Department of Radiation Oncology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.
Department of Radiation Oncology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.
J Med Imaging Radiat Sci. 2024 Jun;55(2):289-296. doi: 10.1016/j.jmir.2024.03.049. Epub 2024 Apr 26.
This study aimed to further understand the psychological distress associated with skin marking during radiotherapy among patients with breast cancer. The potential benefits of skin mark-free radiotherapy were also explored.
The study population included female breast cancer patients scheduled for radiation therapy and skin marking. A 12-item survey was administered, encompassing demographics (age, treatment site and mode, and duration of hospital visits), awareness of skin marking, stress induced by skin marking in various life contexts, and perceived advantages of a skin mark-free alternative. Responses were recorded on a 5-point Likert scale.
The survey was completed by 107 patients, of whom 90 (84%) underwent whole breast irradiation, 15 (14%) received breast/chest wall and supraclavicular lymph node irradiation, and 2 (2%) were unspecified. The common sources of stress were from the presence of skin markings (33%), bathing (41%), clothing selection (25%), and skincare (30%), whereas 17 patients (16%) were not stressed by any of those factors. Meanwhile, 73% of patients reported taking precautions to prevent the skin marks from fading. Most patients (63%, n = 76) expressed preference for a skin mark-free radiotherapy option, with many willing to spend extra finances and time for this.
A significant proportion of female breast cancer patients experience stress from skin markings in various aspects of their daily lives. A preference for skin mark-free radiotherapy was noted among many patients, that next-generation technologies, such as surface-guided radiotherapy, could alleviate patient stress.
The need for permanent or temporary skin markings in the era of state-of-the-art imaging technology should be reconsidered.
本研究旨在进一步了解乳腺癌患者放射治疗期间皮肤标记相关的心理困扰，并探讨无皮肤标记放射治疗的潜在益处。
研究对象为计划接受放射治疗和皮肤标记的女性乳腺癌患者。采用包含人口统计学信息（年龄、治疗部位和方式、住院访视次数）、对皮肤标记的认知、不同生活情境下皮肤标记引起的压力，以及对无皮肤标记替代方案的感知优势等 12 项内容的问卷进行调查，答案采用 5 级 Likert 量表记录。
共 107 例患者完成了问卷调查，其中 90 例（84%）接受全乳照射，15 例（14%）接受乳房/胸壁和锁骨上淋巴结照射，2 例（2%）不详。常见的压力源包括皮肤标记的存在（33%）、洗澡（41%）、衣物选择（25%）和皮肤护理（30%），而 17 例（16%）患者不受这些因素中的任何一种影响。同时，73%的患者表示会采取预防措施防止皮肤标记褪色。大多数患者（63%，n=76）表示更喜欢无皮肤标记的放射治疗选择，许多患者愿意为此花费额外的金钱和时间。
相当一部分女性乳腺癌患者在日常生活的各个方面都会因皮肤标记而感到压力。许多患者倾向于选择无皮肤标记的放射治疗，下一代技术，如表面引导放射治疗，可能会减轻患者的压力。
在现代成像技术时代，永久性或临时性皮肤标记的必要性值得重新考虑。
