Objective: Severe acute radiation-induced skin reactions occur in a significant proportion of women who receive radiation therapy for breast cancer. We previously showed that Mepilex Lite dressings decreased the severity of erythema. Here we report their effect on the full range of skin reactions in 74 breast cancer patients post-mastectomy.
Methods:A total of 80 women were recruited from four hospitals in New Zealand with 74 women contributing a full data set for analysis. The first skin area on the chest wall to develop erythema was randomly divided into two similar halves; one half was treated with Mepilex Lite dressings, the other half with aqueous cream. Skin reactions were assessed using the Radiation-Induced Skin Reaction Assessment Scale.
Results:Compared with aqueous cream, Mepilex Lite dressings did not significantly reduce the incidence of moist desquamation but did reduce the overall severity of skin reactions by 41% (p<0.001), the average moist desquamation score by 49% (p=0.043) and the sum of the moist desquamation time for all patches by 28% from 25 to 18 weeks. Most patients preferred the dressings, found them easy to use and very comfortable to wear.
Conclusions:Mepilex Lite dressings reduce all aspects of radiation-induced skin reactions.
IntroductionThe aim of this study was to investigate the dosimetric differences between surface mould high‐dose‐rate (HDR) brachytherapy and external beam volumetric‐modulated arc therapy (VMAT) for two treatment sites.MethodsPreviously treated HDR brachytherapy surface mould scalp (n = 4) and lower leg (n = 3) treatments were retrospectively analysed. The VMAT plans were optimised using an additional 3‐mm setup margin on the clinical target volume (CTV) of the previously treated HDR plans. The HDR plans were calculated and normalised using the TG‐43 formalism and recalculated with Acuros BV (AC).ResultsOn average, the mean brain and normal tissue doses were reduced by 44.8% and 27.4% for scalp and lower leg VMAT cases, respectively, when compared to AC calculated HDR plans. For VMAT plans, the average dose to a 1‐mm thick skin structure deep to the target volume was not any lower than that in AC HDR plans. On average, the CTV coverage was 13.8% and 9.6% lower for scalp cases with AC dose calculation than with TG‐43 and 8.3% and 5.3% lower for lower leg cases if 0‐ or 1‐cm backscatter material was applied above the catheters, respectively.Conclusions
VMAT is a feasible treatment option in the case of extensive skin malignancies of the scalp and lower leg. Uncertainties related to delivered dose with HDR brachytherapy when using the TG‐43 dose calculation model or possible air gaps between the mould and skin favour the use of VMAT. The potential soft tissue deformation needs to be considered if VMAT is used.
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