[an error occurred while processing this directive]|[an error occurred while processing this directive]
放射性皮炎预防与治疗研究进展
欧丹, 王孝深, 胡超苏
复旦大学附属肿瘤医院放疗科 复旦大学上海医学院肿瘤学系 200032
Research advances in the prevention and treatment of radiation-induced dermatitis
Ou Dan, Wang Xiaoshen, Hu Chaosu
Department of Radiation Oncology,Fudan University Shanghai Cancer Center;Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032,China
Abstract:Radiation-induced dermatitis (RD) is one of the most common complications induced by radiotherapy in cancer patients. The incidence and severity of RD are largely associated with the risk factors of patients. RD can severely affect the quality of life, even discontinue the treatment and reduce the tumor control rate in severe patients. Currently, randomized control trials evaluating the preventive measures for acute RD have been rarely conducted. The clinical interventions for acute RD significantly vary. In this article, the pathogenesis, risk factors, clinical manifestations, evaluation, prevention and treatment of RD were investigated.
Ou Dan,Wang Xiaoshen,Hu Chaosu. Research advances in the prevention and treatment of radiation-induced dermatitis[J]. Chinese Journal of Radiation Oncology, 2019, 28(2): 151-154.
[1] McQuestion M.Evidence-based skin care management in radiation therapy:clinical update[J].Semin Oncol Nurs,2011,27(2):e1-17.DOI:10.1016/j.soncn.2011.02.009. [2] Lopez E,Guerrero R,Nunez MI,et al. Early and late skin reactions to radiotherapy for breast cancer and their correlation with radiation-induced DNA damage in lymphocytes[J].Breast Cancer Res,2005,7(5):R690-698.DOI:10.1186/bcr1277. [3] Trott KR,Shirazi A,Heasman F.Modulation of accelerated repopulation in mouse skin during daily irradiation[J].Radiother Oncol,1999,50(3):261-266.DOI:10.1016/S0167-8140(98)00136-4. [4] Koenig TR,Wolff D,Mettler FA,et al. Skin injuries from fluoroscopically guided procedures:part 1,characteristics of radiation injury[J].AJR Am J Roentgenol,2001,177(1):3-11.DOI:10.2214/ajr.177.1.1770003. [5] Muller K,Meineke V.Radiation-induced alterations in cytokine production by skin cells[J].Exp Hematol,2007,35(4 Suppl 1):96-104.DOI:10.1016/j.exphem.2007.01.017. [6] Muller K,Meineke V.Radiation-induced mast cell mediators differentially modulate chemokine release from dermal fibroblasts[J].J Dermatol Sci,2011,61(3):199-205.DOI:10.1016/j.jdermsci.2011.01.003. [7] Martin M,Lefaix J,Delanian S.TGF-beta1 and radiation fibrosis:a master switch and a specific therapeutic target?[J].Int J Radiat Oncol Biol Phys,2000,47(2):277-290.DOI:10.1016/S0360-3016(00)00435-1. [8] Denham JW,Hauer-Jensen M.The radiotherapeutic injury—a complex ‘wound’[J].Radiother Oncol,2002,63(2):129-45.DOI:10.1016/S0167-8140(02)00060-9. [9] Quarmby S,Kumar P,Kumar S.Radiation-induced normal tissue injury:role of adhesion molecules in leukocyte-endothelial cell interactions[J].Int J Cancer,1999,82(3):385-95.DOI:10.1002/(SICI)1097-0215(19990730)82:3<385::AID-IJC12>3.0.CO;2-5. [10] Delfino S,Brunetti B,Toto V,et al. Burn after breast reconstruction[J].Burns,2008,34(6):873-7.DOI:10.1016/j.burns.2007.11.004. [11] Bray FN,Simmons BJ,Wolfson AH,et al. Acute and chronic cutaneous reactions to ionizing radiation therapy[J].Dermatol Ther (Heidelb),2016,6(2):185-206.DOI:10.1007/s13555-016-0120-y. [12] Hymes SR,Strom EA,Fife C.Radiation dermatitis:clinical presentation,pathophysiology,and treatment 2006[J].J Am Acad Dermatol,2006,54(1):28-46.DOI:10.1016/j.jaad.2005.08.054. [13] Dorr W.Skin and other reactions to radiotherapy—clinical presentation and radiobiology of skin reactions[J].Front Radiat Ther Oncol,2006,39(1):96-101.DOI:10.1159/000090854. [14] Lee N,Chuang C,Quivey JM,et al. Skin toxicity due to intensity-modulated radiotherapy for head-and-neck carcinoma[J].Int J Radiat Oncol Biol Phys,2002,53(3):630-637.DOI:10.1016/S0360-3016(02)02756-6. [15] Tejwani A,Wu S,Jia Y,et al. Increased risk of high-grade dermatologic toxicities with radiation plus epidermal growth factor receptor inhibitor therapy[J].Cancer,2009,115(6):1286-1299.DOI:10.1002/cncr.24120. [16] Ryan JL.Ionizing radiation:the good,the bad,and the ugly[J].J Invest Dermatol,2012,132(3 pt 2):985-993.DOI:10.1038/jid.2011.411. [17] NCI. Common terminology criteria for adverse events (CTCAE) v5.0[S].2017-11-27. [18] Cox JD,Stetz J,Pajak TF.Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)[J].Int J Radiat Oncol Biol Phys,1995,31(5):1341-1346.DOI:10.1016/0360-3016(95)00060-C. [19] LENT SOMA scales for all anatomic sites[J].Int J Radiat Oncol Biol Phys,1995,31(5):1049-1091. [20] Shukla PN,Gairola M,Mohanti BK,et al. Prophylactic beclomethasone spray to the skin during postoperative radiotherapy of carcinoma breast:a prospective randomized study[J].Indian J Cancer,2006,43(2):180-184.DOI:10.4103/0019-509X.29424. [21] Schmuth M,Wimmer MA,Hofer S,et al. Topical corticosteroid therapy for acute radiation dermatitis:a prospective,randomized,double-blind study[J].Br J Dermatol,2003,146(6):983-991.DOI:10.1046/j.1365-2133.2002.04751.x. [22] Boström A,Lindman H,Swartling C,et al. Potent corticosteroid cream (mometasone furoate) significantly reduces acute radiation dermatitis:results from a double-blind,randomized study[J].Radiother Oncol,2001,59(3):257-265.DOI:10.1016/S0167-8140(01)00327-9. [23] Miller RC,Schwartz DJ,Sloan JA,et al. Mometasone furoate effect on acute skin toxicity in breast cancer patients receiving radiotherapy:a phase Ⅲ double-blind,randomized trial from the North Central Cancer Treatment Group N06C4[J].Int J Radiat Oncol Biol Phys,2011,79(5):1460-6.DOI:10.1016/j.ijrobp.2010.01.031. [24] Hindley A,Zain Z,Wood L,et al. Mometasone furoate cream reduces acute radiation dermatitis in patients receiving breast radiation therapy:results of a randomized trial[J].Int J Radiat Oncol Biol Phys,2014,90(4):748-755.DOI:10.1016/j.ijrobp.2014.06.033. [25] Abbas H,Bensadoun RJ.Trolamine emulsion for the prevention of radiation dermatitis in patients with squamous cell carcinoma of the head and neck[J].Support Care Cancer,2012,20(1):185-190.DOI:10.1007/s00520-011-1110-3. [26] 魏世鸿,罗宏涛,王小虎,等.医用射线防护剂防治乳腺癌根治术后急性放射性皮肤损伤的临床观察[J].中国临床医生杂志,2018,46(8):59-60.DOI:10.3969/ j.issn.2095-8552.2018.08. Wei SH,Luo HT,Wang XH,et al. Clinical effect of medical radiation protective ointment to prevent acute radiation-induced skin injury in breast cancer patients undergoing radiotherapy after radical mastectomy[J]. Chin Clin Dr,2018,46(8):59-60.DOI:10.3969/ j.issn.2095-8552.2018.08. [27] 刘瑛,李丽莎,谢逢安,等.医用射线防护剂可减轻头颈部鳞癌患者的放疗皮肤损伤[J].南方医科大学学报,2016,36(3):443-444.DOI:10.3969/j.issn.1673-4254.2016.03.29. Liu Y,Li LS,Xie FA,et al. Clinical effect of medical radiation protective ointment to reduce radiation-induced skin injury in head and neck squamous cell cancer patients[J].J Southern Med Univ,2016,36(3):443-444.DOI:10.3969/j.issn.1673-4254.2016.03.29. [28] 蓝晓雯,林潇,何海艳,等.医用射线防护剂对比三乙醇胺乳膏防治乳腺癌改良根治术后放疗皮肤损伤临床观察[J].中华放射肿瘤学杂志,2018,27(9):818-821.DOI:10.3760/cma.j.issn.1004-4221.2018.09.006. Lan XW,Lin S,He HY,et al. Clinical effect of medical radiation protective ointment compared with trolamine cream to prevent acute radiation-induced skin injury in breast cancer patients undergoing radiotherapy after modified radical mastectomy[J].Chin J Radiat Oncol,2018,27(9):818-821.DOI:10.3760/cma.j.issn.1004-4221.2018.09.006. [29] Kaul R,Mishra BK,Sutradar P,et al. The role of Wobe-Mugos in reducing acute sequela of radiation in head and neck cancers—a clinical phase-Ⅲ randomized trial[J].Indian J Cancer,1999,36(2-4):141-148. [30] Gujral MS,Patnaik PM,Kaul R,et al. Efficacy of hydrolytic enzymes in preventing radiation therapyinduced side effects in patients with head and neck cancers[J].Cancer Chemother Pharmacol,2001,47(Suppl 1):S23-S28.