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辅助放疗对乳腺癌伴淋巴水肿风险患者皮肤生物物理特性的影响:一项前瞻性研究。

The effect of adjuvant radiotherapy on skin biophysical properties in patients with breast cancer at risk for breast lymphedema: A prospective study.

机构信息

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Bakırçay University, Izmir, Turkey.

Department of Medical Oncology, Faculty of Medicine, Izmir Bakırçay University, Izmir, Turkey.

出版信息

Clin Physiol Funct Imaging. 2023 Jul;43(4):263-270. doi: 10.1111/cpf.12815. Epub 2023 Mar 2.

Abstract

Breast cancer (BC) is the most common type of cancer among women. Radiotherapy (RT) is one of the main and primary treatment options for BC, especially in breast-conserving surgery (BCS). BC patients who underwent RT experience a wide range of symptoms, in which breast oedema and irritation of the skin take the lion's share. Breast oedema/lymphedema, which is also a prominent side effect after RT should be well determined in earlier settings due to the chronicity of lymphedema. Therefore, this study aimed to analyze the biophysical parameters of skin on the ipsilateral (IL) and contralateral (CL) sites via Tissue dielectric constant (TDC) and Transepidermal water loss (TEWL) methods in terms of oedema and skin barrier function (SBF). The following reference points before and after the RT were measured: (R1: Pectoralis muscle, R2: Upper breast, R3: Lower breast, R4: Lateral site of the thorax). A total of 24 BC patients (mean age and BMI: 52.78 ± 9.85 years and 28.42 ± 5.64 kg/m ) were evaluated. In the IL site, the SBF was not found significant in R1-R3, whereas significantly lower SBF was observed in R4 after RT (t = -3.361, p = 0.003). A significant increase in TDC was observed in R2 at the 5.0 mm depth (t = -2.500, p = 0.02). We suggest that a longer period of follow-up should be carefully carried out to track changes in terms of SBF and oedema in the irradiated breast. The increased need for early detection of changes associated with breast lymphedema can be achievable via noninvasive, safe, cheap, and easily repeatable devices.

摘要

乳腺癌(BC)是女性最常见的癌症类型。放射治疗(RT)是 BC 的主要和首选治疗方法之一,特别是在保乳手术(BCS)中。接受 RT 的 BC 患者会经历各种症状,其中乳房水肿和皮肤刺激占主导地位。乳房水肿/淋巴水肿是 RT 后突出的副作用之一,由于淋巴水肿的慢性,应在早期确定。因此,本研究旨在通过组织介电常数(TDC)和经皮水分流失(TEWL)方法分析同侧(IL)和对侧(CL)部位的皮肤生物物理参数,以评估水肿和皮肤屏障功能(SBF)。在 RT 前后测量以下参考点:(R1:胸大肌,R2:上乳房,R3:下乳房,R4:胸外侧)。共评估了 24 名 BC 患者(平均年龄和 BMI:52.78±9.85 岁和 28.42±5.64 kg/m2)。在 IL 部位,R1-R3 处 SBF 无显著差异,而 RT 后 R4 处 SBF 明显降低(t=-3.361,p=0.003)。在 5.0mm 深度处 R2 处 TDC 显著增加(t=-2.500,p=0.02)。我们建议应仔细进行更长时间的随访,以跟踪照射乳房中 SBF 和水肿的变化。通过非侵入性、安全、廉价且易于重复的设备,可以更早地发现与乳房淋巴水肿相关的变化。

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