Acute radiodermatitis in cancer patients: incidence and severity estimates

Abstract

Objective: To estimate the incidence and distribution of the degree of radiodermatitis in cancer patients submitted to radiotherapy in the regions of head and neck, breast, and pelvis. Method: Prospective, longitudinal, quantitative study conducted from March 15, 2016 to May 4, 2017 with patients observed for five weeks of treatment. The primary outcome was the proportion of grade 1 or higher radiodermatitis each week. The degree of radiodermatitis and mean time of occurrence for each patient were secondary outcomes. Results: This study included 112 patients. The incidence of radiodermatitis was 100% among those whose head and neck region was irradiated, followed by 98% for breast and 48% for the pelvic region. The degree of radiodermatitis varied with the irradiated site; the worst degrees were found in the head and neck region, followed by the breast. In the three groups, the mean time of the first occurrence of radiodermatitis was approximately eleven days. Conclusion: The incidence of radiodermatitis in the studied groups was high, which reinforces the need to perform the same evaluation nationwide. This would support creating and standardizing protocols and recommendations for a proper management of radiodermatitis, specially concerning its prevention.

Factors on development and severity of acute radiodermatitis: prospective single-center study

“…According to this study, the first appearance of RD was approximately 11 days (24). In current study, in patients with grade 1 RD and not progressing to grade 2 or 3; the starting dose of grade 1 RD is 32 Gy (range, 16-56).…”

Rastreamento e caracterização de lesões de pele pré-cancerosas: uma revisão integrativa

“…Em geral, as manifestações cutâneas aparecem dentro de 10 a 14 dias após o início da e-Acadêmica, v. 3, n. 3, e2033300, 2022 (CC BY 4.0) | ISSN 2675-8539 | DOI: http://dx.doi.org/10.52076/eacad-v3i3.300 radioterapia e observa-se, tipicamente, uma intensificação das lesões em sessões subsequentes, pela exposição contínua à radiação, sem tempo adequado para reparação do dano tecidual. (Rocha et al, 2021;Bontempo et al, 2021) Contudo, as radiodermites podem ser classificadas de acordo com o período de aparecimento em manifestações precoces ou tardias. Os danos precoces ou agudos surgem horas a semanas após a exposição e geralmente possuem melhor prognóstico, podendo evoluir até mesmo com remissão espontânea.…”

“…Neste sentido, sobressaem-se condições como obesidade e presença de mamas volumosas, que potencialmente aumentam a quantidade de dobras cutâneas gerando regiões de maior fricção e fragilidade. (Bontempo et al, 2021) Além disso, fatores relacionados à técnica empregada e o número de sessões também são relevantes. Estudos comprovam que a técnica de radioterapia modulada por intensidade (IMRT) gera resultados mais satisfatórios quando comparada à irradiação convencional, por administrar doses mais homogêneas, evitando pontos quentes de radiação e reduzindo, dessa forma, a quantidade e a intensidade das manifestações cutâneas subsequentes.…”

Prevention of Radiodermatitis With Topical Chinese Herbal Medicine: A Systematic Review and Meta-Analysis

“…Patients with breast cancer, head and neck cancer, lung cancer, or sarcoma are more likely to suffer from RD ( Fuzissaki et al, 2019 ; Tinkle et al, 2021 ; Yokota et al, 2021 ; Louie et al, 2022 ). Erythema is the predominant sign among RD patients, while 42 and 15% of patients developed RT-induced grade 3 and 4 skin toxicities characterized by desquamation, ulceration, and pigment changes ( Hu et al, 2018 ; Bontempo et al, 2021 ). The consequences of RD can be serious, including dose reduction or discontinuation of therapy, delayed treatment, diminished esthetic appeal, and significantly impaired quality of life.…”