全乳放疗后皮脂腺损伤和保湿剂疗效的随机对照研究。
Damage to sebaceous gland and the efficacy of moisturizer after whole breast radiotherapy: a randomized controlled trial.
机构信息
Department of Radiation Oncology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.
Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyoku, Tokyo, 113-8655, Japan.
出版信息
BMC Cancer. 2019 Feb 7;19(1):125. doi: 10.1186/s12885-019-5334-9.
BACKGROUND
We conducted a randomized trial to evaluate the efficacy of heparinoid moisturization for radiation dermatitis. We report the time-course of sebum content after whole breast radiotherapy (WBRT) and the efficacy of heparinoid moisturizer.
METHODS
Patients receiving adjuvant breast RT were randomly assigned into three groups; prophylaxis, post-WBRT and control groups. Patients used moisturizer on the irradiated breast from the beginning of RT in the prophylaxis group, 2 weeks post-RT in the post-WBRT group, and no moisturizer in the control group. Sebum content of the irradiated and non-irradiated breast was measured to assess sebaceous gland damage. Sebum composition was also analyzed.
RESULTS
A total of 76 patients were analyzed; 30 in the post-WBRT group, 32 in the control group, 14 in the prophylaxis group. The sebum content in the irradiated breast significantly decreased after WBRT in the post-WBRT and control groups. The decrease was sustained in the control group. In the non-irradiated breast, sebum content also decreased after WBRT in the post-WBRT and control groups. After moisturizer application, sebum content by sebumeter returned to pre-RT level in the post-WBRT group, while the decrease was sustained in the control group. Sebum content measured by evaporative light scattering detector and sebumeter was similar in the control group, but the dissociation was observed after moisturizer application in the post-WBRT group. The proportion of wax esters decreased in the irradiated breast after WBRT.
CONCLUSIONS
Radiotherapy significantly reduced sebum content in both irradiated and non-irradiated breast, indicating that RT caused quantifiably persistent sebaceous gland damage in irradiated sites and the surrounding tissue. Combined with the results from our previous study, heparinoid moisturizer treatment effectively prevents water loss by retaining oil contents on the skin surface.
TRIAL REGISTRATION
UMIN, UMIN000005532 . Registered 1 April 2011.
背景
我们进行了一项随机试验，以评估肝素类保湿剂预防放射性皮炎的疗效。我们报告全乳放疗（WBRT）后皮脂含量的时间过程以及肝素类保湿剂的疗效。
方法
接受辅助乳房放疗的患者被随机分为三组；预防组、WBRT 后组和对照组。预防组从放疗开始时就在照射乳房上使用保湿剂，WBRT 后 2 周在 WBRT 后组使用，对照组则不使用保湿剂。测量照射和未照射乳房的皮脂含量以评估皮脂腺损伤。还分析了皮脂成分。
结果
共分析了 76 例患者；WBRT 后组 30 例，对照组 32 例，预防组 14 例。WBRT 后照射和对照组的照射乳房皮脂含量明显减少。对照组的减少持续存在。在未照射的乳房中，WBRT 后照射和对照组的皮脂含量也减少。应用保湿剂后，WBRT 后组皮脂计的皮脂含量恢复到放疗前水平，而对照组则持续减少。对照组皮脂计和蒸发光散射探测器测量的皮脂含量相似，但 WBRT 后组应用保湿剂后出现了分离。WBRT 后照射侧的蜡酯比例降低。
结论
放疗显著降低了照射和未照射乳房的皮脂含量，表明放疗导致照射部位和周围组织的皮脂腺受到可量化的持续性损伤。结合我们之前的研究结果，肝素类保湿剂治疗通过保留皮肤表面的油分，有效地防止水分流失。
试验注册
UMIN，UMIN000005532。于 2011 年 4 月 1 日注册。
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