Kondziołka Joanna, Wilczyński Sławomir, Michalecki Łukasz
Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland.
University Clinical Center of the Medical University of Silesia, Katowice, Poland.
Clin Cosmet Investig Dermatol. 2022 Apr 22;15:725-733. doi: 10.2147/CCID.S354320. eCollection 2022.
More than 95% of patients who undergo radiotherapy report symptoms of radiation dermatitis, which is a side effect of this therapy. Erythema, edema, dry and moist desquamation intensify with each fraction of irradiation and can significantly reduce a patient's quality of life. Therefore, an effective skin care procedure is needed for skin that has been exposed to ionizing radiation in order to avoid unplanned treatment interruptions. The methods that are currently used to assess the severity of an acute radiation reaction are based on visual scales (RTOG, EORTC, NCI CTCAE, LENT-SOMA). Because the assessment is made subjectively, the results depend on the researchers, their experience and perceptiveness. Until now, several studies have been carried out to check the possibility of using an objective methods like hyperspectral imaging, thermal imaging, laser Doppler flowmetry, dielectric and electrochemical methods, reflection spectrophotometry and Courage-Khazaka Multi-skin instrument to radiation-induced dermatitis assessment. Unfortunately, due to various limitations that occurred in the research, none of these techniques was successfully implement as alternative for visual assessment. The continuous development of technology enables researchers to access new techniques that might constitute useful diagnostic and cognitive tools. Infrared thermal imaging, hyperspectral imaging and reflectance spectroscopy are examples of the visual techniques that have been used for many years in various fields of medicine, including dermatology and chronic wound or burn care. They provide information on the skin parameters, such as the temperature, concentration and distribution of chromophores (eg, hemoglobin and melanin), saturation or perfusion changes. The aim of this study is to review the available literature on the use of imaging methods in the clinical assessment of skin with lesions of various origins, evaluation of their suitability for the assessment of radiation reaction and consideration the possibility of creating a quantitative scale for assessing severity of acute radiation dermatitis.
接受放射治疗的患者中，超过95%会出现放射性皮炎症状，这是该治疗的一种副作用。红斑、水肿、干性和湿性脱屑会随着每次照射而加剧，并会显著降低患者的生活质量。因此，对于暴露于电离辐射的皮肤，需要一种有效的皮肤护理程序，以避免计划外的治疗中断。目前用于评估急性放射反应严重程度的方法是基于视觉量表（RTOG、EORTC、NCI CTCAE、LENT-SOMA）。由于评估是主观进行的，结果取决于研究人员、他们的经验和洞察力。到目前为止，已经进行了几项研究，以检验使用高光谱成像、热成像、激光多普勒血流仪、介电和电化学方法、反射分光光度法以及Courage-Khazaka多皮肤仪等客观方法评估放射性皮炎的可能性。不幸的是，由于研究中出现的各种局限性，这些技术都没有成功地作为视觉评估的替代方法实施。技术的不断发展使研究人员能够获得可能构成有用诊断和认知工具的新技术。红外热成像、高光谱成像和反射光谱是在包括皮肤病学、慢性伤口或烧伤护理在内的医学各个领域已经使用多年的视觉技术的例子。它们提供有关皮肤参数的信息，如温度、发色团（如血红蛋白和黑色素）的浓度和分布、饱和度或灌注变化。本研究的目的是回顾关于成像方法在临床评估各种起源病变皮肤中的应用的现有文献，评估它们对放射反应评估的适用性，并考虑创建一个评估急性放射性皮炎严重程度的定量量表的可能性。
