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1.
J Pineal Res ; 75(1): e12873, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37055944

RESUMO

AIM: This was a double-blind, placebo-controlled randomized study investigating whether melatonin can protect against radiation dermatitis in women receiving radiation therapy for primary breast cancer. METHODS: Patients were included before radiation therapy and followed once weekly throughout treatment with a 3-week follow-up. Patients applied 1 g of cream to the irradiated skin twice daily, consisting of either 25 mg/g melatonin and 150 mg/g dimethyl sulfoxide, or placebo. Our outcomes were the Radiation Therapy Oncology Group's (RTOG) acute radiation morbidity scoring criteria for skin, a pixel analysis of erythema in clinical photographs, and patients' use of corticosteroid cream. Outcomes were evaluated once weekly throughout the trial. The primary outcomes were RTOG-score and pixel analysis at 2 weeks follow-up. Secondary outcomes were the use of corticosteroid cream and analyses of RTOG-scores and pixel analyses throughout the trial. RESULTS: Sixty-five patients were included, 17 dropped out, totaling 26 and 22 patients randomized to melatonin and placebo, respectively. RTOG-scores and pixel analyses at 2 weeks follow-up showed no difference p = .441 and p = .890, respectively). There was no difference in the use of corticosteroid cream (p = .055). Using logistic regression, the melatonin group had a higher likelihood of having a low RTOG-score (p = .0016). The logistic regression showed no difference between the groups for the pixel analyses. CONCLUSION: Our primary outcome showed no difference in RTOG-scores at 2 weeks follow-up, however, the RTOG-score over the entire duration of the study demonstrated a protective effect of melatonin. Further studies are warranted investigating higher doses of melatonin, and whether corticosteroids may influence the effect of melatonin cream against radiation dermatitis.


Assuntos
Neoplasias da Mama , Melatonina , Radiodermite , Humanos , Feminino , Melatonina/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/radioterapia , Radiodermite/tratamento farmacológico , Pele , Método Duplo-Cego
2.
J Pineal Res ; 74(1): e12840, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36385713

RESUMO

The aim of this double-blind, placebo-controlled, randomized study was to investigate whether topical melatonin administered during radiation therapy could increase the quality of life in patients with primary breast cancer. Patients were followed from the first radiation fraction until 3 weeks after the last. The patients applied 1 g of cream to the irradiated area of the skin twice daily, consisting of either 25 mg/g melatonin and 150 mg/g dimethyl sulfoxide, or a placebo cream. Outcomes were the European Organisation for Research and Treatment of Cancer's quality-of-life questionnaires for breast cancer (QLQ-C30 and QLQ-BR23) on the last day of radiation therapy. As a secondary outcome, we evaluated the breast symptom (BS) scores over the entire duration of the trial in a repeated measures linear model. We included 65 patients and had 17 drop-outs, thus totaling 26 and 22 patients in the melatonin and placebo groups, respectively. BS scores on the last day of radiation did not differ between groups (p = .333). However, the linear model analyzing BS for the entire duration showed that melatonin significantly decreased the symptoms (p = .001). There was no difference in the BS score on the last day of radiation, however, we found that the patients in the melatonin group had significantly lower BS scores over the entire duration of the trial.


Assuntos
Neoplasias da Mama , Dermatite , Melatonina , Humanos , Feminino , Melatonina/uso terapêutico , Qualidade de Vida , Neoplasias da Mama/radioterapia , Método Duplo-Cego
3.
Eur J Obstet Gynecol Reprod Biol ; 244: 128-133, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31785469

RESUMO

Incisional hernia is a well-known complication following abdominal surgery. A frequently performed abdominal operative procedure is cesarean section. In 2015 the median cesarean section rate in Europe was 27 % with rates up to 57 % when looking at individual countries, and the rates of cesarean sections increased with 4 % in Europe from 2010 to 2015. Nonetheless, the occurrence of incisional hernia subsequent to cesarean sections is uncertain. The aim of this study was to investigate the reported occurrence of incisional hernia after cesarean section. We included original studies with women who had given birth at least once through a cesarean section. For studies to be eligible for inclusion, a minimum follow-up period of six months as well as a population of ten or more included patients were required. The primary outcome was occurrence of incisional hernia after cesarean section. The secondary outcomes were frequency of subsequent hernia operations, and if the hernia occurrence differed between midline and lower transverse incision, and between acute and elective cesarean section. Three databases were systematically searched: PubMed, Embase, and the Cochrane Library. The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guideline (PRISMA) and registered with the international prospective register of systematic reviews (PROSPERO) (registration number: CRD42019129998). A total of 2170 potentially relevant studies were identified, and of these 28 studies were identified for full text screening. Five studies met the inclusion criteria comprising 275,878 women with a previous cesarean section. The studies reported an occurrence of incisional hernia subsequent to cesarean section between 0.0-5.6 % with a follow-up time ranging from six months to ten years. Very few known risk factors for incisional hernia development were reported in the included studies. Overall, we found a low risk of incisional hernia subsequent to cesarean sections, even after a long follow-up period. Based on the included studies it was not feasible to estimate the occurrence of incisional hernia in different types of incisions, whether the urgency of the cesarean section affected the incisional hernia development, or to estimate the frequency of subsequent hernia repair. Further well-designed studies are therefore warranted.


Assuntos
Cesárea/efeitos adversos , Hérnia Incisional/etiologia , Cesárea/métodos , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Herniorrafia , Humanos , Hérnia Incisional/cirurgia , Gravidez
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