Hiroshi Sekine1, Yoshikazu Kijima2, Masao Kobayashi2, Jun Itami3, Kana Takahashi3, Hiroshi Igaki3, Yasuo Nakai4, Hitoshi Mizutani4,5, Yoshihito Nomoto6, Katsuko Kikuchi7,8, Haruo Matsushita9, Keiko Nozawa10. 1. Department of Radiology, The Jikei University School of Medicine, The Jikei University Daisan Hospital, 4-11-1 Izumi-Honcyo, Komae, Tokyo, 201-8601, Japan. h-sekine@jikei.ac.jp. 2. Department of Radiology, The Jikei University School of Medicine, The Jikei University Daisan Hospital, 4-11-1 Izumi-Honcyo, Komae, Tokyo, 201-8601, Japan. 3. Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan. 4. Department of Dermatology, Mie University Graduate School of Medicine, Tsu, Mie, Japan. 5. Sakuragi Memorial Hospital, Matsusaka, Mie, Japan. 6. Department of Radiation Oncology, Mie University Graduate School of Medicine, Tsu, Mie, Japan. 7. Sendai Taihaku Dermatology Clinic, Sendai, Miyagi, Japan. 8. Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. 9. Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. 10. Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan.
Abstract
BACKGROUND: Recent improvement of machinery evaluation for the skin changes in various therapies enabled us to evaluate fine changes quantitatively. In this study, we performed evaluation of the changes in radiation dermatitis (RD) using quantitative and qualitative methods, and verified the validity of the conventional qualitative assessment for clinical use. METHODS: Forty-three breast cancer patients received conventional fractionated radiotherapy to whole breast after breast-conserving surgery. Erythema, pigmentation and skin dryness were evaluated qualitatively, and biophysical parameters of RD were measured using a Multi-Display Device MDD4 with a Corneometer for capacitance, a Tewameter for transepidermal water loss (TEWL), a Mexameter for erythema index and melanin index. Measurements were performed periodically until 1 year. RESULTS: The quantitative manifestations developed serially from skin erythema followed by dryness and pigmentation. Quantitative measurements detected the effects of irradiation earlier than that of qualitative indices. However, the grades of the domains in RD by qualitative and quantitative assessment showed similar time courses and peak periods. However, no significant correlation was observed between the skin dryness grade and skin barrier function. In contrast to serial increase in pigmentation grades, melanin index showed initial decrease followed by marked increase with significant correlation with pigmentation grades. CONCLUSION: Subjectively and objectively measured results of RD were almost similar course and peak points through the study. Therefore, validity of the conventional qualitative scoring for RD is confirmed by the present quantitative assessments. Instrumental evaluations revealed the presence of modest inflammatory changes before radiotherapy and long-lasting skin dryness, suggesting indication of intervention for RD.
BACKGROUND: Recent improvement of machinery evaluation for the skin changes in various therapies enabled us to evaluate fine changes quantitatively. In this study, we performed evaluation of the changes in radiation dermatitis (RD) using quantitative and qualitative methods, and verified the validity of the conventional qualitative assessment for clinical use. METHODS: Forty-three breast cancerpatients received conventional fractionated radiotherapy to whole breast after breast-conserving surgery. Erythema, pigmentation and skin dryness were evaluated qualitatively, and biophysical parameters of RD were measured using a Multi-Display Device MDD4 with a Corneometer for capacitance, a Tewameter for transepidermal water loss (TEWL), a Mexameter for erythema index and melanin index. Measurements were performed periodically until 1 year. RESULTS: The quantitative manifestations developed serially from skin erythema followed by dryness and pigmentation. Quantitative measurements detected the effects of irradiation earlier than that of qualitative indices. However, the grades of the domains in RD by qualitative and quantitative assessment showed similar time courses and peak periods. However, no significant correlation was observed between the skin dryness grade and skin barrier function. In contrast to serial increase in pigmentation grades, melanin index showed initial decrease followed by marked increase with significant correlation with pigmentation grades. CONCLUSION: Subjectively and objectively measured results of RD were almost similar course and peak points through the study. Therefore, validity of the conventional qualitative scoring for RD is confirmed by the present quantitative assessments. Instrumental evaluations revealed the presence of modest inflammatory changes before radiotherapy and long-lasting skin dryness, suggesting indication of intervention for RD.
Entities:
Keywords:
Erythema; Pigmentation; Radiation dermatitis; Skin water content; Transepidermal water loss
Authors: Y Huang; J Sanz; N Rodríguez; X Duran; A Martínez; X Li; P Foro; M Conde; M Zhao; F Liu; A Reig; J Dengra; I Membrive; P Pérez; M Algara Journal: Clin Transl Oncol Date: 2021-11-18 Impact factor: 3.340