Department of Oncology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan Province; Hubei Key Laboratory of Tumour Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China.
Hubei Key Laboratory of Tumour Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China.
J Cancer Res Ther. 2022 Dec;18(7):1903-1909. doi: 10.4103/jcrt.jcrt_1203_22.
To investigate the incidence and influencing factors of acute radiation dermatitis (ARD) induced by radiotherapy in postoperative patients with breast cancer.
A retrospective analysis was conducted on 598 patients with breast cancer who received postoperative radiotherapy from November 18, 2014 to September 14, 2019. The radiotherapy technology included two-dimensional radiotherapy, three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and tomotherapy. The occurrence of ARD in patients was then followed up and recorded. The independent risk factors for radiation-induced dermatitis were analyzed by using an orderly logistic regression model.
Of the 598 patients, 431 had mild skin reactions, including pigmentation and dry desquamation (grade 1), 151 developed wet desquamation and tender erythema (grade 2), and 16 had severe skin reactions, including flaky wet scaling and erosion (grade 3). There were no grade 4 skin reactions. The severity of ARD was independent of the following factors: Age, diabetes, allergy, quadrant, pathological type, the clinical stage, the tumor stage, triple-negative breast cancer, ki-67 expression, adjuvant chemotherapy, endocrine therapy, targeted therapy, radiotherapy area, and boost irradiation. However, it was found to be dependent on the body mass index, surgery type, radiotherapy technique, node stage, and the prophylactic use of topical agents.
ARD in response to postoperative radiotherapy in patients with breast cancer is common and mild. Clinicians and patients need to cultivate awareness of the potential risk factors involved and then intervene to alleviate skin reactions and improve the quality of life.
调查乳腺癌术后患者放疗引起急性放射性皮炎（ARD）的发生率及影响因素。
回顾性分析 2014 年 11 月 18 日至 2019 年 9 月 14 日接受术后放疗的 598 例乳腺癌患者。放疗技术包括二维放疗、三维适形放疗、调强放疗和托姆放疗。然后对患者的 ARD 发生情况进行随访和记录。采用有序逻辑回归模型分析放射性皮炎的独立危险因素。
598 例患者中，431 例出现轻度皮肤反应，包括色素沉着和干性脱屑（1 级），151 例出现湿性脱屑和红斑（2 级），16 例出现严重皮肤反应，包括片状湿性脱屑和糜烂（3 级）。无 4 级皮肤反应。ARD 的严重程度与以下因素无关：年龄、糖尿病、过敏、象限、病理类型、临床分期、肿瘤分期、三阴性乳腺癌、Ki-67 表达、辅助化疗、内分泌治疗、靶向治疗、放疗区域和加量照射。然而，它与体重指数、手术类型、放疗技术、淋巴结分期和预防性使用局部药物有关。
乳腺癌术后放疗后 ARD 较为常见且轻微。临床医生和患者需要认识到潜在的危险因素，并进行干预以减轻皮肤反应，提高生活质量。
