Evidence-Based Skin Care Management in Radiation Therapy: Clinical Update

McQuestion, Maurene

doi:10.1016/j.soncn.2011.02.009

Cited by 243 publications

(284 citation statements)

References 58 publications

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“…1 Typical skin reactions begin with erythema and may progress through stages of dry desquamation, moist desquamation and ulceration. [1][2][3] Skin reactions are patient specific and factors affecting the onset and severity of skin reactions are treatment and patient dependent. Treatment associated factors include target location, beam type, energy and technique, fraction size, fraction and total dose, and use of dose modifying materials such as bolus, wedges and filters.…”

Section: Introductionmentioning

confidence: 99%

“…Patient related factors may include age, concurrent therapy (e.g., chemotherapy) and condition of the skin which may be affected by previous surgery or disease, patient's typical skin routine and previous sun exposure. 1,3 Oncology staff provide information and interventions to manage these acute effects. Information includes instructions on maintaining skin cleanliness and integrity preventatively.…”

Section: Introductionmentioning

confidence: 99%

“…Interventions may include medicated topical agents and dressings to manage discomfort, avoid infection and promote healing. 1,4,5 Optimal prevention and management of skin reactions in RT is complicated by wide-spread concerns among professionals in the field that applying products on the skin during radiation delivery will increase skin dose and toxicity. [6][7][8] Patient education often includes teaching patients to avoid applying creams, lotions and deodorants on the skin before RT due to fear of increasing the severity of skin reactions.…”

Section: Introductionmentioning

confidence: 99%

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Dosimetric impacts on skin toxicity for patients using topical agents and dressings during radiotherapy

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dosimetric impacts on skin toxicity for patients using topical agents and dressings during radiotherapy

et al. 2016

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“…RT-induced dermatitis. 2 Acute skin toxicities arise in greater than 40% of all patients receiving RT; the most common of these include erythema and moist desquamation. 2 Severe acute skin toxicities, as scored by Common Toxicity Criteria (CTC) grade (according to the National Cancer Institute CTC v3.0), can result in termination of RT, impairing the adjuvant management of BC.…”

Section: Introductionmentioning

confidence: 99%

ElevatedARG1expression in primary monocytes-derived macrophages as a predictor of radiation-induced acute skin toxicities in early breast cancer patients

Jung

Sabri

Hanson

et al. 2015

Cancer Biology & Therapy

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Radiation therapy (RT) the front-line treatment after surgery for early breast cancer patients is associated with acute skin toxicities in at least 40% of treated patients. Monocyte-derived macrophages are polarized into functionally distinct (M1 or M2) activated phenotypes at injury sites by specific systemic cytokines known to play a key role in the transition between damage and repair in irradiated tissues. The role of M1 and M2 macrophages in RT-induced acute skin toxicities remains to be defined. We investigated the potential value of M1 and M2 macrophages as predictive factors of RT-induced skin toxicities in early breast cancer patients treated with adjuvant RT after lumpectomy. Blood samples collected from patients enrolled in a prospective clinical study (n D 49) were analyzed at baseline and after the first delivered 2Gy RT dose. We designed an ex vivo culture system to differentiate patient blood monocytes into macrophages and treated them with M1 or M2-inducing cytokines before quantitative analysis of their "M1/M2" activation markers, iNOS, Arg1, and TGFß1. Statistical analysis was performed to correlate experimental data to clinical assessment of acute skin toxicity using Common Toxicity Criteria (CTC) grade for objective evaluation of skin reactions. Increased ARG1 mRNA significantly correlated with higher grades of erythema, moist desquamation, and CTC grade. Multivariate analysis revealed that increased ARG1 expression in macrophages after a single RT dose was an independent prognostic factor of erythema (p D 0 .032), moist desquamation (p D 0 .027), and CTC grade (p D 0 .056). Interestingly, multivariate analysis of ARG1 mRNA expression in macrophages stimulated with IL-4 also revealed independent prognostic value for predicting acute RT-induced toxicity factors, erythema (p D 0 .069), moist desquamation (p D 0 .037), and CTC grade (p D 0 .046). To conclude, our findings underline for the first time the biological significance of increased ARG1 mRNA levels as an early independent predictive biomarker of RT-induced acute skin toxicities.

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“…Its physiopathology is complex, possibly related to injury of epidermis and endothelial cells from the basal layer by radiolysis, overproduction of free radicals, pro-inflammatory cytokines, and inflammation [3]. The presence of elements called inflammasomes, innate immune system receptors and sensors that regulate the activation of caspase-1 may induce inflammation in response to infectious microbes and molecules derived from host proteins [4] [5] or stress such as exposition of queratinocytes to radiation [6], releasing pro-inflammatory cytokines and exacerbated immune response.…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of PTCTS Cosmetic Gel: Study on Human Radiodermatitis Lesions

Graziani¹,

Eyll²,

Fristachi³

et al. 2015

CRCM

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Radiodermatitis is a constant complication after radiotherapy with no efficient drug for prevention and treatment. Its physiopathology is complex, possibly related to injury of epidermis and endothelial cells from the basal layer by radiolysis, overproduction of free radicals, pro-inflammatory cytokines, and inflammation. PTCTS gel is an after sun cosmetic gel composed by antioxidative plant extract rich in natural nanoparticles and thermal water (Complex A) and recombinant protein of Trypanosoma cruzi transialidase (Complex B), with high anti-oxidative and antiapoptotic effects, presenting anti-aging and healing cutaneous properties. Objective: To study the safety and efficacy of PTCTS gel for topic use in volunteer subjects with healthy skin, and in patients with radiodermatitis, in different concentrations of Complexes A and B. Material and Methods: The project was approved by the Ethical Committee of Arnaldo Vieira de Carvalho Institute, Sao Paulo, Brazil. The individuals were submitted to laboratorial toxicity study through tests for liver and kidney function, levels of blood glucose and blood count before and after 7 days of PTCTS application. We studied two groups: GI-22 volunteers with healthy skin, presenting articular or skeletal muscle pain and GII-38 patients in radiotherapy for breast or head and neck cancer, with radiodermatitis grade 2 or 3. The patients were evaluated before and after 1.0 ml/cm 2 PTCTS gel application, twice a day. We tested Complex B in four different concentrations, and Complex A concentrations varied inversely. Results: No irritation signs were observed in GI nor GII group, 64% of GI had important decrease in the intensity of the muscular or articular pain, and 99% of GII showed regression of radiodermatitis, all exhibiting relief of pain. No patient presented hematologic, renal or hepatic toxicity. Conclusion: PTCTS cosmetic gel is a safe option for radiodermatitis treatment, with no side effects or laboratorial toxicity in different concentrations. This product presented excellent clinical results even if used diluted 4 times more than the original product and may be a good option for treatment of radiodermatitis. Further studies may show if it is also indicated in the prevention of the lesion, and if it is better than products containing corticoids. S. R. Graziani et al.328

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Evidence-Based Skin Care Management in Radiation Therapy: Clinical Update

Cited by 243 publications

References 58 publications

Dosimetric impacts on skin toxicity for patients using topical agents and dressings during radiotherapy

Dosimetric impacts on skin toxicity for patients using topical agents and dressings during radiotherapy

ElevatedARG1expression in primary monocytes-derived macrophages as a predictor of radiation-induced acute skin toxicities in early breast cancer patients

Safety and Efficacy of PTCTS Cosmetic Gel: Study on Human Radiodermatitis Lesions

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