Department of Nursing, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brazil; Sector of Radiotherapy, Hospital das Clínicas de Botucatu, Botucatu, SP, Brazil.
Sector of Radiotherapy, Hospital das Clínicas de Botucatu, Botucatu, SP, Brazil.
An Bras Dermatol. 2024 Jan-Feb;99(1):57-65. doi: 10.1016/j.abd.2023.01.004. Epub 2023 Aug 30.
One of the main adverse reactions of adjuvant radiotherapy for breast cancer is radiodermatitis.
To assess the incidence of radiodermatitis in women with breast cancer, identify factors associated with its severity and determine the time at which this event occurs.
Prospective cohort study in 113 women with breast cancer who were evaluated before radiotherapy and at every fifth session until the end of treatment. Logistic regression and Cox proportional regression model were used for the assessment of risk factors; P values < 0.05 were considered significant.
The incidence rate of radiodermatitis was 98.2% and it was demonstrated that for each additional point of the Body Mass Index (BMI), the chance of occurrence of grades II to IV radiodermatitis increases by 14% (OR=1.14 [95% CI 1.04-1.26]; p=0.004) and statin use increases the risk of more severe skin lesions by four-fold (OR=4.27 [95% CI 1.11-16.42]; p=0.035). The exclusive use of hydrogel for skin hydration was an independent factor in delaying the onset of radiodermatitis (HR=0.55 [95% CI 0.36-0.82]; p=0.004).
The main limitation of this study was its external validity. The identified factors should be considered for services and populations similar to those in this study.
There was a high incidence of radiodermatitis and its severity was related to higher BMI, statin use; there was a protective effect of hydrogel use.
乳腺癌辅助放疗的主要不良反应之一是放射性皮炎。
评估乳腺癌女性放射性皮炎的发生率,确定与严重程度相关的因素,并确定该事件发生的时间。
对 113 例接受放疗的乳腺癌患者进行前瞻性队列研究,在放疗前和每五次治疗后进行评估。采用逻辑回归和 Cox 比例风险回归模型评估危险因素;P 值<0.05 为差异有统计学意义。
放射性皮炎的发生率为 98.2%,结果表明,BMI 每增加 1 分,发生 2 至 4 级放射性皮炎的几率增加 14%(OR=1.14 [95%CI 1.04-1.26];p=0.004),他汀类药物的使用使皮肤损伤更严重的风险增加 4 倍(OR=4.27 [95%CI 1.11-16.42];p=0.035)。单独使用水凝胶进行皮肤保湿是延迟放射性皮炎发生的独立因素(HR=0.55 [95%CI 0.36-0.82];p=0.004)。
本研究的主要局限性在于其外部有效性。在类似本研究的服务和人群中,应考虑确定的因素。
放射性皮炎的发生率较高,其严重程度与 BMI 较高、使用他汀类药物有关;使用水凝胶有保护作用。