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预防性应用薄膜敷料减少乳腺癌患者放疗引起的皮肤反应:系统评价。

Decrease of radiation-induced skin reactions in breast cancer patients by preventive application of film dressings-a systematic review.

机构信息

Department of Radiation Oncology, Ortenau Klinikum Offenburg-Kehl, Academic Teaching Hospital of the Albert Ludwig University of Freiburg, Weingartenstraße 70, 77654, Offenburg, Germany.

出版信息

Strahlenther Onkol. 2024 Feb;200(2):109-122. doi: 10.1007/s00066-023-02151-0. Epub 2023 Sep 27.

Abstract

PURPOSE

Radiation-induced skin reactions remain one of the most frequent side effects of adjuvant radiotherapy for breast cancer, which is the most common global malignancy. In individual cases, we observed a decrease in radiation dermatitis under film dressings used for skin marking purposes. Therefore, we decided to revise the available evidence regarding the prophylactic use of film dressings to reduce radiation dermatitis in breast cancer patients.

METHODS

On 20 March 2023, we conducted a systematic review of literature for randomized controlled trials published in the English, German, French, or Spanish language, available in the PubMed database.

RESULTS

Of 82 publications, 9 full texts were assessed and 6 randomized controlled trials were included in the final synthesis. Two trials analyzed the application of polyurethane film (Hydrofilm, Paul Hartmann AG, Heidenheim, Germany), the other four of silicone-based polyurethane film (Mepitel film, Molnlycke Health Care Limited, Milton Keynes, United Kingdom). The evaluation scales Common Terminology Criteria for Adverse Events (CTCAE), Radiation Therapy Oncology Group (RTOG), and the Radiation-Induced Skin Reaction Assessment Scale (RISRAS) were used for assessment. All six trials, with a total of 788 patients yielding data for analysis, demonstrate a significant decrease in radiation-induced skin reactions by use of the film (mainly p < 0.001).

CONCLUSION

Our analysis demonstrates a significant decrease in radiation-induced skin reactions by prophylactically applied film dressings in breast cancer patients. Consequent preventive use of film dressings might systematically reduce acute radiation-induced skin reactions in these patients.

摘要

目的

放射诱导的皮肤反应仍然是乳腺癌辅助放疗最常见的副作用之一,乳腺癌是全球最常见的恶性肿瘤。在个别情况下,我们观察到在用于皮肤标记的膜敷料下,放射性皮炎的发生率有所下降。因此,我们决定重新评估膜敷料预防应用以减少乳腺癌患者放射性皮炎的现有证据。

方法

2023 年 3 月 20 日,我们对发表在英语、德语、法语或西班牙语的 Pubmed 数据库中的随机对照试验进行了系统的文献回顾。

结果

在 82 篇出版物中,评估了 9 篇全文,并纳入了 6 项随机对照试验进行最终综合分析。两项试验分析了聚氨酯膜(Hydrofilm,Paul Hartmann AG,Heidenheim,德国)的应用,另外四项则分析了基于硅酮的聚氨酯膜(Mepitel 膜,Molnlycke Health Care Limited,Milton Keynes,英国)。使用常见不良事件术语标准(CTCAE)、放射治疗肿瘤学组(RTOG)和放射诱导皮肤反应评估量表(RISRAS)进行评估。这六项试验共有 788 名患者的数据可用于分析,均表明膜的预防性应用可显著降低放射性皮肤反应(主要是 p < 0.001)。

结论

我们的分析表明,乳腺癌患者预防性应用膜敷料可显著降低放射诱导的皮肤反应。因此,在这些患者中系统地使用膜敷料预防可能会降低急性放射诱导的皮肤反应。

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