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1.
Rev Bras Enferm ; 75(1): e20210118, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34614087

RESUMO

OBJECTIVE: To estimate the incidence and degree of acute radiodermatitis at the end and after the end of treatment in women with breast cancer undergoing hypofractionated radiotherapy. METHODS: Observational, prospective, and longitudinal study, conducted between March 2019 and January 2020, in a radiotherapy outpatient clinic. RESULTS: Thirty-two women participated in the study, among whom, in the last session of hypofractionated radiotherapy, 15 (46.9%) had radiodermatitis, erythema in 13 (40.6%), and wet peeling in 2 (6.3%). In the post-treatment evaluation, 27 (84.4%) had radiodermatitis, erythema in 17 (53.1%), dry peeling in 8 (25%), and wet peeling in 2 (6.3%). CONCLUSION: The general incidence of radiodermatitis after hypofractionated radiotherapy in women with breast cancer was 37.5%, erythema, 12.5%, and dry peeling, 25%. The development of care protocols for the management of radiodermatitis after treatment is of paramount importance.


Assuntos
Neoplasias da Mama , Radiodermatite , Neoplasias da Mama/complicações , Neoplasias da Mama/radioterapia , Feminino , Humanos , Incidência , Estudos Longitudinais , Estudos Prospectivos , Radiodermatite/epidemiologia , Radiodermatite/etiologia
2.
Oncology ; 99(11): 740-746, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34515174

RESUMO

INTRODUCTION: It has been suggested that age could influence the treatment-induced side effects and survival time of cancer patients. The influence of age on blood-based biomarkers, acute radiation skin reactions (ARSRs), and survival time of breast cancer patients was analysed. MATERIALS AND METHODS: Two hundred ninety-three individuals, 119 breast cancer patients, and 174 healthy blood donors were included. RESULTS: Before radiotherapy (RT), decreased levels of lymphocytes, interleukin 2, platelet-derived growth factors, and tumour necrosis factor but increased levels of monocyte-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, C-reactive protein, and macrophage inflammatory protein 1b (MIP1b) were detected in the patient group. All of the patients developed ARSRs and intensity of ARSRs was inversely related to the MIP1b level before RT. Fifteen out of 119 (13%) patients deceased during follow-up time. No influence of age (≤50 compared to >50 years) on survival time was detected (p = 0.442). Tumour recurrence, found in 11 out of 119 (9%) patients, had impact on survival time of these patients (p < 0.001). CONCLUSIONS: The level of circulating MIP1b before RT was associated with intensity of ARSRs. Tumour recurrence, but not age, was associated with poor survival time. Analysis of circulating MIP1b was low cost, rapid, and could be done in routine laboratory facility. Since RT almost always induces ARSRs, the possibility of using MIP1b as a prognostic biomarker for ARSRs is of interests for further investigation.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/sangue , Neoplasias da Mama/sangue , Neoplasias da Mama/mortalidade , Recidiva Local de Neoplasia/mortalidade , Radiodermatite/sangue , Radiodermatite/etiologia , Radioterapia Adjuvante/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Neoplasias da Mama/radioterapia , Proteína C-Reativa/análise , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Contagem de Linfócitos , Linfócitos/metabolismo , Pessoa de Meia-Idade , Monócitos , Neutrófilos/metabolismo , Prognóstico , Estudos Prospectivos , Taxa de Sobrevida , Resultado do Tratamento
3.
Curr Oncol ; 28(5): 3474-3487, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34590607

RESUMO

We report long-term results (median follow-up 12 years) of hypofractionated accelerated radiotherapy (HypoAR) in patients treated with breast-conserving surgery. In total, 367 women were treated with HypoAR. Axillary and supraclavicular area (ASA) were treated in patients with involved nodes. In total, 290 patients (scheme A) received 3.5 Gy/day ×10 fractions (breast/ASA) followed by two 4 Gy fractions with electrons to the affected breast quadrant within 16 days. In total, 77 patients (Scheme B) received 2.7 Gy/day for 16 consecutive fractions (breast/ASA) within 22 days, while concurrently, the affected breast quadrant received an electron booster dose of 0.8 Gy for the first 13 fractions. Amifostine was offered to 252/367 patients. Early radiation toxicity was minimal. Regarding late toxicities, symptomatic breast edema was noted in 2.2%, asymptomatic breast fibrosis in 1.9%, and arm lymphedema in 3.7% of patients. Amifostine reduced early radiation dermatitis (p = 0.001). In total, 2.2% of patients developed contralateral breast and 1.6% other carcinomas. Locoregional recurrence (LR) occurred in 3.1% of patients (0% for in situ carcinomas). Positive margins after surgery, extracapsular node invasion, and HER2-enriched/triple-negative tumors were linked with significantly worse LR-free survival. The involvement of more than three nodes and luminal type other than A were independent prognostic variables of metastasis and death events. HypoAR delivering a biological dose of 50-52 Gy to the breast/ASA is a safe and effective therapy for patients treated with conservative surgery. The risk of carcinogenesis is low. Positive surgical margins, extracapsular node invasion, and HER2-enriched/triple-negative phenotypes appear as a cluster of features linked with a higher risk for locoregional relapse.


Assuntos
Amifostina , Radiodermatite , Feminino , Humanos , Linfonodos , Mastectomia Segmentar , Hipofracionamento da Dose de Radiação
5.
Int J Mol Sci ; 22(17)2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34502247

RESUMO

Previously, we showed that a nitric oxide synthase (NOS) inhibitor, compound T1023, induces transient hypoxia and prevents acute radiation syndrome (ARS) in mice. Significant efficacy (according to various tests, dose modifying factor (DMF)-1.6-1.9 against H-ARS/G-ARS) and safety in radioprotective doses (1/5-1/4 LD10) became the reason for testing its ability to prevent complications of tumor radiation therapy (RT). Research methods included studying T1023 effects on skin acute radiation reactions (RSR) in rats and mice without tumors and in tumor-bearing animals. The effects were evaluated using clinical, morphological and histological techniques as well as RTOG classification. T1023 administration prior to irradiation significantly limited the severity of acute RSR. This was due to a decrease in radiation alteration of the skin and underlying tissues, and the preservation of the functional activity of cell populations that are critical in the pathogenesis of radiation burn. The DMF values for T1023 for skin protection were 1.4-1.7. Moreover, its radioprotective effect was fully selective to normal tissues in RT models of solid tumors-T1023 reduced the severity of acute RSR and did not modify the antitumor effects of γ-radiation. The results indicate that T1023 can selectively protect the non-malignant tissues against γ-radiation due to hypoxic mechanism of action and potentiate opportunities of NOS inhibitors in RT complications prevention.


Assuntos
Carcinoma de Ehrlich/radioterapia , Raios gama/efeitos adversos , Óxido Nítrico Sintase/antagonistas & inibidores , Protetores contra Radiação/farmacologia , Radiodermatite/tratamento farmacológico , Sarcoma Experimental/radioterapia , Tioureia/análogos & derivados , Animais , Carcinoma de Ehrlich/patologia , Feminino , Masculino , Camundongos , Camundongos Endogâmicos ICR , Proteção Radiológica/métodos , Radiodermatite/etiologia , Radiodermatite/patologia , Ratos , Ratos Sprague-Dawley , Sarcoma Experimental/patologia , Tioureia/farmacologia
6.
Stem Cell Res Ther ; 12(1): 447, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372921

RESUMO

BACKGROUND: Radiation-induced dermatitis is a serious side effect of radiotherapy, and very few effective treatments are currently available for this condition. We previously demonstrated that apoptosis is an important feature of radiation-induced dermatitis and adipose-derived stem cells (ADSCs) are one of the most promising types of stem cells that have a protective effect on acute radiation-induced dermatitis. Cathepsin F (CTSF) is a recently discovered protein that plays an important role in apoptosis. In this study, we investigated whether ADSCs affect chronic radiation-induced dermatitis, and the underlying mechanisms involved. METHODS: ADSCs were isolated from male Sprague-Dawley (SD) rats and characterized. For in vivo studies, rats were randomly divided into control and ADSC-treated groups, and cultured ADSCs were transplanted into radiation-induced dermatitis model rats. The effects of ADSC transplantation were determined by skin damage scoring, histopathological analysis, electron microscopy, immunohistochemical staining, and western blotting analysis of apoptosis-related proteins. To evaluate the effects of ADSCs in vitro, radiation-induced apoptotic cells were treated with ADSC culture supernatant, and apoptosis-related protein expression was investigated by TUNEL staining, flow cytometry, and western blotting. RESULTS: In the in vivo studies, skin damage, inflammation, fibrosis, and apoptosis were reduced and hair follicle and sebaceous gland regeneration were enhanced in the ADSC group compared with the control group. Further, CTSF and downstream pro-apoptotic proteins (Bid, BAX, and caspase 9) were downregulated, while anti-apoptotic proteins (Bcl-2 and Bcl-XL) were upregulated. In vitro, ADSCs markedly attenuated radiation-induced apoptosis, downregulated CTSF and downstream pro-apoptotic proteins, and upregulated anti-apoptotic proteins. CONCLUSION: ADSCs protect against radiation-induced dermatitis by exerting an anti-apoptotic effect through inhibition of CTSF expression. ADSCs may be a good therapeutic candidate to prevent the development of radiation-induced dermatitis.


Assuntos
Células-Tronco Mesenquimais , Radiodermatite , Tecido Adiposo , Animais , Apoptose , Catepsina F , Células Cultivadas , Masculino , Ratos , Ratos Sprague-Dawley , Células-Tronco
7.
Gan To Kagaku Ryoho ; 48(7): 955-957, 2021 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-34267035

RESUMO

The case involved a 51-year-old woman who was diagnosed with Stage Ⅰ right breast cancer(cT1, N0, M0). Partial resection of the right breast and sentinel lymph node biopsy were performed. The histological type was found to be Stage Ⅰ triple-negative medullary carcinoma with pT1c, pN0(sn), and M0. A pituitary tumor was diagnosed after discharge. After removal of the pituitary tumor, whole-breast irradiation was performed. Subsequently, chemotherapy was started. Approximately 5 months after surgery, redness and swelling of the right breast were observed. Inflammatory breast cancer recurrence could not be ruled out by imaging, and skin biopsy was performed. No malignant findings were observed, and the symptoms were considered to indicate radiation recall dermatitis caused by chemotherapy. When chemotherapy was discontinued, the redness of the right breast improved.


Assuntos
Neoplasias da Mama , Neoplasias Inflamatórias Mamárias , Radiodermatite , Axila , Neoplasias da Mama/cirurgia , Feminino , Humanos , Neoplasias Inflamatórias Mamárias/diagnóstico , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Radiodermatite/diagnóstico , Radiodermatite/etiologia , Biópsia de Linfonodo Sentinela
8.
Cancer Radiother ; 25(6-7): 584-592, 2021 Oct.
Artigo em Francês | MEDLINE | ID: mdl-34272181

RESUMO

PURPOSE: To evaluate the current and potential indications of photobiomodulation (PBM) and their level of evidence in the prevention or management of radiation therapy-related side effects. MATERIALS AND METHODS: The Embase, Medline/PubMed, Cochrane, EBSCO, Scopus, and LILACS databases were systematically reviewed to include and analyze publications of clinical studies that have assessed PBM in the prevention or management of radiotherapy-related side effects. The keywords used were "photobiomodulation"; "low level laser therapy"; "acute oral mucositis"; "acute dysphagia"; "acute radiation dermatitis"; "lymphedema"; "xerostomia"; "hyposalivation"; "trismus"; "bone necrosis"; "osteoradionecrosis"; and "radiation induced fibrosis". Prospective studies were included, whereas retrospective cohorts and non-original articles were excluded from the analysis. RESULTS: PBM in the red or infrared spectrum has demonstrated efficacy in randomized controlled trials in the prevention and management of radiotherapy-related side effects, especially acute oral mucositis, acute radiation dermatitis, and upper extremity lymphedema. The level of evidence associated with PBM was heterogeneous, but overall was still moderate. The main shortcomings were the diversity and lack of detail in treatment protocols, which could have compromised efficiency and reproducibility of PBM results. CONCLUSION: The published data suggest that PBM may be considered as a full-fledged supportive care for patients treated with radiotherapy, or at least in the setting of a therapeutic clinical trial. However, until strong evidence has been published on its long-term safety, the use of PBM should be considered with caution, specifically when applied near areas with proven or potential tumors. The patient should be informed of the theoretical benefits and risks of PBM in order to obtain his informed consent before treatment.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Lesões por Radiação/radioterapia , Doença Aguda , Protocolos Clínicos , Transtornos de Deglutição/radioterapia , Fibrose/radioterapia , Humanos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Linfedema/radioterapia , Osteorradionecrose/radioterapia , Estudos Prospectivos , Radiodermatite/radioterapia , Radioterapia/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Reprodutibilidade dos Testes , Estomatite/radioterapia , Trismo/radioterapia , Xerostomia/radioterapia
9.
Clin J Oncol Nurs ; 25(4): E44-E49, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34269339

RESUMO

BACKGROUND: Radiation-induced skin dermatitis (RISD) is a common outcome experienced by adult patients with head and neck cancer (HNC) who have undergone radiation therapy. There is no standardized recommended agent for the prevention or management of RISD. OBJECTIVES: The primary objective of this study was to retrospectively evaluate for effectiveness of a botanical topical agent, CamWell® Herb to Soothe® cream, on RISD. METHODS: 112 patients with HNC undergoing radiation therapy self-reported their RISD topical skin care agent during treatment as standard of care, CamWell used prophylactically, or CamWell use started after the first week of treatment. The primary endpoint was impact of RISD on the patient, as measured by mean Skindex-16 score throughout treatment. Measures were completed weekly. FINDINGS: The mean Skindex score was statistically significantly lower for the prophylactic group than for the standard-of-care group. CamWell may have played a role in managing RISD when compared to standard-of-care agents.


Assuntos
Neoplasias de Cabeça e Pescoço , Radiodermatite , Adulto , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Radiodermatite/tratamento farmacológico , Radiodermatite/etiologia , Radiodermatite/prevenção & controle , Estudos Retrospectivos , Pele
10.
Crit Rev Oncol Hematol ; 163: 103391, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34102286

RESUMO

PURPOSE: Post mastectomy radiation therapy (PMRT) reduces locoregional recurrence (LRR) and breast cancer mortality for selected patients. Bolus overcomes the skin-sparing effect of external-beam radiotherapy, ensuring adequate dose to superficial regions at risk of local recurrence (LR). This systematic review summarizes the current evidence regarding the impact of bolus on LR and acute toxicity in the setting of PMRT. RESULTS: 27 studies were included. The use of bolus led to higher rates of acute grade 3 radiation dermatitis (pooled rates of 9.6% with bolus vs. 1.2% without). Pooled crude LR rates from thirteen studies (n = 3756) were similar with (3.5%) and without (3.6%) bolus. CONCLUSIONS: Bolus may be indicated in cases with a high risk of LR in the skin, but seems not to be necessary for all patients. Further work is needed to define the role of bolus in PMRT.


Assuntos
Neoplasias da Mama , Radiodermatite , Neoplasias da Mama/patologia , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Radioterapia Adjuvante/efeitos adversos
12.
Radiat Res ; 196(3): 250-260, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34107043

RESUMO

Severe radiation-induced skin injury is a complication of tumor radiotherapy and nuclear accidents. Cell therapy is a potential treatment for radiation-induced skin injury. The stromal vascular fraction (SVF) is a newer material in stem cell therapy that is made up of stem cells harvested from adipose tissue, which has been shown to promote the healing of refractory wounds of different causes. In this study, SVF was isolated from patients with radiation-induced skin injury. Adipose-derived stem cells (ADSCs) accounted for approximately 10% of the SVF by flow cytometry. Compared with the control group of rats, administration with SVF attenuated the skin injury induced by electron beam radiation. The effect of SVF on the human skin fibroblast microenvironment was determined by proteomic profiling of secreted proteins in SVF-co-cultured human skin fibroblast WS1 cells. Results revealed 293 upregulated and 1,481 downregulated proteins in the supernatant of SVF-co-cultured WS1 cells. WS1 co-culture with SVF induced secretion of multiple proteins including collagen and MMP-1. In the clinic, five patients with radiation-induced skin injury were recruited to receive SVF transfer-based therapy, either alone or combined with flap transplantation. Autogenous SVF was isolated and introduced into a multi-needle precision electronic injection device, which automatically and aseptically distributed the SVF to the exact layer of the wound in an accurate amount. After SVF transfer, wound healing clearly improved and pain was significantly relieved. The patients' skin showed satisfactory texture and shape with no further wound recurrence. Our findings suggest that transplantation of SVF could be an effective countermeasure against severe radiation-induced skin injury.


Assuntos
Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/citologia , Radiodermatite/terapia , Adulto , Aloenxertos , Animais , Células Cultivadas , Técnicas de Cocultura , Meios de Cultivo Condicionados , Elétrons/efeitos adversos , Feminino , Fibroblastos/metabolismo , Ontologia Genética , Redes Reguladoras de Genes , Traumatismos da Mão/terapia , Xenoenxertos , Humanos , Radioisótopos de Irídio/efeitos adversos , Masculino , Transplante de Células-Tronco Mesenquimais/instrumentação , Transplante de Células-Tronco Mesenquimais/métodos , Pessoa de Meia-Idade , Proteoma , Lesões Experimentais por Radiação/terapia , Radiodermatite/etiologia , Radiodermatite/patologia , Radiodermatite/cirurgia , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Pele/efeitos da radiação , Organismos Livres de Patógenos Específicos , Retalhos Cirúrgicos
15.
J Wound Care ; 30(Sup6): S44-S50, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34120463

RESUMO

OBJECTIVE: Little is known about the efficacy of products aiming to prevent radiodermatitis, which affects between 90-95% of women with breast cancer. The use of antioxidants is promising, however, there is a lack of evidenceon their effectiveness. Here, the authors present a clinical trial protocol to evaluate the effects of applying a cream containing nanoparticles with vitamin E to prevent radiodermatitis in patients with breast cancer. METHOD: The protocol recommends that 108 women with breast cancer, receiving radiotherapy, are included in this triple-blinded, randomized, controlled study at an oncology hospital. Patients will be divided in three groups of 36 individuals each: group A will receive a cream with lipid nanoparticles and vitamin E, group B will receive a cream without nanoparticles nor vitamin E, and group C will receive a cream with nanoparticles without vitamin E. The primary endpoints will evaluate the incidence, degree, and time of onset of radiodermatitis. The secondary endpoints will focus on the quality of life, symptoms, and local temperature. Patients will be assessed three times a week, from the start of their radiotherapy treatment to two weeks after the last session. This protocol was approved by the research ethics committee of the institutions involved and registered on an international trials database.


Assuntos
Neoplasias da Mama/radioterapia , Nanopartículas/administração & dosagem , Protetores contra Radiação/administração & dosagem , Radiodermatite/prevenção & controle , Vitamina E/administração & dosagem , Administração Cutânea , Administração Tópica , Protocolos Clínicos , Feminino , Humanos , Nanopartículas/uso terapêutico , Pomadas , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Vitamina E/uso terapêutico
17.
Skin Pharmacol Physiol ; 34(4): 229-238, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33965956

RESUMO

BACKGROUND: There has been few research on how to measure skin status quantitatively throughout the course of radiotherapy (RT). We evaluated the changes in the skin induced by 2 different RT techniques using objective measurements in breast cancer patients. METHODS: In this prospective study, between August 2015 and March 2019, serial measurements of the dermatological factors during and after postmastectomy radiotherapy (PMRT) were made in 40 breast cancer patients. PMRT was performed using the conventional photon tangential technique (PTT) or patient-tailored bolus technique (PTB). We analyzed these measurements using a mixed effect model and compared the clinically evaluated radiation dermatitis and patient-reported outcomes (PROs). RESULTS: The trend of changes in melanin and erythema was significantly different between the PTB and PTT groups (p = 0.045 and 0.016, respectively). At the 3-month follow-up erythema intensity and melanin were higher in the PTB group than in PTT group (both p < 0.001). Eight patients (40% in the PTB group) reported grade 2 radiation dermatitis and 1 patient (5% in the PTB group) reported grade 3 radiation dermatitis. No grade 2 or higher radiation dermatitis was found in the PTT group. Ten patients (50%) in the PTB group and 3 patients (15%) in the PTT group reported severe erythema likely due to questionable clinical evaluation, but hyperpigmentation was rarely reported at the follow-up visits. CONCLUSION: The PTB group showed higher intensity of erythema at the end of RT than the PTT group and the increase in melanin lasted until the 3-month follow-up visits in the PTB group. Moreover, patients subjectively appealed more severe symptoms following PTB in PROs.


Assuntos
Neoplasias da Mama/radioterapia , Radiodermatite/patologia , Neoplasias da Mama/cirurgia , Eritema/patologia , Feminino , Humanos , Mastectomia , Melaninas/efeitos da radiação , Pessoa de Meia-Idade , Estudos Prospectivos , República da Coreia , Pele , Índices de Gravidade do Trauma
18.
Semin Oncol Nurs ; 37(3): 151148, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34011460

RESUMO

OBJECTIVES: This study aimed to investigate the impacts of team health education on radiodermatitis in patients undergoing head and neck radiotherapy. DATA SOURCES: A total of 118 patients undergoing radiotherapy at the Oncology Department of Qingdao Municipal Hospital under the Joint Committee International (JCI) accreditation standards of medical and health institutions were divided into two groups according to the order of the admission: the intervention group (n = 66) and the control group (n = 52). The patients in the control group were given routine nursing, while those in the intervention group received team health education based on the control group. The incidence and satisfaction of radiodermatitis were observed and compared between the groups, and the EORTC QLQ-C30 and General Quality of Life Inventory-74 were used to evaluate the patients' quality of life when after radiotherapy and when after 6 months post the radiotherapy, respectively. CONCLUSION: The incidence of radiodermatitis was 100% in both groups, and the difference in the grade of radiodermatitis and quality of life was significant (P < .05) between them. IMPLICATIONS FOR NURSING PRACTICE: Team health education under the JCI standards team can reduce the degree of skin injury due to radiodermatitis and improve the quality of life.


Assuntos
Neoplasias de Cabeça e Pescoço , Radiodermatite , Neoplasias de Cabeça e Pescoço/radioterapia , Educação em Saúde , Humanos , Qualidade de Vida , Radiodermatite/etiologia , Radiodermatite/prevenção & controle
19.
Ann Chir Plast Esthet ; 66(5): 410-412, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34020818

RESUMO

INTRODUCTION: Radiation therapy may cause a range of side effects of the skin within the irradiated area. Not of all the reactive effects of the skin induced by radiation therapy have to be related to some forms of radiodermatitis, and when non-standard clinical presentations overcome, it may be necessary to undertake appropriate diagnostic tools to not be in trap of wrong diagnosis. CLINICAL CASE DESCRIPTION: A 76 years-old man undertook resection surgery after a neoadjuvant radiation therapy for a soft tissue sarcoma of his groin region. After surgery, he developed an acute skin reaction comparable with a severe form of radiodermatitis. Despite cares, his clinical status got worse. Only skin biopsies guided us to the right diagnosis: it was a form of a bullous pemphigoid induced by radiation therapy. The consequent appropriate treatment was finally resolute. CONCLUSION: These forms have to be recognized in time, to undertake skin biopsies as soon as an evocative clinical presentation appears. The appropriate treatment, which consists in local or systemic corticotherapy, is resolute in most cases.


Assuntos
Penfigoide Bolhoso , Radiodermatite , Sarcoma , Neoplasias de Tecidos Moles , Idoso , Humanos , Masculino , Penfigoide Bolhoso/etiologia , Radiodermatite/etiologia , Sarcoma/radioterapia , Sarcoma/cirurgia , Pele
20.
Crit Rev Oncol Hematol ; 162: 103349, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33989768

RESUMO

PURPOSE: To evaluate the effectiveness of photobiomodulation therapy (PBMT) in the prevention and treatment of radiation dermatitis (RD). METHODS: A systematic review was conducted using seven databases and the gray literature. We performed a meta-analysis to summarize the effect sizes of response rates (RRs). RESULTS: We included seven clinical trials. Breast cancer patients receiving PBMT developed more grade 1 RD than the control group (RR 1.55, 95 % CI 1.14-2.10, I2 = 51 %). PBMT appears to prevent RD grade 2 (RR 0.33, 95 % CI 0.09-1.23, I2 = 85 %) and RD grade 3 (RR 0.21, 95 % CI 0.05-0.94, I2 = 0%) with very low certainty of evidence. CONCLUSIONS: There is very low certainty of evidence that PBMT was effective in the prevention of RD. However, PBMT showed a significant effect to prevent grade 3 RD in breast cancer patients. Thus, further randomized clinical trials are required to confirm the promising effect of PBMT in RD.


Assuntos
Neoplasias da Mama , Terapia com Luz de Baixa Intensidade , Radiodermatite , Mama , Neoplasias da Mama/radioterapia , Feminino , Humanos
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