Berger Antoine, Regueiro Carlos, Hijal Tarek, Pasquier David, De La Fuente Cristina, Le Tinier Florence, Coche-Dequeant Bernard, Lartigau Eric, Moyal Dominique, Seité Sophie, Bensadoun René-Jean
CHU de Poitiers, Poitiers, France.
Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
Breast Cancer (Auckl). 2018 Jan 23;12:1178223417752772. doi: 10.1177/1178223417752772. eCollection 2018.
As many as 50% of patients with cancer develop acute skin reactions to some degree with radiotherapy. Proactive skin care is often recommended to minimise these skin reactions and maintain the integrity of the epidermal barrier; nevertheless, no consensual guidelines are systematically used. This multicentre, observational, prospective study evaluated the tolerability and benefit of supportive and barrier protective skin care products in preventing radiotherapy-induced skin reactions in 253 women initiating radiotherapy (exclusive or adjuvant) for breast cancer.
Patients received a kit of 5 commercially available skin care products before the first radiotherapy treatment. The following variables were assessed: cutaneous adverse events, investigator-assessed skin reactions (oedema, erythema, dryness, desquamation) before and after radiotherapy course, investigator, and patient opinion on products benefit. Results were analysed by frequency of product use (heavy versus low).
Average age was 60 years (range: 34-85). Over 92% of patients reported good to excellent tolerance on irradiated skin for each product. During the 6-week radiotherapy period, we observed that heavy product users had less skin reactions than the low users, particularly within 10 days of radiotherapy initiation (8% versus 18%; = .031). Positive physician's opinion on product use was more frequent for high (66.6%) versus low (32%) users. Patient-assessed patient benefit index was generally >1, indicating relevant treatment benefit, with a tendency for better benefit in high versus low users.
These results support recommendations to use skin care products to minimise the impact of secondary cutaneous reactions with radiotherapy cancer treatment.
多达50%的癌症患者在放疗过程中会出现不同程度的急性皮肤反应。通常建议采取积极的皮肤护理措施,以尽量减少这些皮肤反应并维持表皮屏障的完整性;然而,目前尚未系统地采用统一的指导方针。这项多中心、观察性、前瞻性研究评估了支持性和屏障保护性皮肤护理产品在预防253名开始接受乳腺癌放疗(根治性或辅助性)的女性患者放疗引起的皮肤反应方面的耐受性和益处。
患者在首次放疗前收到一套包含5种市售皮肤护理产品的套装。评估以下变量:皮肤不良事件、放疗疗程前后由研究者评估的皮肤反应(水肿、红斑、干燥、脱屑)、研究者及患者对产品益处的看法。根据产品使用频率(高与低)对结果进行分析。
平均年龄为60岁(范围:34 - 85岁)。超过92%的患者报告每种产品在照射皮肤上的耐受性良好至极佳。在6周的放疗期间,我们观察到频繁使用产品的患者皮肤反应比使用频率低的患者少,尤其是在放疗开始后的10天内(8%对18%;P = 0.031)。频繁使用产品的患者中,医生对产品使用持积极看法的比例更高(66.6%),而使用频率低的患者中这一比例为32%。患者评估的患者受益指数通常>1,表明有相关治疗益处,且频繁使用产品的患者比使用频率低的患者有更好益处的趋势。
这些结果支持使用皮肤护理产品以尽量减少放疗癌症治疗引起的继发性皮肤反应影响的建议。