a Department of Radiology and Radiation Oncology , University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universität Bonn , Bonn , Germany.
Acta Oncol. 2018 Jul;57(7):908-915. doi: 10.1080/0284186X.2018.1441542. Epub 2018 Feb 20.
Radiation-induced skin injury represents one of the most common side effects in breast cancer patients receiving adjuvant whole-breast radiotherapy. Numerous systemic and topical treatments have been studied in the prevention and management of radiation-induced skin injury without providing sustainable treatment strategies. While superficial barrier-forming skin products such as dressings are the standard of care in wound care management, their utilization as preventive treatment approach in radiotherapy has barely attracted attention.
In this prospective, intra-patient randomized study, Hydrofilm polyurethane film dressings were applied prophylactically to either the medial or lateral breast half of 62 patients with breast cancer undergoing adjuvant radiation therapy following breast conserving surgery. The breast half contralateral to the film dressing was concurrently treated with 5% urea lotion as control skin care. Maximum severity of radiation dermatitis was assessed using RTOG/EORTC toxicity scores, photospectrometric erythema measurements and patient-assessed modified RISRAS scale.
In the Hydrofilm compartments, mean maximum RTOG/EORTC radiation dermatitis severity grades were significantly reduced from 1.33 to 0.35 and photospectrometric measurements showed significantly reduced erythema severity, as compared to the control compartments, with an overall response rate of 89.3%. Hydrofilm completely prevented moist desquamation and significantly reduced patients' subjective experience of itching and pain.
The obtained results along with a favorable cost-benefit ratio and an easy and quick application suggest a prophylactic application of Hydrofilm in adjuvant radiotherapy of breast cancer patients to reduce or even prevent radiation dermatitis.
放射诱导的皮肤损伤是接受辅助全乳放疗的乳腺癌患者最常见的副作用之一。虽然在伤口护理管理中,浅表屏障形成皮肤产品(如敷料)是标准护理,但它们作为放射治疗中的预防治疗方法的应用几乎没有引起关注。
在这项前瞻性、患者内随机研究中,将 Hydrofilm 聚氨酯薄膜敷料预防性地应用于 62 例接受保乳手术后辅助放疗的乳腺癌患者的乳房内侧或外侧半部分。薄膜敷料对侧的乳房半部分同时用 5%尿素乳液作为对照皮肤护理。使用 RTOG/EORTC 毒性评分、光分光光度计红斑测量和患者评估的改良 RISRAS 量表评估最大放射性皮炎严重程度。
在 Hydrofilm 隔室中,与对照隔室相比,平均最大 RTOG/EORTC 放射性皮炎严重程度评分从 1.33 显著降低至 0.35,光分光光度计测量显示红斑严重程度显著降低,总体缓解率为 89.3%。Hydrofilm 完全防止了湿性脱屑,并显著减轻了患者的瘙痒和疼痛的主观体验。
获得的结果以及良好的成本效益比、简便快捷的应用提示预防性应用 Hydrofilm 可减少甚至预防乳腺癌辅助放疗中的放射性皮炎。