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Tsai PC, Liu YC, Li TS, Hsu FT, Lee YH, Chiang IT, Chang Y, Lee CH. Clinical Effect of Moisturized Skin Care on Radiation Dermatitis of Head and Neck Cancer. In Vivo 2023; 37:2776-2785. [PMID: 37905662 PMCID: PMC10621431 DOI: 10.21873/invivo.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND/AIM Radiation therapy (RT) for head and neck cancer may cause severe radiation dermatitis (RD) resulting in RT interruption and affecting disease control. A few studies address skin moisture changes during RT for head and neck cancer. The purpose of this study was to explore the effect of moisturized skin care (MSC) on severity of RD. PATIENTS AND METHODS The study includes newly diagnosed head and neck cancer patients undergoing RT. Participants were divided into MSC group and routine skin care (RSC) group based on patient's preferred decision. Skin moisture in the four quadrants of the neck was measured weekly before and after RT. RD was assessed with the Radiation Induced Skin Reaction Assessment Scale (RISRAS) and the Radiation Therapy Oncology Group (RTOG) acute skin toxicity grading criteria. RESULTS A total of 54 patients were enrolled, of which 49 patients were suitable for the statistical analysis. There was a statistically significant difference in the RISRAS total score since the 5th week after RT between the groups. The severity of RD was less (B=0.814, p=0.021) and the onset was later (B=-0.384, p=0.006) in the MSC group when compared to the RSC group. Skin moisture decreased with cumulative radiation dose. In the upper neck, the MSC group had a slower rate of skin moisture decrease compared to the RSC group (right upper neck: B=0.935, p=0.007; left upper neck: B=0.93, p=0.018). CONCLUSION MSC can effectively reduce the severity and delay the onset of RD, while slows down skin moisture decrease during RT.
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Affiliation(s)
- Pei-Chuan Tsai
- Center of Hyperbaric Oxygen Center and Wound Care, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan, R.O.C
- Department of Nursing Chung Shan Medical University, Taichung, Taiwan, R.O.C
| | - Yu-Chang Liu
- Department of Radiation Oncology, Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan, R.O.C
- Department of Radiation Oncology, Show Chwan Memorial Hospital, Changhua, Taiwan, R.O.C
- Department of Medical Imaging and Radiologic Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan, R.O.C
| | - Tzong Shiun Li
- Department of Plastic Surgery, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan, R.O.C
- Innovation Research Center, Show Chwan Health Care System, Changhua, Taiwan, R.O.C
| | - Fei-Ting Hsu
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan, R.O.C
| | - Yuan-Hao Lee
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan, R.O.C
| | - I-Tsang Chiang
- Department of Radiation Oncology, Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan, R.O.C
- Department of Radiation Oncology, Show Chwan Memorial Hospital, Changhua, Taiwan, R.O.C
- Department of Medical Imaging and Radiologic Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan, R.O.C
- Medical Administrative Center, Show Chwan Memorial Hospital, Changhua, Taiwan, R.O.C
| | - Yuan Chang
- Department of Radiology, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan, R.O.C
| | - Chiu-Hsiang Lee
- Department of Nursing Chung Shan Medical University, Taichung, Taiwan, R.O.C.;
- Department of Nursing Chung Shan Medical University Hospital, Taichung, Taiwan, R.O.C
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Guberti M, Schiroli D, Marraccini C, Mazza G, Iotti C, Baricchi R, Iotti B, Merolle L. Homologous platelet gel on radiation-induced dermatitis in a patient receiving head and neck radiotherapy plus cetuximab: A case report. Medicine (Baltimore) 2023; 102:e34779. [PMID: 37653754 PMCID: PMC10470763 DOI: 10.1097/md.0000000000034779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION Acute radiodermatitis is a significant complication of cancer radiotherapy, and platelet-based therapies are emerging as potential new treatments. MAIN SYMPTOMS AND IMPORTANT CLINICAL FINDINGS In this report, we present the case of a patient with head and neck cancer undergoing radiotherapy combined with the monoclonal antibody cetuximab. After 4 weeks of this treatment, the patient developed cutaneous radiation dermatitis. Despite receiving standard treatment with corticosteroids and emollient cream, the lesion did not improve. MAIN DIAGNOSIS cutaneous radiation dermatitis on head and neck cancer patient. THERAPEUTIC INTERVENTIONS Topical application of platelet gel was initiated on the wound. From the second week of radiotherapy to the 4th week, homologous platelet-rich plasma was applied on the dermatitis using a bandage, 4 times a day. OUTCOMES The topical treatment with homologous platelet gel resulted in complete healing of the radiodermatitis, including restoration of the epidermis, reepithelialization, and reduction in associated pain. CONCLUSION homologous platelet gel might be an alternative to standard treatment of radiation dermatitis.
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Affiliation(s)
- Monica Guberti
- Nursing Research and EBP Unit – Health Professions Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Davide Schiroli
- Transfusion Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Marraccini
- Transfusion Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Genny Mazza
- Oncology Day Care Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cinzia Iotti
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Roberto Baricchi
- Transfusion Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Barbara Iotti
- Transfusion Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Merolle
- Transfusion Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Luu Y, Han J, Owji S, Kamat S, Luu C, Ungar J, Gulati N. Accelerated Healing from Severe Radiation Dermatitis Using Noncontact, Low-frequency Ultrasound-assisted Saline Wash Therapy. Adv Skin Wound Care 2023; 36:41-43. [PMID: 36537774 DOI: 10.1097/01.asw.0000897440.98255.e5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
ABSTRACT Radiotherapy (RT) is a modality for cancer management that frequently causes critical injury to tissues adjacent to the targeted cancer site. Acute radiation dermatitis (RD) is one of the most common adverse effects of RT and may lead to secondary infection, disfigurement, and discontinuation of therapy. The authors report the efficacy of a multidisciplinary collaboration between radiation oncology, dermatology, and wound care teams in the management of severe, acute RD. This case report describes the use of noncontact, low-frequency ultrasound (NCLFU)-assisted saline wash therapy leading to accelerated healing of severe RD in an older man treated with RT for scalp squamous cell carcinoma. Although NCLFU-assisted saline wash therapy provides gentle debridement of wound surfaces and has demonstrated efficacy in the management of chronic wounds, the potential role for NCLFU therapy in RD management has not yet been explored.
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Affiliation(s)
- Yen Luu
- Yen Luu, BA, is Medical Student Research Fellow, University of Missouri, Kansas City. At Icahn School of Medicine at Mount Sinai, Department of Dermatology, New York, New York, Joseph Han, BS, Shayan Owji, BS, and Samir Kamat, BA, are Medical Student Research Fellows. Chuc Luu is Undergraduate Student Research Fellow, University of California, Los Angeles. Also at Icahn School of Medicine at Mount Sinai, Department of Dermatology, Jonathan Ungar, MD, is Instructor and Nicholas Gulati, MD, PhD, is Assistant Professor
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Burke G, Faithfull S, Probst H. Radiation induced skin reactions during and following radiotherapy: A systematic review of interventions. Radiography (Lond) 2022; 28:232-239. [PMID: 34649789 DOI: 10.1016/j.radi.2021.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/20/2021] [Accepted: 09/13/2021] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Radiation induced skin reactions (RISR) are a common adverse effect of radiotherapy that can impact on patient quality of life. The aim of this systematic review was to identify new research evidence on interventions for RISR to guide health practitioners on best practice skin care for people receiving radiotherapy. METHODS A narrative systematic review was adopted including published research since 2014. The MESH search terms used in the 2014 College of Radiographers skin care systematic review were supplemented with terms identified through a pearl growing search technique. RESULTS Thirty-three studies were identified and reviewed, 13(39.4%) were assessed as having a high risk of bias 6(18.2%) moderate risk of bias, and 13(39.4%) low risk of bias; one pilot study was not assessed. Twenty-one of the studies were randomised controlled trials, 2 feasibility studies, 9 non-randomised trials, and 1 a pilot study. CONCLUSION Evidence from well conducted studies identified prophylactic use of steroid cream for patients, at high risk of RISR, as being the most efficacious in reducing acute skin reactions. Further research is needed on photo biomodulation therapy, studied within standard dose fractionation schedules, before it is recommended for use in practice. There is insufficient evidence to support the use of barrier films or any topical emollients currently in practice to reduce RISRs. Despite the number of new studies in this area there is limited good comparative research of RISR that accounts for predictive risk and new radiotherapy techniques. IMPLICATIONS FOR PRACTICE Practitioners are encouraged to risk assess patients prior to radiotherapy to guide interventions and record and monitor patient skin toxicity regularly during treatment, comparing toxicity changes with scores recorded at baseline and support patient self-monitoring of skin reactions.
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Affiliation(s)
- G Burke
- College of Health, Well-being and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - S Faithfull
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - H Probst
- College of Health, Well-being and Life Sciences, Sheffield Hallam University, Sheffield, UK.
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Song F, Liao Z, Li T, Kang N, Li Z, Fan S, Liu F. Topical use of Jiawei Simiao Yongan Gao to prevent radiodermatitis in patients with head and neck cancer: A retrospective cohort study. Medicine (Baltimore) 2020; 99:e23318. [PMID: 33235092 PMCID: PMC7710264 DOI: 10.1097/md.0000000000023318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Radiodermatitis is a common side effect of radiotherapy, but currently there is no standard treatment for its prevention. This study aimed to observe the effect of topical application of a paste based on traditional Chinese medicine, Jiawei Simiao Yongan Gao, on radiodermatitis caused by radiotherapy for patients with head and neck cancer.This was a retrospective cohort study of 40 patients with head and neck cancer evaluated during their radiotherapy. Of these, 20 patients were treated with Jiawei Simiao Yongan Gao on the irradiated skin from the beginning of radiotherapy (JSY group). The other 20 patients were given standard nursing (standard group). Acute skin reactions were classified according to the radiation-induced skin reaction assessment scale (RISRAS) and American radiation therapy oncology group (RTOG) acute toxicity grading criteria every 2 weeks, and adverse effects were recorded until the end of the radiotherapy.The two groups showed differences in severity of radiodermatitis. At 0 to 30 Gy, the skin reactions were similar in the two groups, while above 40 Gy the skin reactions were significantly lower grade in the JSY group (P < .05). At 0 to 20 Gy, there was no statistical significance (P > .05); but above 30 Gy they were lower in the JSY group (P < .05).Jiawei Simiao Yongan Gao effectively alleviated acute radiodermatitis caused by radiotherapy of head and neck cancer patients compared with standard nursing.
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Affiliation(s)
- Fengli Song
- Department of Oncology, Beijing University of Chinese Medicine Third Affiliated Hospital
| | - Ziling Liao
- Beijing University of Chinese Medicine, Beijing
| | - Tong Li
- Department of Oncology, Beijing University of Chinese Medicine Third Affiliated Hospital
| | - Ning Kang
- Department of Oncology, Beijing University of Chinese Medicine Third Affiliated Hospital
| | - Zhiming Li
- Beijing University of Chinese Medicine, Beijing
| | - Shufang Fan
- Department of Oncology, TCM Hospital of Shi Jia Zhuang City, Shi Jia Zhuang, China
| | - Fengzhi Liu
- Beijing University of Chinese Medicine, Beijing
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Borrelli MR, Shen AH, Lee GK, Momeni A, Longaker MT, Wan DC. Radiation-Induced Skin Fibrosis: Pathogenesis, Current Treatment Options, and Emerging Therapeutics. Ann Plast Surg 2019; 83:S59-S64. [PMID: 31513068 PMCID: PMC6746243 DOI: 10.1097/sap.0000000000002098] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Radiotherapy (RT) has become an indispensable part of oncologic treatment protocols for a range of malignancies. However, a serious adverse effect of RT is radiodermatitis; almost 95% of patients develop moderate to severe skin reactions following radiation treatment. In the acute setting, these can be erythema, desquamation, ulceration, and pain. Chronically, soft tissue atrophy, alopecia, and stiffness can be noted. Radiodermatitis can delay oncologic treatment protocols and significantly impair quality of life. There is currently a paucity of effective treatment options and prevention strategies for radiodermatitis. Importantly, recent preclinical and clinical studies have suggested that fat grafting may be of therapeutic benefit, reversing detrimental changes to soft tissue following RT. This review outlines the damaging effects of RT on the skin and soft tissue as well as discusses available treatment options for radiodermatitis. Emerging strategies to mitigate detrimental, chronic radiation-induced changes are also presented.
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Affiliation(s)
- Mimi R. Borrelli
- Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic Surgery, Stanford University School of Medicine, Stanford, California
| | - Abra H. Shen
- Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic Surgery, Stanford University School of Medicine, Stanford, California
| | - Gordon K. Lee
- Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California
| | - Arash Momeni
- Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California
| | - Michael T. Longaker
- Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic Surgery, Stanford University School of Medicine, Stanford, California
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California
| | - Derrick C. Wan
- Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic Surgery, Stanford University School of Medicine, Stanford, California
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Zhang X, Li H, Li Q, Li Y, Li C, Zhu M, Zhao B, Li G. Application of red light phototherapy in the treatment of radioactive dermatitis in patients with head and neck cancer. World J Surg Oncol 2018; 16:222. [PMID: 30419911 PMCID: PMC6233368 DOI: 10.1186/s12957-018-1522-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/29/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND To observe the effect of red light phototherapy (RLPT) on radioactive dermatitis (RD) caused by radiotherapy in patients with head and neck cancer (HNC). METHODS Sixty patients with HNC admitted to our hospital were randomly divided into experimental group and control group, 30 patients in each group. The control group received routine daily care during radiotherapy treatment. In the experimental group, in addition to routine daily care during radiotherapy treatment, photon therapy apparatus RLPT was added, 10 min/time, 2 times/day, and lasted until the end of radiotherapy. The pain and conditions of the patients' skin were assessed daily, and the skin pain and dermatitis grades of the two groups were compared. RESULTS In terms of the reaction degree of RD, experimental group was mainly grade 0-2, and control group was mainly grade 2-3, with a significant difference (P < 0.05). In terms of skin pain, according to the pain records at week 2, 3, and 4, the pain degree increased with time. However, the score of wound pain in experimental group was significantly lower than that in control group, and there was a significant difference between the two groups (P < 0.05). CONCLUSIONS The application of RLPT in the treatment of RD can help accelerate wound healing and significantly shorten healing time. It can not only reduce wounds pain of patients, promote inflammation and ulcer healing, but also ensure the smooth progress of patients' radiotherapy and improve their quality of lives, which is worth popularization and application in the clinical practice.
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Affiliation(s)
- Xudong Zhang
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Hongfei Li
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Qian Li
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Ying Li
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Chao Li
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Minmin Zhu
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Bing Zhao
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
| | - Guowen Li
- Radiotherapy inpatient Ward II, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450000 Henan China
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Abstract
INTRODUCTION Radiation recall dermatitis (RRD) associated with actinomycin D was first described by in 1959, followed by the reporting of several RRD-inducing drugs. In 1994, a study demonstrated docetaxel-induced RRD for the first time; however, despite some case studies reporting RRD, a little has been reported on it since then. Here we present a rare case of atypical docetaxel-induced RRD. CASE PRESENTATION The patient in his 60s was administered radiotherapy for high-risk prostate cancer. He continued receiving hormonal therapy for 2 years because of being in a high-risk group and became nadir. Six months since the completion of hormonal therapy, his prostate-specific antigen (PSA) level increased again. Based on the radiological examination, he was diagnosed with multiple lung, bone, and lymph node metastases. Accordingly, we started docetaxel (75 mg/m) every 5 weeks in consideration of myelosuppression for hormone-resistant multiple metastases. Although lung metastasis shrunk by one cycle docetaxel, radiotherapy for the thoracic and lumbar vertebrae was performed for back pain and lumbago. On day 21, at the end of radiotherapy, the same dose of docetaxel was administrated for the third time. On day 7, after third docetaxel administration, erythema appeared in a irradiated field of the thoracic and lumbar vertebra. Erythema primarily appeared on the anterior side of the body, and no skin reaction was noted on the posterior part of the thoracic irradiated area. Notably, no skin reaction was observed in the previously irradiated field for prostate cancer. CONCLUSIONS This case report draws attention to the development of atypical RRD after administration of docetaxel and advises careful follow-up even if RRD does not appear after the first docetaxel administration.
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Leventhal J, Young MR. Radiation Dermatitis: Recognition, Prevention, and Management. Oncology (Williston Park) 2017; 31:885-899. [PMID: 29297172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Radiation therapy (RT) is a frequently used modality for cancer treatment. Acute and/or chronic skin changes may occur and carry risk of influencing quality of life during and after completion of RT. Radiation reactions may lead to delays in treatment, diminished cosmesis, and functional deficits. Lifestyle factors, treatment modalities, topical agents, and, in some cases, wound dressings may be utilized to help prevent or ameliorate radiation-induced skin reactions. While rigorous evidence supporting specific interventions may be lacking or contradictory, this article summarizes the current knowledge of the etiology, manifestations, and interventions available for prevention and management of radiation dermatitis. Further well-designed studies are needed to confirm the efficacy of current recommendations and facilitate development of novel strategies for optimal care of patients with radiation dermatitis.
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Rothenberger J, Constantinescu MA, Held M, Aebersold DM, Stolz A, Tschumi C, Olariu R. Use of a Polylactide-based Copolymer as a Temporary Skin Substitute for a Patient With Moist Desquamation Due to Radiation. Wounds 2016; 28:E26-E30. [PMID: 27428721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Skin reactions are known adverse effects of radiation therapy. Despite advances in skin care products, there is still a demand for optimal skin care products to improve the therapy of these lesions. The authors report the use of a polylactide-based copolymer (Suprathel, PolyMedics Innovations GmbH, Denkendorf, Germany) as a temporary skin substitute for covering the skin defects of a patient with moist desquamation due to radiation.
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Abstract
Radiation injury to skin results in a variety of deterministic effects including inflammatory reactions and cell depletion leading to distinct clinical symptoms following a defined time pattern. Therapeutic approaches are still limited, a complete restitution of affected areas is so far impossible. In the last few years increasing experimental knowledge about acquisition and administration of autologous stem cells also in the field of radiation injuries has been obtained. Evidence reviewed in this article shows that the beneficial effects of stem cell transplantation are not necessarily due to the replacement of damaged cells by transplanted cells but most probably due in the most part to a paracrine effect. Transplanted cells secrete bioactive factors that initiate the stimulation of the host stem cells to regenerate the damaged tissues. Transplanted stem cells produce trophic factors which aid the systemic healing of the victims. Furthermore, administration of stem cell secretomes in the form of conditioned media containing microvesicles or exosomes can be as effective as administering the stem cells. This hypothesis is supported by findings that cell-free derivatives from hMSCs were useful for wound healing purposes and could circumvent the need for intact cells. Furthermore, the beneficial effect of MSC injection on reperfusion and tissue damage in a mouse model of hind limb ischemia could be attributed to paracrine mechanisms with local release of arteriogenic cytokines. Further evaluation of the paracrine potential of autologous stem cells may open new means for treatment of acute as well as chronic sequelae of cutaneous radiation injuries.
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Affiliation(s)
- M Rezvani
- Natural Biosciences SA, Lake Garden Medical Center, Kilchberg, Zurich, Switzerland,
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Chan RJ, Webster J, Chung B, Marquart L, Ahmed M, Garantziotis S. Prevention and treatment of acute radiation-induced skin reactions: a systematic review and meta-analysis of randomized controlled trials. BMC Cancer 2014; 14:53. [PMID: 24484999 PMCID: PMC3909507 DOI: 10.1186/1471-2407-14-53] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/27/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Radiation-induced skin reaction (RISR) is a common side effect that affects the majority of cancer patients receiving radiation treatment. RISR is often characterised by swelling, redness, pigmentation, fibrosis, and ulceration, pain, warmth, burning, and itching of the skin. The aim of this systematic review was to assess the effects of interventions which aim to prevent or manage RISR in people with cancer. METHODS We searched the following databases up to November 2012: Cochrane Skin Group Specialised Register, CENTRAL (2012, Issue 11), MEDLINE (from 1946), EMBASE (from 1974), PsycINFO (from 1806), CINAHL (from 1981) and LILACS (from 1982). Randomized controlled trials evaluating interventions for preventing or managing RISR in cancer patients were included. The primary outcomes were development of RISR, and levels of RISR and symptom severity. Secondary outcomes were time taken to develop erythema or dry desquamation; quality of life; time taken to heal, a number of skin reaction and symptom severity measures; cost, participant satisfaction; ease of use and adverse effects. Where appropriate, we pooled results of randomized controlled trials using mean differences (MD) or odd ratios (OR) with 95% confidence intervals (CI). RESULTS Forty-seven studies were included in this review. These evaluated six types of interventions (oral systemic medications; skin care practices; steroidal topical therapies; non-steroidal topical therapies; dressings and other). Findings from two meta-analyses demonstrated significant benefits of oral Wobe-Mugos E for preventing RISR (OR 0.13 (95% CI 0.05 to 0.38)) and limiting the maximal level of RISR (MD -0.92 (95% CI -1.36 to -0.48)). Another meta-analysis reported that wearing deodorant does not influence the development of RISR (OR 0.80 (95% CI 0.47 to 1.37)). CONCLUSIONS Despite the high number of trials in this area, there is limited good, comparative research that provides definitive results suggesting the effectiveness of any single intervention for reducing RISR. More research is required to demonstrate the usefulness of a wide range of products that are being used for reducing RISR. Future efforts for reducing RISR severity should focus on promising interventions, such as Wobe-Mugos E and oral zinc.
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Affiliation(s)
- Raymond Javan Chan
- Cancer Care Services, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston Q4029, Australia
- School of Nursing, Queensland University of Technology, Kelvin Grove Q4059, Australia
- Centre for Health Practice Innovation, Griffith University, Nathan Q4111, Australia
| | - Joan Webster
- School of Nursing, Queensland University of Technology, Kelvin Grove Q4059, Australia
- Centre for Clinical Nursing, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston Q4029, Australia
- Centre for Health Practice Innovation, Griffith University, Nathan Q4111, Australia
| | - Bryan Chung
- Division of Plastic Surgery, QEII Health Science Centre, Halifax, Canada
| | - Louise Marquart
- Statistics Unit, QIMR Berghofer Medical Research Institute, Herston, Brisbane Q4029, Australia
| | - Muhtashimuddin Ahmed
- Safety and Quality Unit, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston Q4029, Australia
| | - Stuart Garantziotis
- Centre for Health Practice Innovation, Griffith University, Nathan Q4111, Australia
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Wong RKS, Bensadoun RJ, Boers-Doets CB, Bryce J, Chan A, Epstein JB, Eaby-Sandy B, Lacouture ME. Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC Skin Toxicity Study Group. Support Care Cancer 2013. [PMID: 23942595 DOI: 10.1007/s00-013-1896-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Radiation dermatitis (RD) results from radiotherapy and often occurs within the first 4 weeks of treatment, although late effects also occur. While RD may resolve over time, it can have a profound effect on patients' quality of life and lead to dose modifications. A study group of international, interdisciplinary experts convened to develop RD prevention and treatment guidelines based on evidence from randomized, controlled trials. Evidence-based recommendations were developed after an extensive literature review. Randomized, controlled trials with standardized measurement of outcomes were considered the best evidence, and a majority of the recommendations were formulated from this literature. The adoption of washing with water, with or without a mild soap, and allowing the use of antiperspirants is supported by randomized trials. Use of topical prophylactic corticosteroids (mometasone) is recommended to reduce discomfort and itching. There is some evidence that silver sulfadiazine cream can reduce dermatitis score. There is insufficient evidence to support, and therefore the panel recommends against the use of trolamine, topical sulcrate, hyaluronic acid, ascorbic acid, silver leaf dressing, light-emitting diode lasers, Theta cream, dexpanthenol, calendula, proteolytic enzymes, sulcralfate, oral zinc, and pentoxifylline. Moreover, there is no evidence to support the superiority for any specific intervention in a reactive fashion. For patients with established radiation-induced telangiectasia and fibrosis, the panel suggests the use of pulse dye laser for visual appearance, and the use of pentoxifylline and vitamin E for the reduction of fibrosis.
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Affiliation(s)
- Rebecca K S Wong
- Department of Radiation Oncology, Radiation Medicine Program, Princess Margaret Cancer Center, University of Toronto, 610 University Avenue, Toronto, M5G 2M9, Canada,
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García Reitböck J, Feldmann R, Rühringer K, Breier F, Steiner A. Chronic radiodermatitis following percutaneous transluminal coronary angioplasty. J Dtsch Dermatol Ges 2013; 11:265-6. [PMID: 23279977 DOI: 10.1111/ddg.12004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chan RJ, Larsen E, Chan P. Re-examining the evidence in radiation dermatitis management literature: an overview and a critical appraisal of systematic reviews. Int J Radiat Oncol Biol Phys 2012; 84:e357-62. [PMID: 22713836 DOI: 10.1016/j.ijrobp.2012.05.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 05/03/2012] [Indexed: 11/18/2022]
Abstract
PURPOSE To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. METHODS AND MATERIALS We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for "assessment of multiple systematic reviews"). RESULTS Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. CONCLUSIONS An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.
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Trueman E. Skin reactions in radiotherapy. Nurs Times 2012; 108:17. [PMID: 22720485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This toolkit offers guidance and education for supporting patients with radiotherapy-induced skin reactions. Early evaluation has shown it to benefit staff at all levels, with and without specialist knowledge, in a variety of settings. It provides a framework that helps staff to do "the right thing, at the right time, in the right way" based on practice and evidence (Byrne et al, 2010; NHS Quality Improvement Scotland, 2010). It will be reviewed and updated as new evidence for managing radiotherapy-induced skin reactions becomes available.
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Bushmanov AI, Eremin II, Moroz BB, Galstian IA, Nadezhina NM, Slobodina TS, Grinakovskaia OS. [Experience of contemporary treatment of radiation burns in individuals subjected to ionizing radiation]. Med Tr Prom Ekol 2012:20-27. [PMID: 23210179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The article presents new approach to treatment of radiation disorders presenting as indolent ulcers. The approach is based on autologous multipotent mesenchimal stromal cells applied locally and injected around the injuried zone. The ulcers heal due to the fact that the transplanted cells stimulate local regeneration processes, angiogenesis, ceased inflammation and apoptosis. The method is a new medical technology based on vast preclinical studies and could be put into medical practice.
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Becze E. Put evidence into practice to manage radiodermatitis. ONS Connect 2011; 26:14-15. [PMID: 22167995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Kotenko KB, Moroz BB, Nadezhina NM, Galstian IA, Onishchenko NA, Eremin II, Deshevoĭ IB, Lebedev VG, Slobodina TS, Dubitskiĭ SE, Grinakovskaia OS, Zhgutov IA, Bushmanov AI. [Mesenchymal stem cells transplantation in the treatment of radiation skin lesions]. Patol Fiziol Eksp Ter 2011:20-25. [PMID: 21692224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Transplantation of mesenchymal stem cells, both at early and later stage after local exposure of rats source beta radiation dose, 90Sr/90Y 140 GR, stimulates recovery of damaged skin. Diminution area local radiation injuries and accelerate healing radiation ulcers. Clinically shows the high efficiency of the transplantations autologous mesenchymal stem cells in treatment of deep beam ulcers, intractable standard conservative treatment. Found promising application of mesenchymal stem cells for treatment of severe local radiation injuries and the need to develop the best possible conditions for their use.
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Hadad I, Johnstone BH, Brabham JG, Blanton MW, Rogers PI, Fellers C, Solomon JL, Merfeld-Clauss S, DesRosiers CM, Dynlacht JR, Coleman JJ, March KL. Development of a porcine delayed wound-healing model and its use in testing a novel cell-based therapy. Int J Radiat Oncol Biol Phys 2010; 78:888-96. [PMID: 20708345 DOI: 10.1016/j.ijrobp.2010.05.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 05/02/2010] [Accepted: 05/04/2010] [Indexed: 12/20/2022]
Abstract
PURPOSE A delayed full-thickness wound-healing model was developed and used for examining the capacity of adipose-derived stem cells (ASCs), either alone or in platelet-rich fibrin gels, to promote healing. METHODS AND MATERIALS Four pigs received electron beam radiation to the dorsal skin surface. Five weeks after radiation, subcutaneous fat was harvested from nonirradiated areas and processed to yield ASCs. Two weeks later, 28 to 30 full-thickness 1.5-cm(2) wounds were made in irradiated and nonirradiated skin. Wounds were treated with either saline solution, ASCs in saline solution, platelet-rich plasma (PRP) fibrin gel, ASCs in PRP, or non-autologous green fluorescence protein-labeled ASCs. RESULTS The single radiation dose produced a significant loss of dermal microvasculature density (75%) by 7 weeks. There was a significant difference in the rate of healing between irradiated and nonirradiated skin treated with saline solution. The ASCs in PRP-treated wounds exhibited a significant 11.2% improvement in wound healing compared with saline solution. Enhancement was dependent on the combination of ASCs and PRP, because neither ASCs nor PRP alone had an effect. CONCLUSIONS We have created a model that simulates the clinically relevant late radiation effects of delayed wound healing. Using this model, we showed that a combination of ASCs and PRP improves the healing rates of perfusion-depleted tissues, possibly through enhancing local levels of growth factors.
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Affiliation(s)
- Ivan Hadad
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
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Abstract
BACKGROUND Homeopathic medicines are used by patients with cancer, often alongside conventional treatment. Cancer treatments can cause considerable morbidity and one of the reasons patients use homeopathic medicines is to help with adverse effects. OBJECTIVES Evaluate effectiveness and safety of homeopathic medicines used to prevent or treat adverse effects of cancer treatments. SEARCH STRATEGY The following were searched up to November 2008: Cochrane PaPaS Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; CINAHL; BNI; CancerLIT; AMED; CISCOM; Hom-Inform; SIGLE; National Research Register; Zetoc; www.controlled-trials.com; http://clinicaltrials.gov; Liga Medicorum Homeopathica Internationalis (LMHI, Liga) conference proceedings; reference lists of relevant studies were checked; and homeopathic manufacturers, leading researchers and practitioners were contacted. SELECTION CRITERIA Randomised controlled trials (RCTs) of homeopathic medicines in participants with a clinical or histological diagnosis of cancer where the intervention was aimed at preventing or treating symptoms associated with cancer treatments. All age groups, and all stages of disease were included. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion and two review authors extracted data. Three review authors independently assessed trial quality using the Delphi List and the Cochrane Collaboration's tool for assessing risk of bias. Disagreements were resolved by consensus. Where available, data were extracted for analysis. MAIN RESULTS Eight controlled trials (seven placebo controlled and one trial against an active treatment) with a total of 664 participants met the inclusion criteria. Three studied adverse effects of radiotherapy, three studied adverse effects of chemotherapy and two studied menopausal symptoms associated with breast cancer treatment.Two studies with low risk of bias demonstrated benefit: one with 254 participants demonstrated superiority of topical calendula over trolamine (a topical agent not containing corticosteroids) for prevention of radiotherapy-induced dermatitis, and another with 32 participants demonstrated superiority of Traumeel S (a proprietary complex homeopathic medicine) over placebo as a mouthwash for chemotherapy-induced stomatitis. Two other studies reported positive results, although the risk of bias was unclear, and four further studies reported negative results.No serious adverse effects or interactions were reported attributable to the homeopathic medicines used. AUTHORS' CONCLUSIONS This review found preliminary data in support of the efficacy of topical calendula for prophylaxis of acute dermatitis during radiotherapy and Traumeel S mouthwash in the treatment of chemotherapy-induced stomatitis. These trials need replicating. There is no convincing evidence for the efficacy of homeopathic medicines for other adverse effects of cancer treatments. Further research is required.
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Affiliation(s)
- Sosie Kassab
- Royal London Homoeopathic Hospital, 60 Great Ormond Street, London, UK, WC1N 3HR.
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Billan S, Abdah-Bortnyak R, Kuten A. Severe desquamation with skin necrosis: a distinct pattern of skin toxicity secondary to head and neck irradiation with concomitant cetuximab. Isr Med Assoc J 2008; 10:247. [PMID: 18494248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Bernier J, Bonner J, Vermorken JB, Bensadoun RJ, Dummer R, Giralt J, Kornek G, Hartley A, Mesia R, Robert C, Segaert S, Ang KK. Consensus guidelines for the management of radiation dermatitis and coexisting acne-like rash in patients receiving radiotherapy plus EGFR inhibitors for the treatment of squamous cell carcinoma of the head and neck. Ann Oncol 2008; 19:142-9. [PMID: 17785763 DOI: 10.1093/annonc/mdm400] [Citation(s) in RCA: 168] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Radiation dermatitis occurs to some degree in most patients receiving radiotherapy, with or without chemotherapy. Patients with squamous cell carcinoma of the head and neck (SCCHN) who receive radiotherapy in combination with epidermal growth factor receptor (EGFR) inhibitors, such as cetuximab, may develop a characteristic acne-like rash in addition to dermatitis. DESIGN An advisory board of 11 experienced radiation oncologists, medical oncologists and dermatologists discussed the management options for skin reactions in patients receiving EGFR inhibitors and radiotherapy for SCCHN. Skin toxicity was categorised according to the National Cancer Institute-Common Terminology Criteria for Adverse Events (version 3) grading. RESULTS Both general and grade-specific approaches for the management of dermatitis in this patient group are presented. It was concluded that where EGFR inhibitor-related acne-like rash and dermatitis coexist within irradiated fields, management should be based on the grade of dermatitis: for grade 1 (or no dermatitis), treatment recommendations for EGFR-related acne-like rash outside irradiated fields should be followed; for grades 2 and above, treatment recommendations for dermatitis were proposed. CONCLUSIONS This paper presents comprehensive consensus guidelines for the treatment of dermatitis in patients with SCCHN receiving EGFR inhibitors in combination with radiotherapy.
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Affiliation(s)
- J Bernier
- Department of Radiation Oncology, Genolier Swiss Medical Network, Genolier, Geneva, Switzerland.
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Russi EG, Merlano MC, Comino A, Numico G. Ultrathin Hydrocolloid Dressing in Skin Damaged From Alternating Radiotherapy and Chemotherapy Plus Cetuximab in Advanced Head and Neck Cancer (G.O.N.O. AlteRCC Italian Trial): In Regard to Macmillan et al. (Int J Radiat Oncol Biol Phys 2007;68:864–872). Int J Radiat Oncol Biol Phys 2007; 69:638-9. [PMID: 17869678 DOI: 10.1016/j.ijrobp.2007.05.063] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Accepted: 05/23/2007] [Indexed: 11/16/2022]
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Markouizou A, Koliarakis N, Paraskevaidis M, Tsakiris G, Karageorgis A, Karageorgis P. Radiation dermatitis: implicated factors, clinical aspects, possible prevention, and medical care. J BUON 2007; 12:463-470. [PMID: 18067203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The increasing incidence of cancer is due to many factors. Among them quite significant is considered the rising proportion of older people in the population and the modern methods of early diagnosis. Radiotherapy (RT), along with surgery and chemotherapy, is a major therapeutic modality in the management of cancer. In the context of current treatment methods and practice, approximately half of the patients with cancer will receive RT at some stage of their illness. RT can lead to cure some kinds of cancer but it can also be delivered for palliation. Unfortunately, skin damage is a complication affecting by and large all patients receiving external beam RT. In order to minimize the risk of this damage it would be helpful to know the complex underlying molecular mechanisms and evaluate the related clinical symptoms, not only for medical but also for psychological reasons related to the patient. The purpose of this article was to review the current approaches to this particular clinical condition, in order to realize an effective patient-oriented clinical practice and keep this radiation-induced complication as low as possible.
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Affiliation(s)
- A Markouizou
- 2nd Department of Radiation Oncology, Metaxa Cancer Hospital, Piraeus, Greece.
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Grimm A, Dimmler A, Stange S, Labanaris A, Sauer R, Grabenbauer G, Horch RE. Expression of HIF-1 alpha in irradiated tissue is altered by topical negative-pressure therapy. Strahlenther Onkol 2007; 183:144-9. [PMID: 17340073 DOI: 10.1007/s00066-007-1560-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2005] [Revised: 12/06/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND PURPOSE Despite the enormous therapeutic potential of modern radiotherapy, common side effects such as radiation-induced wound healing disorders remain a well-known clinical phenomenon. Topical negative pressure therapy (TNP) is a novel tool to alleviate intraoperative, percutaneous irradiation or brachytherapy. Since TNP has been shown to positively influence the perfusion of chronic, poorly vascularized wounds, the authors applied this therapeutic method to irradiated wounds and investigated the effect on tissue oxygenation in irradiated tissue in five patients. MATERIAL AND METHODS With informed patients' consent, samples prior to and 4 and 8 days after continuous TNP with -125 mmHg were obtained during routine wound debridements. Granulation tissue was stained with hematoxylin-eosin, and additionally with CD31, HIF-1 alpha (hypoxia-inducible factor-1 alpha), and D2-40 to detect blood vessels, measure indirect signs of hypoxia, and lymph vessel distribution within the pre- and post-TNP samples. RESULTS In this first series of experiments, a positive influence of TNP onto tissue oxygenation in radiation-induced wounds could be demonstrated. TNP led to a significant decrease of 53% HIF-1 alpha-positive cell nuclei. At the same time, a slight reduction of CD31-stained capillaries was seen in comparison to samples before TNP. Immunostaining with D2-40 revealed an increased number of lymphatic vessels with distended lumina and an alteration of the parallel orientation within the post-TNP samples. CONCLUSION This study is, to the authors' knowledge, the first report on a novel previously not described histological marker to demonstrate the effects of TNP on HIF-1 alpha expression as an indirect marker of tissue oxygenation in irradiated wounds, as demonstrated by a reduction of HIF-1 alpha concentration after TNP. Since this observation may be of significant value to develop possible new strategies to treat radiation-induced tissue injury, further investigations of HIF-1 alpha regulation under TNP are warranted.
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Affiliation(s)
- Andreas Grimm
- Department of Plastic and Hand Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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García-Donoso C, Tardío JC, Arias D, Romero A, Borbujo JM. Eosinophilic, polymorphic and pruritic eruption associated with radiotherapy (EPPER) in two patients with breast tumour. J Eur Acad Dermatol Venereol 2007; 21:1102-4. [PMID: 17714133 DOI: 10.1111/j.1468-3083.2007.02180.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Eosinophilic polymorphic and pruritic eruption associated with radiotherapy (EPPER) is a rare entity that appears in oncological patients after radiotherapy. We describe two patients with breast tumour who presented with EPPER in a different area from the one that had been irradiated. One of them needed different types of treatment, topical and systemic corticosteroids, antihistamines and narrowband ultraviolet B. The other one responded to the application of topical corticosteroids. We suggested that this eruption could be more frequent than has been reported.
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Affiliation(s)
- C García-Donoso
- Department of Dermatology, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Spain.
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Macmillan MS, Wells M, MacBride S, Raab GM, Munro A, MacDougall H. Randomized Comparison of Dry Dressings Versus Hydrogel in Management of Radiation-Induced Moist Desquamation. Int J Radiat Oncol Biol Phys 2007; 68:864-72. [PMID: 17363185 DOI: 10.1016/j.ijrobp.2006.12.049] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2006] [Revised: 12/18/2006] [Accepted: 12/19/2006] [Indexed: 11/25/2022]
Abstract
PURPOSE We present the results of a randomized controlled clinical trial that evaluated the effect of a hydrogel or dry dressing on the time to healing of moist desquamation after radiotherapy to the head-and-neck, breast, or anorectal areas. METHODS AND MATERIALS A total of 357 patients were randomized before radiotherapy to receive simple dry dressings (Tricotex) or a hydrogel (Intrasite), with Tricotex as a secondary dressing. Patients were instructed to use their dressings from the onset of moist desquamation, if it occurred. RESULTS Of the 357 patients, 100 (28%) developed moist desquamation. The time to healing was significantly prolonged (hazard ratio, 0.64; 95% confidence interval, 0.42-0.99), in patients assigned to gel dressings. No evidence was found that gel dressings had a significant impact on subjectively reported skin symptoms. CONCLUSION The results of this study have not supported the routine use of hydrogels in the care of patients with moist desquamation and suggests that the healing times are prolonged, without any improvement in patient comfort.
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Abstract
BACKGROUND Fluoroscopy-induced chronic radiation dermatitis (FICRD) resulting from prolonged exposure to ionizing radiation during interventional procedures has been documented in the radiology and cardiology literature. However, the phenomenon has been rarely reported in the dermatologic literature. Since patients with FICRD often see a dermatologist or a primary care physician to treat their injuries, the diagnosis of FICRD is perhaps often overlooked. OBSERVATIONS A 62-year-old man with type 2 diabetes mellitus and severe coronary artery disease was seen with a 2-year history of a pruritic, tender, telangiectatic patch lesion over his left scapula. Over the next 2 years, the lesion became indurated and eventually ulcerated. A skin biopsy specimen demonstrated changes consistent with a chronic radiation dermatitis. The patient was unaware of radiation exposure, but persistent questioning from his dermatologists revealed that he had undergone multiple fluoroscopy-guided cardiac procedures. This was confirmed by a review of his medical records. CONCLUSION The diagnosis of FICRD should be considered for any patient who is seen with an acquired vascular lesion, a morphealike lesion, or an unexplained ulcer localized over the scapula, the back, or lateral trunk below the axilla.
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Affiliation(s)
- Thomas H Frazier
- Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA
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Le Scodan R, Wyplosz B, Couchon S, Housset M, Laccourreye O. UV-light induced radiation recall dermatitis after a chemoradiotherapy organ preservation protocol. Eur Arch Otorhinolaryngol 2007; 264:1099-102. [PMID: 17415577 DOI: 10.1007/s00405-007-0298-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Accepted: 03/12/2007] [Indexed: 11/28/2022]
Abstract
This case report documents a UV-light-induced recall phenomenon and reviews the medical literature. In this patient, we observed a severe recall phenomenon precipitated by an extensive sunlight exposure after a chemoradiotherapy organ preservation protocol. Radiation recall phenomenon is a rare but well-described phenomenon, without clear radiation or drug-specific characteristics. In the medical literature, radiation recall following UV-sunlight exposure seems to be an exceptional event. The etiology remains unknown but could involve local hypersensitivity through a non-immune activation of inflammatory pathways. Due to the increasing number of patients with head and neck malignancies managed with induction chemotherapy and/or chemoradiation organ preservation protocols, the otorhinolaryngologist--head and neck surgeons as well as the radiation therapist should become aware and familiar with this phenomenon.
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Affiliation(s)
- Romuald Le Scodan
- Department of Radiation Oncology, Université Paris V-René Descartes, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
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Nystedt K. In response to the article "The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline" (Bolderston et al. 2006). Support Care Cancer 2007; 15:1219; author reply 1221. [PMID: 17372772 DOI: 10.1007/s00520-007-0249-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2007] [Accepted: 03/08/2007] [Indexed: 10/23/2022]
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Moolenaar M, Poorter RL, van der Toorn PPG, Lenderink AW, Poortmans P, Egberts ACG. The effect of honey compared to conventional treatment on healing of radiotherapy-induced skin toxicity in breast cancer patients. Acta Oncol 2007; 45:623-4. [PMID: 16864180 DOI: 10.1080/02841860600781799] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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François S, Mouiseddine M, Mathieu N, Semont A, Monti P, Dudoignon N, Saché A, Boutarfa A, Thierry D, Gourmelon P, Chapel A. Human mesenchymal stem cells favour healing of the cutaneous radiation syndrome in a xenogenic transplant model. Ann Hematol 2006; 86:1-8. [PMID: 17043780 DOI: 10.1007/s00277-006-0166-5] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Accepted: 06/23/2006] [Indexed: 02/07/2023]
Abstract
It has been suggested that human mesenchymal stem cells (hMSC) could be used to repair numerous injured tissues. We have studied the potential use of hMSC to limit radiation-induced skin lesions. Immunodeficient NOD/SCID mice were locally irradiated to the leg (30 Gy, dose rate 2.7 Gy/min) using a (60)Co source to induce a severe skin lesion. Cultured bone marrow hMSC were delivered intravenously to the mice. The irradiated skin samples were studied for the presence of the human cells, the severity of the lesions and the healing process. Macroscopic analysis and histology results showed that the lesions were evolving to a less severe degree of radiation dermatitis after hMSC transplant when compared to irradiated non-transplanted controls. Clinical scores for the studied skin parameters of treated mice were significantly improved. A faster healing was observed when compared to untreated mouse. Immunohistology and polymerase chain reaction analysis provided evidence that the human cells were found in the irradiated area. These results suggest a possible use of hMSC for the treatment of the early phase of the cutaneous radiation syndrome. A successful transplant of stem cells and subsequent reduction in radiation-induced complication may open the road to completely new strategies in cutaneous radiation syndrome therapy.
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Affiliation(s)
- Sabine François
- Laboratory of Cell Therapy and Radioprotection of the Accident, Radiobiology and Epidemiology Department, Institut de Radioprotection et de Sûreté Nucléaire DRPH/SRBE/LTCRA, Fontenay aux Roses CEDEX, France.
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Abstract
OBJECTIVES To review published studies evaluating interventions for the prevention and management of radiation skin reactions/dermatitis. DATA SOURCES Research studies, review articles, and clinical practice guidelines. CONCLUSION There is insufficient evidence in the literature to recommend specific topical or oral agents in the prevention or management of skin reactions. Recent limited evidence suggests that the use of calendula cream may reduce the incidence of grade 2 and 3 reactions in women with breast cancer. Additionally, early studies evaluating the use of barrier films or creams may improve moist desquamation. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses need to increase their awareness of the evidence or lack of evidence when recommending interventions to their patients. Further research is required to evaluate interventions in the prevention and management of radiation dermatitis.
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Affiliation(s)
- Maurene McQuestion
- Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario, Canada.
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Bolderston A, Lloyd NS, Wong RKS, Holden L, Robb-Blenderman L. The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer 2006. [PMID: 16758176 DOI: 10.1007/s00-006-0063-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
GOALS OF WORK To develop a practice guideline report on the questions: What are the optimal methods to prevent acute skin reactions (occurring within the first 6 months of irradiation) related to radiation therapy? What are the optimal methods to manage acute skin reactions related to radiation therapy? MATERIALS AND METHODS Cancer Care Ontario's Supportive Care Guidelines Group (SCGG) conducted a systematic review of literature on this topic. Evidence-based recommendations were formulated to guide clinical decision making, and a formal external review process was conducted to validate the relevance of these opinions for Ontario practitioners. MAIN RESULTS Twenty-eight trials meeting the inclusion criteria were identified. Of the twenty-three trials that evaluated preventative methods, washing was the only practice which significantly prevented skin reaction. Some evidence suggested topical steroid creams and calendula ointment might be effective. None of the five trials evaluating skin reaction management detected a positive effect using steroid cream, sucralfate cream, or dressings. CONCLUSIONS Skin washing, including gentle washing with water alone with or without mild soap, should be permitted in patients receiving radiation therapy to prevent acute skin reaction. There is insufficient evidence to support or refute specific topical or oral agents for the prevention or management of acute skin reaction. In the expert opinion from the SCGG, the use of a plain, non-scented, lanolin-free hydrophilic cream may be helpful in preventing radiation skin reactions. In addition, a low dose (i.e., 1%) corticosteroid cream may be beneficial in the reduction of itching and irritation.
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Affiliation(s)
- Amanda Bolderston
- Department of Radiation Oncology, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada
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Bolderston A, Lloyd NS, Wong RKS, Holden L, Robb-Blenderman L. The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer 2006; 14:802-17. [PMID: 16758176 DOI: 10.1007/s00520-006-0063-4] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2005] [Accepted: 03/09/2006] [Indexed: 10/24/2022]
Abstract
GOALS OF WORK To develop a practice guideline report on the questions: What are the optimal methods to prevent acute skin reactions (occurring within the first 6 months of irradiation) related to radiation therapy? What are the optimal methods to manage acute skin reactions related to radiation therapy? MATERIALS AND METHODS Cancer Care Ontario's Supportive Care Guidelines Group (SCGG) conducted a systematic review of literature on this topic. Evidence-based recommendations were formulated to guide clinical decision making, and a formal external review process was conducted to validate the relevance of these opinions for Ontario practitioners. MAIN RESULTS Twenty-eight trials meeting the inclusion criteria were identified. Of the twenty-three trials that evaluated preventative methods, washing was the only practice which significantly prevented skin reaction. Some evidence suggested topical steroid creams and calendula ointment might be effective. None of the five trials evaluating skin reaction management detected a positive effect using steroid cream, sucralfate cream, or dressings. CONCLUSIONS Skin washing, including gentle washing with water alone with or without mild soap, should be permitted in patients receiving radiation therapy to prevent acute skin reaction. There is insufficient evidence to support or refute specific topical or oral agents for the prevention or management of acute skin reaction. In the expert opinion from the SCGG, the use of a plain, non-scented, lanolin-free hydrophilic cream may be helpful in preventing radiation skin reactions. In addition, a low dose (i.e., 1%) corticosteroid cream may be beneficial in the reduction of itching and irritation.
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Affiliation(s)
- Amanda Bolderston
- Department of Radiation Oncology, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada
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Hymes SR, Strom EA, Fife C. Radiation dermatitis: clinical presentation, pathophysiology, and treatment 2006. J Am Acad Dermatol 2006; 54:28-46. [PMID: 16384753 DOI: 10.1016/j.jaad.2005.08.054] [Citation(s) in RCA: 361] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2005] [Revised: 07/15/2005] [Accepted: 08/30/2005] [Indexed: 11/16/2022]
Affiliation(s)
- Sharon R Hymes
- Dermatology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
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Yildiz S, Cimsit M, Ilgezdi S, Uzun G, Gumus T, Qyrdedi T, Dalci D. Hyperbaric oxygen therapy used to treat radiation injury: two case reports. Ostomy Wound Manage 2006; 52:14-6, 18, 20. [PMID: 16773750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- Senol Yildiz
- Department of Underwater and Hyperbaric Medicine, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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Affiliation(s)
- Heinrich Seegenschmiedt
- Klinik für Radioonkologie und Strahlentherapie, Alfried Krupp Krankenhaus, Essen-Rüttenscheid, Germany
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Abstract
The response of skin to irradiation is highly complex and is dependent on many radiation-related, patient-related, and treatment-related factors. No standardized treatment of skin reactions related to radiation exists at this time. Ongoing research studying acute and late skin effects works to minimize reactions and improve patient quality-of-life. However, research with strong methodology is needed to determine if any management strategy is superior.
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Affiliation(s)
- Gloria Wood
- Radiation Therapy, H. Lee Moffitt Cancer Center, Tampa, FL, USA
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Azria D, Magné N, Zouhair A, Castadot P, Culine S, Ychou M, Stupp R, Van Houtte P, Dubois JB, Ozsahin M. Radiation recall: A well recognized but neglected phenomenon. Cancer Treat Rev 2005; 31:555-70. [PMID: 16168567 DOI: 10.1016/j.ctrv.2005.07.008] [Citation(s) in RCA: 146] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Radiation recall is an inflammatory skin reaction at a previously irradiated field subsequent to the administration of a variety of pharmacologic agents. Although skin has been the major site of radiation recall toxicity, instances involving other organ have been reported. MATERIALS AND METHODS Data for this review were identified by searches of Medline and Cancerlit. The search terms "radiation", "recall", and "toxicity" were used. References identified from within retrieved articles were also used. There was no limitation on year of publication and no abstract forms were included. Only articles published in English were taken into consideration. RESULTS Idiosyncratic drug hypersensitivity phenomenon is a recent hypothesis which correlates best with the available facts at this moment. The phenomenon may occur days to years after radiotherapy has been completed. The majority of the drugs commonly used in cancer therapy have been involved in the radiation recall phenomenon. A mixed non-specific inflammatory infiltrate seems to be the common histopathologic criteria in previous published reports. Universally, corticosteroids or the use of non-steroidal anti-inflammatory agents, in conjunction with withdrawal of the offending agent, produce prompt improvement. CONCLUSION We propose to collect all future radiation recall phenomenon in a Rare Cancer Network database in order to augment our understanding of this rare reaction.
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Affiliation(s)
- David Azria
- Department of Radiation Oncology, Val d'Aurelle-Paul Lamarque Cancer Institute, Montpellier, France
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Hill S. Managing radiation skin injury. Ostomy Wound Manage 2005; 51:26-30. [PMID: 16294462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Sue Hill
- Wound, Ostomy and Continence Department, Banner Baywood Medical Center, Mesa, AZ, USA
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Stiefelhagen P. [Every 10th person has actinic keratosis. Cold, light and cream prevent skin cancer]. MMW Fortschr Med 2005; 147:14. [PMID: 16245772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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Abstract
As cancer continues to represent a major health problem in the United States and in other developed countries, MCWs will continue to represent a complex problem for patients and health care professionals alike. Goals of care may range from healing to palliation, depending on the underlying pathology and patient preferences regarding their personal goals of wound or disease management. Palliative wound care should focus on patient comfort and quality of life as the goals, instead of wound. As evidence related to wound healing, products, and technology continues to increase,nurses can be at the forefront of putting into practice the science of wound healing for the benefit of patients.
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Affiliation(s)
- Mary A Gerlach
- Division of Nursing, St. Joseph's Mercy of Macomb Hospital, 15855 Nineteen Mile Road, Clinton Township, MI 48038, USA.
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Wollina U. Gestörte HautfunktionKonservative wiederherstellende Verfahren. Laryngorhinootologie 2005; 84 Suppl 1:S228-32. [PMID: 15846555 DOI: 10.1055/s-2005-861127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- U Wollina
- Krankenhaus Dresden-Friedrichstadt, Städtisches Klinikum, Akademisches Lehrkrankenhaus der TU Dresden, Friedrichstrasse 41, 01067 Dresden.
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Oppenheimer R, Finkel R, Brennan A. Treatment of radiation-induced fibrosis of the face with manual compression therapy. Ear Nose Throat J 2004; 83:478-80. [PMID: 15372919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Radiation-induced fibrosis (RIF) is an uncommon complication of radiation therapy. RIF most often occurs in the extremities; it is rare in the head and neck. Only a few medical treatments for RIF are available, and they have been mediocre at best. We describe a case of RIF of the face that was treated successfully with a nonmedical modality: manual compression therapy.
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Affiliation(s)
- Randy Oppenheimer
- Department of Surgery, Carl T. Hayden VA Medical Center, Phoenix, AZ 85012, USA.
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Cuadrillero Martín F, Sandoval Cuadrado P, Rodríguez Hernández F. [Collagen powder: hydrocolloidal dressings. Their effectiveness in radiodermatitis]. Rev Enferm 2004; 27:17-22. [PMID: 15239494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
The authors analyze the effectiveness of a collagen cicatrizant powder for use in treating radiodermatitis compared with extra fine hydrocolloidal dressings by evaluating skin lesions according to the Radiation Therapy Oncology Group (RTOG) intensity scale. As the same time, the authors evaluate the patient's opinion regarding the treatment he/she receives. This study was carried out in the Valladolid University Clinical Hospital's Department of Radiotherapy. This study showed that the Catrix brand dressing is more effective than hydrocolloidal dressings as a treatment of lesions caused by radiodermatitis. Both the nursing personnel and patients involved in this study rated this Catrix product higher than those hydrocolloidal dressings products tested.
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Ohta H, Ninomiya Y, Seki M, Ueno M, Oguchi M, Yamashita T, Yanagisawa A. [Detrimental phenomena and their treatment in radiotherapy for rectal cancer]. Nihon Rinsho 2003; 61 Suppl 7:444-8. [PMID: 14574932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- Hirotoshi Ohta
- Department of Gastrointestinal Surgery, Cancer Institute Hospital
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Carrotte-Lefebvre I, Delaporte E, Mirabel X, Piette F. [Radiation-induced skin reactions (except malignant tumors)]. Bull Cancer 2003; 90:319-25. [PMID: 12801815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The aim of this work, synthesized from personal case reports and a review of literature is to describe cutaneous complications of radiation therapy (except radiation-induced cancers): known and frequent such as radiation dermatitis or less frequent, beginning or strictly limited on irradiated skin areas: acne, infectious diseases, dyskeratosis, Grover's disease, sub-cutaneous pustulosis, cutaneous lichen, morphea, autoimmune bullous dermatosis, subacute cutaneous lupus erythematosus. Furthermore, we try to precise the physiopathogenic mechanisms of these dermatosis and we want to draw the attention on these dermatoses which sometimes need a multidisciplinary approach.
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Abstract
More than 50% of all cancer patients receive some form of radiotherapy for tumor control preoperatively, postoperatively, or as sole treatment. Radiation-induced wounds are a concern for patients and practitioners. Current research investigating alternative treatment strategies offers the hope of improved wound healing and enhanced quality of life for patients with these wounds. This paper reviews the pathophysiology of wounds following radiation treatment, the methods for treating radiation-induced wounds, and experimental treatment strategies that have been investigated.
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