Sekiguchi Kenji, Akahane Keiko, Ogita Mami, Haga Chiori, Ito Ryoko, Arai Satoru, Ishida Yasushi, Tsukada Yoichiro, Kawamori Jiro
Department of Radiation Oncology, St. Luke's International Hospital.
Department of Radiation Oncology, Sonoda-kai Radiation Oncology Clinic, Tokyo.
Jpn J Clin Oncol. 2018 May 1;48(5):450-457. doi: 10.1093/jjco/hyy045.
The application of heparinoid moisturizer for 2 weeks following whole-breast radiotherapy (WBRT) was previously reported to significantly increase skin water content (WC) and help improve skin dryness and desquamation. The prospective open-label, randomized trial included an exploratory arm to investigate the preventive efficacy of heparinoid moisturizer for acute radiation dermatitis (ARD).
Between April 2011 and April 2013, patients receiving WBRT were assigned (1:2:2) to receive either: moisturizer for prophylaxis (group P), moisturizer starting 2 weeks after WBRT for treatment (group M), and no moisturizer (group C). This paper presents the results of comparison between the exploratory arm and no moisturizer group. Skin WC was measured prior to WBRT, on the last day of WBRT, and 2 weeks, 4 weeks and 3 months following WBRT. Signs and symptoms were also assessed.
Comparing two groups, WC values were significantly higher in group P until 4 weeks following WBRT. At 2 weeks following WBRT, mean WC values in group P and C were 38.5 ± 6.1 arbitrary units (a.u.) and 30.2 ± 7.8 a.u., respectively (P < 0.001). In group C, dryness was more severe at 2 and 4 weeks following WBRT and desquamation more severe until 3 months following WBRT. However, the erythema score showed no difference between the two groups. Regarding symptoms, group C pain scores on the last day of WBRT were significantly higher than in group P (P < 0.030).
The preventive application of heparinoid moisturizer has the potential of reducing skin desquamation and dryness in patients receiving WBRT.
先前有报道称,在全乳放疗(WBRT)后应用类肝素保湿剂2周可显著增加皮肤含水量(WC),并有助于改善皮肤干燥和脱屑情况。这项前瞻性开放标签随机试验包括一个探索性组,以研究类肝素保湿剂对急性放射性皮炎(ARD)的预防效果。
在2011年4月至2013年4月期间,接受WBRT的患者按1:2:2分配,分别接受以下治疗:预防性使用保湿剂(P组)、WBRT后2周开始使用保湿剂进行治疗(M组)以及不使用保湿剂(C组)。本文展示了探索性组与不使用保湿剂组之间的比较结果。在WBRT前、WBRT最后一天以及WBRT后2周、4周和3个月测量皮肤WC。同时也对体征和症状进行了评估。
两组比较,在WBRT后4周内,P组的WC值显著更高。WBRT后2周时,P组和C组的平均WC值分别为38.5±6.1任意单位(a.u.)和30.2±7.8 a.u.(P<0.001)。在C组,WBRT后2周和4周时干燥情况更严重,脱屑情况在WBRT后3个月内更严重。然而,两组之间的红斑评分没有差异。关于症状,WBRT最后一天C组的疼痛评分显著高于P组(P<0.030)。
预防性应用类肝素保湿剂有可能减少接受WBRT患者的皮肤脱屑和干燥情况。