PURPOSE: Radiation-induced normal-tissue toxicities are common, complex, and distressing side effects that affect 90% of patients receiving breast-cancer radiotherapy and 40% of patients post radiotherapy. In this study, the authors investigated the use of spectrophotometry and ultrasound to quantitatively measure radiation-induced skin discoloration and subcutaneous-tissue fibrosis. The study's purpose is to determine whether skin discoloration correlates with the development of fibrosis in breast-cancer radiotherapy. METHODS: Eighteen breast-cancer patients were enrolled in our initial study. All patients were previously treated with a standard course of radiation, and the median follow-up time was 22 months. The treated and untreated breasts were scanned with a spectrophotometer and an ultrasound. Two spectrophotometer parameters-melanin and erythema indices-were used to quantitatively assess skin discoloration. Two ultrasound parameters-skin thickness and Pearson coefficient of the hypodermis-were used to quantitatively assess severity of fibrosis. These measurements were correlated with clinical assessments (RTOG late morbidity scores). RESULTS: Significant measurement differences between the treated and contralateral breasts were observed among all patients: 27.3% mean increase in skin thickness (p < 0.001), 34.1% mean decrease in Pearson coefficient (p < 0.001), 27.3% mean increase in melanin (p < 0.001), and 22.6% mean increase in erythema (p < 0.001). All parameters except skin thickness correlated with RTOG scores. A moderate correlation exists between melanin and erythema; however, spectrophotometer parameters do not correlate with ultrasound parameters. CONCLUSIONS: Spectrophotometry and quantitative ultrasound are objective tools that assess radiation-induced tissue injury. Spectrophotometer parameters did not correlate with those of quantitative ultrasound suggesting that skin discoloration cannot be used as a marker for subcutaneous fibrosis. These tools may prove useful for the reduction of radiation morbidities and improvement of patient quality of life.
PURPOSE: Radiation-induced normal-tissue toxicities are common, complex, and distressing side effects that affect 90% of patients receiving breast-cancer radiotherapy and 40% of patients post radiotherapy. In this study, the authors investigated the use of spectrophotometry and ultrasound to quantitatively measure radiation-induced skin discoloration and subcutaneous-tissue fibrosis. The study's purpose is to determine whether skin discoloration correlates with the development of fibrosis in breast-cancer radiotherapy. METHODS: Eighteen breast-cancerpatients were enrolled in our initial study. All patients were previously treated with a standard course of radiation, and the median follow-up time was 22 months. The treated and untreated breasts were scanned with a spectrophotometer and an ultrasound. Two spectrophotometer parameters-melanin and erythema indices-were used to quantitatively assess skin discoloration. Two ultrasound parameters-skin thickness and Pearson coefficient of the hypodermis-were used to quantitatively assess severity of fibrosis. These measurements were correlated with clinical assessments (RTOG late morbidity scores). RESULTS: Significant measurement differences between the treated and contralateral breasts were observed among all patients: 27.3% mean increase in skin thickness (p < 0.001), 34.1% mean decrease in Pearson coefficient (p < 0.001), 27.3% mean increase in melanin (p < 0.001), and 22.6% mean increase in erythema (p < 0.001). All parameters except skin thickness correlated with RTOG scores. A moderate correlation exists between melanin and erythema; however, spectrophotometer parameters do not correlate with ultrasound parameters. CONCLUSIONS: Spectrophotometry and quantitative ultrasound are objective tools that assess radiation-induced tissue injury. Spectrophotometer parameters did not correlate with those of quantitative ultrasound suggesting that skin discoloration cannot be used as a marker for subcutaneous fibrosis. These tools may prove useful for the reduction of radiation morbidities and improvement of patient quality of life.
Authors: Soren M Bentzen; Wolfgang Dörr; Mitchell S Anscher; James W Denham; Martin Hauer-Jensen; Lawrence B Marks; Jacqueline Williams Journal: Semin Radiat Oncol Date: 2003-07 Impact factor: 5.934
Authors: B Emami; J Lyman; A Brown; L Coia; M Goitein; J E Munzenrider; B Shank; L J Solin; M Wesson Journal: Int J Radiat Oncol Biol Phys Date: 1991-05-15 Impact factor: 7.038
Authors: Tian Liu; Jun Zhou; Emi J Yoshida; Shermian A Woodhouse; Peter B Schiff; Tony J C Wang; Zheng Feng Lu; Eliza Pile-Spellman; Pengpeng Zhang; Gerald J Kutcher Journal: Int J Radiat Oncol Biol Phys Date: 2010-02-19 Impact factor: 7.038
Authors: Bernard Fisher; Stewart Anderson; John Bryant; Richard G Margolese; Melvin Deutsch; Edwin R Fisher; Jong-Hyeon Jeong; Norman Wolmark Journal: N Engl J Med Date: 2002-10-17 Impact factor: 91.245
Authors: Sandra Collette; Laurence Collette; Tom Budiharto; Jean-Claude Horiot; Philip M Poortmans; Henk Struikmans; Walter Van den Bogaert; Alain Fourquet; Jos J Jager; Willem Hoogenraad; Rolf-Peter Mueller; John Kurtz; David A L Morgan; Jean-Bernard Dubois; Emile Salamon; Rene Mirimanoff; Michel Bolla; Marleen Van der Hulst; Carla C Wárlám-Rodenhuis; Harry Bartelink Journal: Eur J Cancer Date: 2008-08-29 Impact factor: 9.162
Authors: Jolien Robijns; Sandrine Censabella; Stefan Claes; Luc Pannekoeke; Lore Bussé; Dora Colson; Iris Kaminski; Joy Lodewijckx; Paul Bulens; Annelies Maes; Leen Noé; Marc Brosens; An Timmermans; Ivo Lambrichts; Veerle Somers; Jeroen Mebis Journal: Support Care Cancer Date: 2018-10-01 Impact factor: 3.603
Authors: Olga Pernía; Cristobal Belda-Iniesta; Veronica Pulido; María Cortes-Sempere; Carlos Rodriguez; Olga Vera; Javier Soto; Julia Jiménez; Alvaro Taus; Federico Rojo; Edurne Arriola; Ana Rovira; Joan Albanell; M Teresa Macías; Javier de Castro; Rosario Perona; Inmaculada Ibañez de Caceres Journal: Epigenetics Date: 2014-11 Impact factor: 4.528