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光生物调节疗法治疗放射性皮炎:一家机构对保乳手术后乳腺癌患者辅助放疗的经验

Photobiomodulation therapy for the management of radiation-induced dermatitis : A single-institution experience of adjuvant radiotherapy in breast cancer patients after breast conserving surgery.

作者信息

Strouthos Iosif, Chatzikonstantinou Georgios, Tselis Nikolaos, Bon Dimitra, Karagiannis Efstratios, Zoga Eleni, Ferentinos Konstantinos, Maximenko Julia, Nikolettou-Fischer Vassiliki, Zamboglou Nikolaos

机构信息

Department of Radiation Oncology, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach, Germany.

Department of Radiotherapy and Oncology, Medical Center - Albert Ludwigs University of Freiburg, Robert Koch 3, 79106, Freiburg, Germany.

出版信息

Strahlenther Onkol. 2017 Jun;193(6):491-498. doi: 10.1007/s00066-017-1117-x. Epub 2017 Feb 27.

Abstract

BACKGROUND

Radiation therapy (RT) comprises a key component in the treatment of breast cancer. Radiation-induced skin toxicity is the major adverse event experienced by patients; however, radiodermatitis (RD) prevention and management remains trivial. It is proven that photobiomodulation (PBM) therapy using light-emitting diode (LED) increases wound healing and depicts an anti-inflammatory effect. This single-institute study evaluates the beneficial role of PBM-LED in preventing/reducing RD during breast cancer RT.

PATIENTS AND METHODS

Of 70 consecutively treated patients, 25 patients were treated with PBM-LED twice a week prior to adjuvant 3D conformal RT after breast-conserving surgery. RD was reported using Common Toxicity Criteria for Adverse Events Version 4.0 and pain intensity using a visual analog scale (VAS). For comparison, a control group (n = 45) received RT without PBM-LED. In addition, a "matched" group (n = 25) was generated from the control group based on propensity for potentially confounding variables.

RESULTS

In the PBM group, 22 patients (88%) presented grade 1 and 3 (12%) grade 2 RD. In the control group, 25 patients (55.6%) developed grade 1 reactions, 18 patients (40%) grade 2, and 2 (4.4%) patients grade 3 RD. Concerning pain intensity, 15 patients (60%) of the PBM treatment arm reported no pain, 5 patients (20%) VAS 2, and 5 (20%) VAS 3. In the control group, 13 patients (28.9%) reported no pain, 2 (4.4%) VAS 1, 7 (15.6%) VAS 2, 9 patients (20%) reported VAS 3, 12 (26.7%) patients VAS 4, and 2 (4.4%) patients VAS 5.

CONCLUSION

PBM-LED therapy applied prior to RT might be effective in decreasing the incidence and sequelae of radiation-induced skin toxicity in breast cancer patients treated with breast-conserving surgery.

摘要

背景

放射治疗(RT)是乳腺癌治疗的关键组成部分。放射性皮肤毒性是患者经历的主要不良事件;然而,放射性皮炎(RD)的预防和管理仍然微不足道。事实证明,使用发光二极管(LED)的光生物调节(PBM)疗法可促进伤口愈合并具有抗炎作用。这项单机构研究评估了PBM-LED在预防/减少乳腺癌放疗期间RD方面的有益作用。

患者与方法

在70例连续接受治疗的患者中,25例患者在保乳手术后辅助3D适形放疗前每周接受两次PBM-LED治疗。使用《不良事件通用毒性标准》第4.0版报告RD,并使用视觉模拟量表(VAS)报告疼痛强度。为作比较,对照组(n = 45)接受不使用PBM-LED的放疗。此外,根据潜在混杂变量的倾向从对照组中生成一个“匹配”组(n = 25)。

结果

在PBM组中,22例患者(88%)出现1级RD,3例患者(12%)出现2级RD。在对照组中,25例患者(55.6%)出现1级反应,18例患者(40%)出现2级反应,2例患者(4.4%)出现3级RD。关于疼痛强度,PBM治疗组中有15例患者(60%)报告无疼痛,5例患者(20%)VAS为2,5例患者(20%)VAS为3。在对照组中,13例患者(28.9%)报告无疼痛,2例患者(4.4%)VAS为1,7例患者(15.6%)VAS为2,9例患者(20%)报告VAS为3,12例患者(26.7%)VAS为4,2例患者(4.4%)VAS为5。

结论

放疗前应用PBM-LED疗法可能有效降低保乳手术治疗的乳腺癌患者放射性皮肤毒性的发生率和后遗症。

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