Herst Patries M, Bennett Noelle C, Sutherland Annie E, Peszynski Ruth I, Paterson Dean B, Jasperse Marieke L
Department of Radiation Therapy, University of Otago, Wellington, New Zealand.
Radiation Oncology Department, Southern Blood and Cancer Centre, Dunedin Hospital, New Zealand.
Radiother Oncol. 2014 Jan;110(1):137-43. doi: 10.1016/j.radonc.2014.01.005. Epub 2014 Jan 30.
Safetac-based soft silicone dressings used in a management setting decrease the severity of radiation-induced acute skin reactions but do not affect moist desquamation rates. Here we investigate the prophylactic use of another Safetac product, Mepitel Film, on moist desquamation rates.
A total of 80 breast cancer patients receiving radiation therapy were recruited between October 2012 and April 2013; 78 participants contributed data for analysis. Lateral and medial halves of the skin areas to be irradiated were randomised to Mepitel Film or aqueous cream; skin dose was measured using thermoluminescent dosimeters; skin reaction severity was assessed using RISRAS and RTOG scales.
Overall skin reaction severity was reduced by 92% (p<0.0001) in favour of Mepitel Film (RISRAS). All patients developed some form of reaction in cream-treated skin which progressed to moist desquamation in 26% of patients (RTOG grades I: 28%; IIA: 46%; IIB: 18%; III: 8%). Only 44% of patients had a skin reaction under the Film, which did not progress to moist desquamation in any of the patients (RTOG grades I: 36%; IIA: 8%).
Mepitel Film completely prevented moist desquamation and reduced skin reaction severity by 92% when used prophylactically in our cohort.
在管理环境中使用的基于Safetac的软硅胶敷料可降低放射性急性皮肤反应的严重程度,但不影响湿性脱屑率。在此,我们研究另一种Safetac产品美皮康银离子抗菌敷料对湿性脱屑率的预防性使用效果。
2012年10月至2013年4月共招募了80例接受放射治疗的乳腺癌患者;78名参与者提供了分析数据。将待照射皮肤区域的外侧和内侧随机分为使用美皮康银离子抗菌敷料或水性乳膏;使用热释光剂量计测量皮肤剂量;使用RISRAS和RTOG量表评估皮肤反应严重程度。
美皮康银离子抗菌敷料组的总体皮肤反应严重程度降低了92%(p<0.0001)(RISRAS)。所有患者在使用乳膏治疗的皮肤中均出现了某种形式的反应,其中26%的患者进展为湿性脱屑(RTOG分级:I级:28%;IIA级:46%;IIB级:18%;III级:8%)。使用敷料的患者中只有44%出现皮肤反应,且无一例进展为湿性脱屑(RTOG分级:I级:36%;IIA级:8%)。
在我们的队列中,美皮康银离子抗菌敷料预防性使用时可完全预防湿性脱屑,并使皮肤反应严重程度降低92%。