Quantitative assessment of radiodermatitis through a non‑invasive objective procedure in patients with breast cancer

Abstract

Assessment of skin condition is necessary for providing advice regarding skin self-care to patients with breast cancer who have undergone radiation therapy. Acute and chronic phases of radiodermatitis were analyzed in patients using objective assessment tools in the present study. A total of 18 women who received radiation therapy for breast cancer were enrolled in the present study and their skin surface temperature (SST), hydration level of the skin surface (HL), melanin intensity (MI) and erythema intensity (EI) were measured prior to radiation therapy and six months thereafter. Furthermore, skin condition was assessed using the Common Terminology Criteria for Adverse Events (CTCAE). EI and MI levels at the irradiated site peaked upon the completion of radiation therapy and declined to baseline at 6 months. In contrast, SST levels were elevated at the irradiated site during radiation therapy (P<0.05) and plateaued after its completion. The same parameters in non-irradiated control sites remained unchanged during the study period. HL reached the minimum in irradiated and non-irradiated sites upon completion of radiation therapy. Although HL returned to baseline in the non-irradiated site 6 months after radiation therapy, it remained low in the irradiated site. No relationship between the CTCAE and EI level was observed. In conclusion, the present study demonstrated that objective assessment tools, including SST and EI levels, were useful for assessing skin condition during radiodermatitis. The combination of the CTCAE and objective assessment tools will enable a more accurate assessment of radiodermatitis.

Objective Evaluation of Risk Factors for Radiation Dermatitis in Whole-Breast Irradiation Using the Spectrophotometric L*a*b Color-Space

“…Owing to the simple and quick application, these subjective gradings are widely accepted. However, such visual assessments were shown to be prone to considerable biases due to substantial intra- and inter-evaluator differences [ 6 , 9 , 11 , 16 , 17 ]. Especially when it comes to evaluating new therapeutic strategies for RID or the combination of radiotherapy with novel immunomodulatory agents, even minimal dermatitis differences are of interest, which in turn renders objective and precise assessments indispensable [ 11 ].…”

“…While initially developed for the dye and textile industry, SP was consequently utilized in the objective and reliable assessment of skin color differences. Feasibility studies showed that SP can determine even slight skin luminance and color differences which may not be perceived by a human observer or photographs [ 10 , 16 , 17 , 18 ]. Turesson et al were among the first to use spectrophotometers for an accurate and objective radiation dermatitis evaluation already in the 1970s [ 19 , 20 , 21 , 22 ].…”

“…In light of the aforementioned and varying study results, this quintessence was not entirely unexpected. Many authors, therefore, concluded that future studies should endeavor to meet the requirement for a more objective approach in the RID evaluation process [ 5 , 6 , 16 , 17 ].…”

Tomato Juice Consumption Could Improve Breast Skin Adverse Effects of Radiotherapy in Breast Cancer Patients

“…Measurement of skin surface temperature and skin moisture. Previous studies have reported changes in skin surface temperature and skin moisture for breast cancer patients undergoing radiotherapy (11). The measurement of skin surface temperature is particularly useful as a method for evaluating the skin condition.…”

Evaluation of the risk factors of radio-dermatitis after breast-conserving surgery

“…The second observation end point was when the patient's skin symptoms were first assessed as radioactive dermatitis. The severity of radiodermatitis was determined on the basis of the clinical manifestations of grade 1-3 radiodermatitis which were defined in the Common terminology criteria for adverse events (CTCAE) version 4.0, which has been designed by the National Cancer Institute (NCI) of the National Institutes of Health (NIH), to evaluate the severity of organ or tissue toxicity or damage for patients receiving cancer therapy [10] . Before radiotherapy, the patients were informed with the information about potential skin damage during the radiotherapy by their attending physician, and to be asked to report the skin changes in a timely manner without self-treatment.…”