancer, Acute Radiation Morbidity Scoring Criteria (RTOG/EORTC scale). Patients reported symptoms using visual analogue scale (VAS). Health related quality of life was assessed by EORTC QLQ-C30 and sleep disturbances by the MOS-Sleep questionnaire. Clinical data included smoking status (carbon monoxide in expired air), body mass index (BMI) and treatment data. RT dose, ≥ 50 Gy (mean difference 1.9 CI: 1.0 to 3.5, p = 0.040), high BMI (mean difference 4.3 CI: 2.2 to 8.3, p < 0.001) and smoking (mean difference 2.5 CI. 1.1 to 5.7, p = 0.027) were the factors strongest related to severe ARSR. Patients' with severe ARSR reported higher levels of pain and increased sleeping problems. To stop smoking during RT is the best decision patients can make to reduce the risk for severe ARSR since smoking is an independent risk factor.
严重急性放射性皮肤反应（ARSR）的危险因素已有描述，但结果相互矛盾。本研究旨在确定接受乳腺癌辅助放疗（RT）的女性发生严重 ARSR 的危险因素。在第一次和最后一次 RT 治疗时以及随访时对 390 名女性进行了评估。ARSR 通过放射治疗肿瘤学组/欧洲癌症研究与治疗组织急性放射损伤评分标准（RTOG/EORTC 量表）进行测量。患者使用视觉模拟量表（VAS）报告症状。使用 EORTC QLQ-C30 评估健康相关生活质量，使用 MOS 睡眠问卷评估睡眠障碍。临床数据包括吸烟状况（呼出空气中的一氧化碳）、体重指数（BMI）和治疗数据。RT 剂量、≥50 Gy（平均差异 1.9 CI：1.0 至 3.5，p = 0.040）、高 BMI（平均差异 4.3 CI：2.2 至 8.3，p < 0.001）和吸烟（平均差异 2.5 CI：1.1 至 5.7，p = 0.027）是与严重 ARSR 最相关的因素。报告严重 ARSR 的患者报告疼痛水平更高，睡眠问题增加。在 RT 期间戒烟是患者降低严重 ARSR 风险的最佳决策，因为吸烟是一个独立的危险因素。
