Jakub Pazdrowski1, Adriana Polaſska2, Joanna Kaźmierska3,4, Wojciech Barczak1,5, Mateusz Szewczyk1, Zygmunt Adamski6, Ryszard Żaba2, Paweſ Golusiſski1,7,8, Wojciech Golusiſski1, Aleksandra Daſczak-Pazdrowska6. 1. Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Garbary 15, 61-866 Poland. 2. Department of Dermatology and Venereology, Poznan University of Medical Sciences, Przybyszewskiego 49, Poznan, 60-355, Poland. 3. Radiotherapy Department II Greater Poland Cancer Center, Garbary 15, Poznan, 61-866 Poland. 4. Electroradiology Department, University of Medical Sciences, Poznan, Poland. 5. Radiobiology Lab, The Greater Poland Cancer Centre, Garbary 15, Poznan, 61-866 Poland. 6. Department of Dermatology, Poznan University of Medical Sciences, Przybyszewskiego 49, Poznan, 60- 355 Poland. 7. Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poland. 8. Department of Otolaryngology and Maxillofacial Surgery, University of ZielonaGóra, Poland.
Abstract
AIM: To present the possibility of non-invasive monitoring of the skin after radiotherapy in regards of epidermal barrier function. BACKGROUND: Radiodermatitis constitutes 95% of all side effects in patients after radiotherapy. The proper assessment of the severity of radiodermatitis can be determined using semi-quantitative clinical scores [Common Terminology Criteria for Adverse Events v 4.0 (CTCAE)].The most accepted way to analyze the epidermal barrier function is to determine Transepidermal Water Loss (TEWL). MATERIAL AND METHODS: In prospective study, we included 16 patients diagnosed with head and neck cancer treated with radiotherapy or concomitant chemoradiation in whom we performed non-invasive assessments of the skin barrier function, including TEWL measurement. The final analysis included 6 patients (4 treated with adjuvant radiotherapy, 2 with radical chemoradiation). Clinical assessment of irradiated skin was based on target lesion score (TLS) and CTCAE v 4.0. RESULTS: The mean TLS score in the middle of irradiation was 1.6 points, after last irradiation it was 2.3 points; 3 months later the mean TLS score was: 0. CTCAE v 4.0 criteria: 2 patients had grade 0, 3 patients - grade 1; 1 patient - grade 2. There were statistically significant differences in TEWL related to irradiated skin in the following time intervals: before vs. in the middle; before vs. day after; in the middle vs. day after; in the middle vs. 3 months after; day after vs. 3 months after. CONCLUSIONS: The study showed that radiotherapy causes skin barrier dysfunction in all patients independently of clinical radiodermatitis. The biophysical features of this dysfunction can precede clinical symptoms and they can be assessed by non-invasive and objective methods.
AIM: To present the possibility of non-invasive monitoring of the skin after radiotherapy in regards of epidermal barrier function. BACKGROUND: Radiodermatitis constitutes 95% of all side effects in patients after radiotherapy. The proper assessment of the severity of radiodermatitis can be determined using semi-quantitative clinical scores [Common Terminology Criteria for Adverse Events v 4.0 (CTCAE)].The most accepted way to analyze the epidermal barrier function is to determine Transepidermal Water Loss (TEWL). MATERIAL AND METHODS: In prospective study, we included 16 patients diagnosed with head and neck cancer treated with radiotherapy or concomitant chemoradiation in whom we performed non-invasive assessments of the skin barrier function, including TEWL measurement. The final analysis included 6 patients (4 treated with adjuvant radiotherapy, 2 with radical chemoradiation). Clinical assessment of irradiated skin was based on target lesion score (TLS) and CTCAE v 4.0. RESULTS: The mean TLS score in the middle of irradiation was 1.6 points, after last irradiation it was 2.3 points; 3 months later the mean TLS score was: 0. CTCAE v 4.0 criteria: 2 patients had grade 0, 3 patients - grade 1; 1 patient - grade 2. There were statistically significant differences in TEWL related to irradiated skin in the following time intervals: before vs. in the middle; before vs. day after; in the middle vs. day after; in the middle vs. 3 months after; day after vs. 3 months after. CONCLUSIONS: The study showed that radiotherapy causes skin barrier dysfunction in all patients independently of clinical radiodermatitis. The biophysical features of this dysfunction can precede clinical symptoms and they can be assessed by non-invasive and objective methods.
Authors: Anna Olewicz-Gawlik; Adriana Polańska; Dorota Trzybulska; Michalina Nowak-Gabryel; Katarzyna Błochowiak; Jarosław Kocięcki; Jerzy Sokalski; Ryszard Żaba; Zygmunt Adamski; Aleksandra Dańczak-Pazdrowska Journal: Acta Dermatovenerol Croat Date: 2018-06 Impact factor: 1.256