Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Department of Radiation Oncology, Jinan Fourth People's Hospital, Jinan, China.
Int J Hyperthermia. 2019;36(1):1160-1167. doi: 10.1080/02656736.2019.1685685.
Radiation skin injury (RSI) causes changes in skin temperature, but detailed information on the thermographic responses is currently lacking. We investigated thermographic patterns after radiotherapy. We hypothesized that skin temperature may be used as a diagnostic and early predictor of RSI severity. All breast cancer patients received radiotherapy after unilateral postmastectomy. The contralateral supraclavicular area served as control, and the frontal thermal image of torso was taken by a thermal infrared imager weekly. We defined areas of interest on bilateral symmetrical supraclavicular area, and analyzed the difference of average and maximum skin temperature (DST and DST) between them. The extent of the weekly variation in DST (DSTW) was calculated using a mathematical formula to represent a trend of skin temperature change. RSI and symptoms related to RSI were scored from baseline to 2 weeks after the end of radiotherapy. Forty-one patients were enrolled in this study. In comparison to the baseline, the DST and DST increased significantly over time during radiotherapy ( .05). The onset of DST increase was accompanied by the onset of radiation dermatitis, and the maximal DST also appeared at the peak of Radiation Therapy Oncology Group (RTOG) and symptom scores. Radiation dose, DST, burning-feeling and pulling were the independent variables affecting RTOG score according to multivariate analysis ( .001 .034 .001 .001). Patients with DSTW>1.223 or DSTW>1.114 in second week showed a late higher dermatitis score (RTOG score ≥2). This study confirmed that RSI was associated with thermographic response. Our results suggested that the follow-up observations of skin temperature during radiotherapy could provide the objective evaluation criteria and prediction methods for RSI.
放射性皮肤损伤（RSI）会导致皮肤温度变化，但目前缺乏有关热成像反应的详细信息。我们研究了放射治疗后的热成像模式。我们假设皮肤温度可以用作 RSI 严重程度的诊断和早期预测指标。所有乳腺癌患者在单侧乳房切除术后均接受放射治疗。对侧锁骨上区域作为对照，每周使用热红外成像仪拍摄躯干正面热图像。我们在双侧对称锁骨上区域定义感兴趣区域，并分析它们之间平均和最大皮肤温度（DST 和 DST）的差异。使用数学公式计算每周 DST 变化程度（DSTW），以表示皮肤温度变化趋势。从基线到放射治疗结束后 2 周，对 RSI 和与 RSI 相关的症状进行评分。本研究共纳入 41 例患者。与基线相比，DST 和 DST 在放射治疗期间随时间显著增加（ .05）。DST 增加的开始伴随着放射性皮炎的开始，最大 DST 也出现在放射治疗肿瘤学组（RTOG）和症状评分的高峰。根据多变量分析，放射剂量、DST、烧灼感和牵拉感是影响 RTOG 评分的独立变量（ .001 .034 .001 .001）。第二周 DSTW>1.223 或 DSTW>1.114 的患者出现晚期更高的皮炎评分（RTOG 评分≥2）。本研究证实 RSI 与热成像反应有关。我们的结果表明，放射治疗期间皮肤温度的随访观察可以为 RSI 提供客观的评估标准和预测方法。
