Kang Hyun-Cheol, Ahn Seung-Do, Choi Doo-Ho, Kang Min Kyu, Chung Woong-Ki, Wu Hong-Gyun
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. ; Department of Radiation Oncology, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea.
Department of Radiation Oncology, Asan Medical Center, Seoul, Korea.
Radiat Oncol J. 2014 Sep;32(3):156-62. doi: 10.3857/roj.2014.32.3.156. Epub 2014 Sep 30.
This study was designed to evaluate the efficacy and safety of topically applied recombinant human epidermal growth factor (rhEGF) for the prevention of radiation-induced dermatitis in cancer patients.
From December 2010 to April 2012, a total of 1,172 cancer patients who received radiotherapy (RT) of more than 50 Gy were prospectively enrolled and treated with EGF-based cream. An acute skin reaction classified according to the Radiation Therapy Oncology Group 6-point rating scale was the primary end point and we also assessed the occurrence of edema, dry skin, or pruritus.
The percentage of radiation dermatitis with maximum grade 0 and grade 1 was 19% and 58% at the time of 50 Gy, and it became 29% and 47% after completion of planned RT. This increment was observed only in breast cancer patients (from 18%/62% to 32%/49%). Adverse events related to the EGF-based cream developed in 49 patients (4%) with mild erythema the most common. Skin toxicity grade >2 was observed in 5% of the patients. Edema, dry skin, and pruritus grade ≥3 developed in 9%, 9%, and 1% of the patients, respectively.
Prophylactic use of an EGF-based cream is effective in preventing radiation dermatitis with tolerable toxicity. Further studies comparing EGF cream with other topical agents may be necessary.
本研究旨在评估局部应用重组人表皮生长因子(rhEGF)预防癌症患者放射性皮炎的疗效和安全性。
2010年12月至2012年4月,前瞻性纳入1172例接受50 Gy以上放疗(RT)的癌症患者,并用含EGF的乳膏进行治疗。根据放射肿瘤学组6分制评分量表分类的急性皮肤反应为主要终点,我们还评估了水肿、皮肤干燥或瘙痒的发生情况。
在50 Gy时,最大分级为0级和1级的放射性皮炎百分比分别为19%和58%,计划放疗结束后变为29%和47%。这种增加仅在乳腺癌患者中观察到(从18%/62%增至32%/49%)。49例患者(4%)出现了与含EGF乳膏相关的不良事件,最常见的是轻度红斑。5%的患者观察到皮肤毒性分级>2级。水肿、皮肤干燥和瘙痒分级≥3级的患者分别占9%、9%和1%。
预防性使用含EGF的乳膏可有效预防放射性皮炎,且毒性可耐受。可能需要进一步开展将EGF乳膏与其他局部用药进行比较的研究。