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放射性皮炎研究与临床护理的新测量方法:一项试点及可行性研究。

Novel measurements for radiodermatitis research and clinical care: A pilot and feasibility study.

作者信息

Beamer Laura Curr

机构信息

School of Nursing, Northern Illinois University, DeKalb, IL, USA; College of Nursing, University of Utah, Salt Lake City, UT, USA.

出版信息

Eur J Oncol Nurs. 2019 Apr;39:62-69. doi: 10.1016/j.ejon.2019.01.003. Epub 2019 Jan 16.

Abstract

PURPOSE

The role of clinician-measured breast length and bra cup size in the development of radiodermatitis over time and the efficacy of using multiple measurements of skin toxicity during radiotherapy were piloted. The feasibility of measures to be used in a larger future study was assessed.

METHODS AND MATERIALS

Participants included women receiving normofractionated or accelerated external breast radiotherapy provided in the supine position using 3-dimensional conformal techniques at a US community cancer center. Acute skin toxicity was assessed using the RTOG scale in 7 areas within the treatment field across 6 timepoints. The total score for the 7 areas was calculated each week. Breast length was measured, examined as an acute radiodermatitis risk factor, and compared against reported bra cup size. RM-ANOVAs examined radiodermatitis using maximum skin toxicity and 7 sites in the radiotherapy field over 6 timepoints. Correlation was implemented to explore the relationship between study variables.

RESULTS

Forty women consented to this study. Increase in breast length significantly correlated with increase in maximum RTOG score (p = .04); increased RTOG score in the upper medial breast quadrant (p = .04), upper lateral quadrant (p = .02), lower lateral quadrant (p = .02), inframammary fold (p = .001); with increasing BMI (p = .002) and bra cup size (p = .0003). The clinician-measured breast lengths and participant-reported bra cup sizes were discordant. Participants completed all measures and measurements including breast length.

CONCLUSIONS

Our results suggest that measuring breast length and assessing radiodermatitis in multiple areas of the treatment field is feasible. These measures may increase the sensitivity of skin toxicity assessment.

摘要

目的

初步探讨临床医生测量的乳房长度和胸罩罩杯尺寸随时间推移在放射性皮炎发生发展中的作用,以及放疗期间多次测量皮肤毒性的疗效。评估了在未来更大规模研究中使用这些测量方法的可行性。

方法和材料

研究对象包括在美国一家社区癌症中心接受常规分割或加速外照射乳房放疗的女性,放疗采用三维适形技术,患者取仰卧位。在6个时间点,使用RTOG量表对治疗区域内的7个部位进行急性皮肤毒性评估。每周计算这7个部位的总分。测量乳房长度,将其作为急性放射性皮炎的危险因素进行检查,并与报告的胸罩罩杯尺寸进行比较。重复测量方差分析使用最大皮肤毒性和放疗区域内的7个部位,在6个时间点对放射性皮炎进行评估。采用相关性分析来探索研究变量之间的关系。

结果

40名女性同意参与本研究。乳房长度增加与最大RTOG评分增加显著相关(p = 0.04);乳房上内侧象限(p = 0.04)、上外侧象限(p = 0.02)、下外侧象限(p = 0.02)、乳房下皱襞(p = 0.001)的RTOG评分增加;与体重指数增加(p = 0.002)和胸罩罩杯尺寸增加(p = 0.0003)相关。临床医生测量的乳房长度与参与者报告的胸罩罩杯尺寸不一致。参与者完成了所有测量,包括乳房长度测量。

结论

我们的结果表明,测量乳房长度并在治疗区域的多个部位评估放射性皮炎是可行的。这些测量方法可能会提高皮肤毒性评估的敏感性。

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