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Meet the expert: Topical management of vulvar dermatoses. J Geriatr Oncol 2021; 13:282-286. [PMID: 34824022 DOI: 10.1016/j.jgo.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 09/26/2021] [Accepted: 10/21/2021] [Indexed: 11/22/2022]
Abstract
Vulvar dermatoses are often debilitating chronic skin conditions associated with pain and pruritus. In oncologic patients, cancer treatments can precipitate and exacerbate vulvar dermatoses. Cytotoxic chemotherapy, hormonal therapies, and local pelvic radiation therapy can lead to vulvar symptoms, and cancer treatment-induced vulvar conditions include graft-versus-host-disease and radiation dermatitis. There have also been reports of lichen sclerosus development or exacerbation secondary to hormonal therapy and immune checkpoint inhibitors, attributed to proposed hormonal and immunologic pathogenesis of lichen sclerosus. Early recognition and treatment of these conditions can significantly improve quality of life. In this review, we summarize the clinical features and management characteristics of six types of common vulvar dermatoses that may present in the oncologic patient.
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Robijns J, Lodewijckx J, Puts S, Vanmechelen S, Van Bever L, Claes S, Pannekoeke L, Timmermans A, Noé L, Govers M, Van de Werf E, Maes A, Bulens P, Mebis J. Photobiomodulation therapy for the prevention of acute radiation dermatitis in breast cancer patients undergoing hypofractioned whole-breast irradiation (LABRA trial). Lasers Surg Med 2021; 54:374-383. [PMID: 34481420 DOI: 10.1002/lsm.23475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/22/2021] [Accepted: 08/21/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To evaluate the efficacy of photobiomodulation therapy in breast cancer patients post-lumpectomy undergoing hypofractionated whole-breast irradiation (HF-WBI) for the prevention and management of acute radiodermatitis (ARD). MATERIALS AND METHODS A randomized, multicentric clinical trial (LABRA trial, NCT03924011) was set up at the Limburg Oncology Center, including the Jessa Hospital (Hasselt, BE) and Ziekenhuis Oost-Limburg (Genk, BE). A total of 71 breast cancer patients planned to undergo HF-WBI were randomized to one of the two study arms: the control group (n = 32) or the PBM group (n = 39). The PBM group received the standard institutional skincare combined with PBM (2×/week) during the complete radiotherapy (RT) course. Patients in the control group received the standard skincare combined with placebo treatment (2x/week). Patients' skin reactions were evaluated weekly during the RT treatment by using the modified version of the Radiation Therapy Oncology Group (RTOG) criteria. RESULTS At week 3 of RT, one patient presented a grade 2 and one patient a grade 3 skin reaction in the control group, while in the PBM group, all patients still presented grade 1 ARD. At the final RT session 28% of the patients presenting grade 2-3 ARD, while in the PBM group 10% presented grade 2 and no grade 3 ARD. PBM reduced the incidence of severe ARD by 18%. However, the difference was not significant (p = 0.053). CONCLUSION Based on the LABRA trial results, PBM seems not able to reduce the incidence of severe ARD in breast cancer patients undergoing HF-WBI. Research in a larger patient population is recommended.
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Affiliation(s)
- Jolien Robijns
- Faculty of Medicine & Life Sciences, Hasselt University, Hasselt, Belgium
| | - Joy Lodewijckx
- Faculty of Medicine & Life Sciences, Hasselt University, Hasselt, Belgium
| | - Sofie Puts
- Faculty of Medicine & Life Sciences, Hasselt University, Hasselt, Belgium
| | - Sofie Vanmechelen
- Faculty of Medicine & Life Sciences, Hasselt University, Hasselt, Belgium
| | - Leen Van Bever
- Limburg Oncology Center, Jessa Hospital - Campus Virga Jesse, Hasselt, Belgium
| | - Stefan Claes
- Limburg Oncology Center, Jessa Hospital - Campus Virga Jesse, Hasselt, Belgium
| | - Luc Pannekoeke
- Limburg Oncology Center, Jessa Hospital - Campus Virga Jesse, Hasselt, Belgium
| | - An Timmermans
- Department of Dermatology, Jessa Hospital, Hasselt, Belgium
| | - Leen Noé
- Limburg Oncology Center, Jessa Hospital - Campus Virga Jesse, Hasselt, Belgium
| | - Mieke Govers
- Limburg Oncology Center, Ziekenhuis Oost-Limburg, Genk, Belgium
| | | | - Annelies Maes
- Limburg Oncology Center, Jessa Hospital - Campus Virga Jesse, Hasselt, Belgium.,Limburg Oncology Center, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Paul Bulens
- Limburg Oncology Center, Jessa Hospital - Campus Virga Jesse, Hasselt, Belgium
| | - Jeroen Mebis
- Faculty of Medicine & Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Medical Oncology, Jessa Hospital, Hasselt, Belgium
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Heydarirad G, Ahadi B, Molavi Vardanjani H, Cramer H, Mirzaei HR, Pasalar M. Herbal Medicines for Treatment of Radiodermatitis: A Systematic Review and Meta-Analysis. J Altern Complement Med 2021; 27:1098-1104. [PMID: 34449259 DOI: 10.1089/acm.2021.0166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: There is some evidence in favor of the efficacy of herbal medicine in the treatment of radiodermatitis as a frequent complication among cancer patients. Purpose: The present study aimed to evaluate the effect of herbal medicines on the treatment of radiodermatitis in cancer patients. Study design: Systematic review performed in accordance with the PRISMA guideline. Methods: We searched the electronic databases, Scopus, PubMed, Cochrane Library, Embase, Google Scholar, and ISI Web of Science, through July 2020 for randomized controlled trials (RCTs) that compared herbal compounds against a standard medication or placebo for treatment or prevention of radiodermatitis. Results: A total of 16 RCTs involving 1886 patients with breast, head and neck, or unspecified cancer were included. Risk of bias generally was high. Of those, three RCTs with 562 cancer patients (mainly breast cancer) who used Aloe vera to treat radiodermatitis were included in the meta-analysis. There was a significant level of heterogeneity between the studies (I2 = 95.8). One RCT found positive effects of Aloe vera in reducing the severity of radiodermatitis (standardized mean difference [SMD] = 3.37), whereas another revealed an inverse effect (SMD = -4). Conclusion: At present, there are no herbal compositions that are effective in treating radiodermatitis, with Aloe vera failing to show sufficient efficacy in the meta-analysis.
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Affiliation(s)
- Ghazaleh Heydarirad
- Traditional Medicine and Materia Medica Research Center, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Ahadi
- Department of Persian Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Hossein Molavi Vardanjani
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Hamid Reza Mirzaei
- Department of Radiation Oncology, Cancer Research Center, Shohadae Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Kondziołka J, Wilczyński S. Overview of the Active Ingredients in Cosmetic Products for the Care of Skin That Has Been Exposed to Ionizing Radiation - Analysis of Their Effectiveness in Breast Cancer Radiotherapy. Clin Cosmet Investig Dermatol 2021; 14:1065-1076. [PMID: 34471371 PMCID: PMC8405097 DOI: 10.2147/ccid.s322228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/16/2021] [Indexed: 01/03/2023]
Abstract
Treatment that uses ionizing radiation is one of the most common therapeutic methods in case of breast cancer. However, it often results in radiation dermatitis, which manifests itself, among others, as erythema, burning, itching and pain as well as dry or moist desquamation of the epidermis in the irradiated areas. The intensity of these symptoms significantly reduces the patient's quality of life, which could affect the effectiveness of the entire therapy. There are more and more cosmetic preparations on the market for daily care of skin that has been exposed to radiation. The composition of the active ingredients in these preparations is designed to support the protective functions of the skin, delay the occurrence of the side effects of ionizing radiation, reduce their intensity, and accelerate the regeneration of the irradiated areas. Unfortunately, there is little scientific evidence of the effectiveness of the active ingredients that are contained in these preparations. This paper presents a narrative review of the most commonly used ingredients and compares them with the current state of knowledge on their effectiveness in preventing radiodermatitis.
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Affiliation(s)
- Joanna Kondziołka
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
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Borghetti P, Imbrescia J, Volpi G, Costantino G, Cossali G, Greco D, Pastorello E, La Mattina S, Bonù ML, Tomasini D, Buglione M. Prevention and management of acute esophageal toxicity during concomitant chemoradiotherapy for locally advanced lung cancer. TUMORI JOURNAL 2021; 108:470-476. [PMID: 34165018 DOI: 10.1177/03008916211025609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC) is concomitant chemoradiotherapy. The survival benefit of combined treatment is partially counterbalanced by an increased rate of acute esophageal toxicity. Several pharmaceutical products are available for prevention and management of esophagitis, including Faringel Plus. AIM To assess the incidence and the grade, identify the correlations with clinical, dosimetric, and therapeutic variables, and analyse the role of Faringel Plus as a pharmaceutical preventive measure against acute esophageal toxicity. METHODS Patients with LA-NSCLC treated with concomitant radiochemotherapy were retrospectively reviewed. Acute esophagitis and dysphagia were graded according to Common Terminology Criteria for Adverse Events version 5.0. Clinical, dosimetric, and therapeutic correlations were investigated using χ2 test. RESULTS Among the 23 analysed patients, 18 (78.3%) and 1 (4.3%) developed G2 and G3 esophagitis, respectively; G1-2 dysphagia were reported in 11 cases (47.8%). No statistically significant correlation between the variables considered and acute esophageal toxicity was identified. In the group of patients who received Faringel Plus as preventive treatment (10 subjects, 43.5%), dysphagia presentation time was significantly longer (p = 0.038); esophagitis onset time was longer and symptoms duration was shorter. Faringel Plus allowed a reduction in the use of analgesic drugs. CONCLUSIONS Acute mild esophageal toxicity was confirmed to be a common side effect in this setting. No clinical-dosimetric parameter has been demonstrated to be effective in predicting acute esophageal toxicity. The use of Faringel Plus appears effective as a therapeutic and prophylactic tool to manage acute esophageal toxicity.
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Affiliation(s)
- Paolo Borghetti
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Jessica Imbrescia
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Giulia Volpi
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Gianluca Costantino
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Gianluca Cossali
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Diana Greco
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Edoardo Pastorello
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Salvatore La Mattina
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Marco Lorenzo Bonù
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Davide Tomasini
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
| | - Michela Buglione
- Radiation Oncology Department, Spedali Civili of Brescia, University of Brescia, Lombardia, Italy
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Dreno B, Amici JM, Demessant-Flavigny AL, Wright C, Taieb C, Desai SR, Alexis A. The Impact of Acne, Atopic Dermatitis, Skin Toxicities and Scars on Quality of Life and the Importance of a Holistic Treatment Approach. Clin Cosmet Investig Dermatol 2021; 14:623-632. [PMID: 34163201 PMCID: PMC8213955 DOI: 10.2147/ccid.s315846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/15/2021] [Indexed: 01/15/2023]
Abstract
Skin conditions such as acne, atopic dermatitis, skin toxicity from oncology treatment, and scars are among the most common health conditions and negatively impact quality of life (QoL). Yet the physician perception of this impact often varies greatly from the patient perception. This is important because patient illness perception is closely linked with seeking help and treatment adherence behaviors. The objective of this review is to better understand the impact of these four highly prevalent skin conditions on QoL including their health-related economic factors to improve treatment outcomes. The literature search included literature published on QoL with acne, atopic dermatitis, scars (from any cause) and skin toxicities on PubMed between 2015 and 2020. We found that patients with skin conditions have a much higher frequency of altered QoL and psychological distress than those without. Also, skin conditions negatively impact self-image and can cause feelings of isolation, loneliness, lower self-esteem, and lower body satisfaction. Additionally, physical discomfort adds to the psychological distress. These physical and psychological impacts are an enormous financial burden on patients, their families and society. We found evidence that holistic treatment including treating the skin condition itself, providing wider peer and psychological support as well as shared decision-making, therapeutic patient education and dermatologist involvement improves outcomes. Holistic history-taking, checklists, or the use of more formal QoL scoring tools can be incorporated into routine consultations to better assess patient well-being and provide clinicians with important information for adapting treatment to individual patient requirements. In conclusion, this review highlights the overall impact of skin conditions (including psychological and QoL impacts) and the importance of providing holistic care to optimize treatment outcomes. A comprehensive QoL screening tool would be useful to help provide patient-centered treatment.
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Affiliation(s)
- Brigitte Dreno
- Dermatology Department, CHU Nantes, CIC 1413, CRCINA, Nantes University, Nantes, Pays de la Loire, France
| | - Jean Michel Amici
- Dermatology Department, Bordeaux University Hospital, Bordeaux, Nouvelle-Aquitaine, France
| | | | - Charlotte Wright
- Speak the Speech Consulting, Asnières-sur-Seine, Ile-de-France, France
| | - Charles Taieb
- Patients Priority Department, European Market Maintenance Assessment, Fontenay Sousbois, Ile-de-France, France
| | - Seemal R Desai
- Department of Dermatology, The University of Texas Southwestern Medical Center & Innovative Dermatology, Dallas, TX, USA
| | - Andrew Alexis
- Skin of Color Center, Mount Sinai St. Luke’s and Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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57
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Patel S, Vargo JA, Olson A, Mahajan A. Supportive care for toxicities in children undergoing radiation therapy. Pediatr Blood Cancer 2021; 68 Suppl 2:e28597. [PMID: 33818886 DOI: 10.1002/pbc.28597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 06/16/2020] [Accepted: 07/01/2020] [Indexed: 11/08/2022]
Abstract
Radiation therapy (RT) is an integral part of the management of many pediatric tumors; however, it is associated with both acute and permanent adverse events that can significantly impact a child's quality of life, lead to treatment delays, and potentially affect outcomes of cancer therapy. Prevention, early detection, and optimal management of these adverse effects will help reduce their impact on the patients' quality of life and overall well-being. Unfortunately, there has not been a coordinated effort to study the etiology, evaluate risk factors, and explore novel treatments for these conditions. Studies of supportive care for children undergoing RT are often small and uncontrolled. This review will focus on the impact of irradiation on the different organ systems and their current management. Further studies are required to improve our understanding of the contributing factors and explore novel treatment options for these adverse effects and to enable children and their families to better cope with some of the unavoidable toxicities following multimodality therapy.
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Affiliation(s)
- Samir Patel
- Divisions of Radiation Oncology and Pediatric Hematology, Oncology and Palliative Care, University of Alberta, Stollery Children's Hospital, Edmonton, Canada
| | - John Austin Vargo
- Department of Radiation Oncology, UPMC Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Adam Olson
- Department of Radiation Oncology, UPMC Children's Hospital of Pittsburg, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Anita Mahajan
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
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Wu T, Gao J, Liu W, Cui J, Yang M, Guo W, Wang FY. NLRP3 protects mice from radiation-induced colon and skin damage via attenuating cGAS-STING signaling. Toxicol Appl Pharmacol 2021; 418:115495. [PMID: 33741346 DOI: 10.1016/j.taap.2021.115495] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
In the present study, the effects of NLRP3 on radiation-induced tissue damage, including colon and skin damage in mice, and the possible mechanisms were explored in vivo and in vitro. The mice were subjected to whole abdomen radiation by timed exposure to X-ray at a cumulative dose of 14 Gy. The survival rate showed that NLRP3 deficiency increased the mortality rate in mice. Furthermore, colon damage, evaluated by H&E staining and barrier function analysis, were significantly aggravated by NLRP3 deficiency. Enhanced phosphorylation of p-TBK1 and p-IRF3 in colonic tissue as well as elevated IFN-β levels in the serum indicated hyperactivation of cGAS-STING signaling. Moreover, radiation-induced expression of p-TBK1, p-IRF3, and IFN-β in BMDMs increased in vitro after NLRP3 knockout. Thus, our study outcomes suggest that NLRP3 may protect mice from radiation-induced tissue damage via attenuating cGAS-STING signaling.
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Affiliation(s)
- Tiancong Wu
- Department of Gastroenterology and Hepatology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing 210002, China; Jinling Hospital, Department of Radiation Oncology, Nanjing University, School Medicine, Nanjing 210002, China
| | - Jianhua Gao
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Science, Nanjing University, Nanjing 210093, China
| | - Wen Liu
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Science, Nanjing University, Nanjing 210093, China
| | - Jian Cui
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Science, Nanjing University, Nanjing 210093, China
| | - Miaofang Yang
- Department of Gastroenterology and Hepatology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu Province, China
| | - Wenjie Guo
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Science, Nanjing University, Nanjing 210093, China.
| | - Fang-Yu Wang
- Department of Gastroenterology and Hepatology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing 210002, China; Department of Gastroenterology and Hepatology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu Province, China.
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Lugtenberg RT, Boers-Doets CB, Witteveen PO, van Herpen CML, Wymenga ANM, de Groot JWB, Hoeben A, Del Grande C, van Doorn B, Koldenhof JJ, Driessen CML, Gelderblom H. Prospective practice survey of management of cetuximab-related skin reactions. Support Care Cancer 2020; 29:3497-3506. [PMID: 33150521 PMCID: PMC8163687 DOI: 10.1007/s00520-020-05862-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/26/2020] [Indexed: 01/09/2023]
Abstract
Purpose Evidence-based guidelines on how to prevent or treat cetuximab-related skin reactions are lacking and multiple care and management strategies are used. The main purpose of the present study is to gain information about the different skincare products being used against skin reactions in metastatic colorectal cancer (mCRC) and recurrent/metastatic (R/M) or locally advanced (LA) squamous cell cancer of the head and neck (SCCHN) patients treated with cetuximab. Methods An open-label, prospective observational study conducted in the Netherlands. The occurrence of skin reactions and the care and management options taken were documented for 16 weeks, starting from the first administration of cetuximab. Results A total of 103 patients were included in 7 hospitals. 38 patients (37%) developed a grade ≥ 2 skin reaction. Eighty-six patients could be analysed for the primary endpoint (73.3% males, mean age 62.4 years, n = 44 LA SCCHN, n = 16 R/M SCCHN, n = 26 mCRC). The most frequently used skin products at some point during the observation period were moisturizing products (70%), systemic antibiotics (64%), topical antibiotics (58%), lipid-regenerating (28%) and other topical products (28%). The overall use of products gradually increased from baseline to week 6–10, reducing by week 16. Hospital protocols were the primary reason (> 50%) for choice of the skincare products and medications. Conclusion A variety of skin care products and antibiotics were commonly used. Only few patients developed severe cutaneous reactions. For patients, the occurrence of skin reactions did not influence their willingness to continue cetuximab therapy.
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Affiliation(s)
- R T Lugtenberg
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
| | - C B Boers-Doets
- Department of Medical Strategy, CancerMed, Wormer, The Netherlands.,Department of Adverse Event Research & Valorisation, Impaqtt Foundation, Wormer, The Netherlands
| | - P O Witteveen
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C M L van Herpen
- Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - A N M Wymenga
- Department of Medical Oncolog, Medical Spectrum Twente, Enschede, The Netherlands
| | - J W B de Groot
- Department of Medical Oncology, Isala Oncology Center, Zwolle, The Netherlands
| | - A Hoeben
- Department of Medical Oncology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center+, Maastricht, The Netherlands
| | - C Del Grande
- Merck B.V., Netherlands, an affiliate of Merck KgaA, Darmstadt Germany, Schiphol-Rijk, The Netherlands
| | - B van Doorn
- Merck B.V., Netherlands, an affiliate of Merck KgaA, Darmstadt Germany, Schiphol-Rijk, The Netherlands
| | - J J Koldenhof
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C M L Driessen
- Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
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Ginex PK, Backler C, Croson E, Horrell LN, Moriarty KA, Maloney C, Vrabel M, Morgan RL. Radiodermatitis in Patients With Cancer: Systematic Review and Meta-Analysis. Oncol Nurs Forum 2020; 47:E225-E236. [PMID: 33063778 DOI: 10.1188/20.onf.e225-e236] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION A systematic review and meta-analysis was conducted to inform the development of guidelines on the management of radiodermatitis among patients with cancer. LITERATURE SEARCH The authors updated a systematic review to include available literature published through September 30, 2019. DATA EVALUATION Two investigators assessed risk of bias using the Cochrane Collaboration risk-of-bias tool and certainty of the evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. SYNTHESIS The use of deodorant/antiperspirant had no effect on development of radiodermatitis. Aloe vera and emu oil were equivalent or less effective than standard care. Oral curcumin had a minimal beneficial effect. Nonsteroidal topical interventions had a minimal beneficial effect on the development of moist desquamation and relief of itching while causing a small increase for grade 2 radiodermatitis. Topical calendula increased risk for the development of radiodermatitis. Topical steroids and dressings each showed benefits to minimize the development of radiodermatitis and moist desquamation while lowering rates of patient-reported symptoms, such as pain and pruritus. IMPLICATIONS FOR RESEARCH Symptom management strategies for radiodermatitis among patients with cancer that are likely to be effective include topical nonsteroidals, topical steroids, and dressings. SUPPLEMENTAL MATERIAL CAN BE FOUND AT HTTPS //bit.ly/2FWj3Kp.
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Gosselin T, Ginex PK, Backler C, Bruce SD, Hutton A, Marquez CM, McGee LA, Shaftic AM, Suarez LV, Moriarty KA, Maloney C, Vrabel M, Morgan RL. ONS Guidelines™ for Cancer Treatment-Related Radiodermatitis. Oncol Nurs Forum 2020; 47:654-670. [PMID: 33063779 DOI: 10.1188/20.onf.654-670] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Radiodermatitis is a side effect of radiation therapy. Evidence-based interventions to minimize severity or delay progression are important for clinical care. This guideline intends to support individuals with cancer, clinicians, and others in decisions regarding radiodermatitis treatment. METHODOLOGIC APPROACH A panel of healthcare professionals with patient representation was convened to develop a national clinical practice guideline for the management of radiodermatitis. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology and the National Academies of Sciences, Engineering, and Medicine criteria for trustworthy guidelines were followed. The Cochrane Collaboration risk-of-bias tool was used, and certainty of the evidence was assessed using the GRADE approach. A quantitative and narrative synthesis of the evidence was completed. FINDINGS The panel agreed on eight recommendations and made a conditional recommendation for deodorant/antiperspirant. Aloe vera and oral curcumin had knowledge gaps and were recommended only in the context of a clinical trial. The panel suggested against emu oil, calendula, and nonsteroidal interventions. IMPLICATIONS FOR NURSING This guideline summarizes evidence-based interventions for the management of radiodermatitis to guide clinical care. SUPPLEMENTARY MATERIAL CAN BE FOUND AT HTTPS //bit.ly/2GEwJtT.
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Simões FV, Santos VO, Silva RND, Silva RCD. Effectiveness of skin protectors and calendula officinalis for prevention and treatment of radiodermatitis: an integrative review. Rev Bras Enferm 2020; 73:e20190815. [PMID: 33084806 DOI: 10.1590/0034-7167-2019-0815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/18/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE to analyze the effectiveness of skin protectors and Calendula officinalis for prevention and treatment of radiodermatitis. METHOD an integrative review conducted at CINAHL, Cochrane Library, Embase, MEDLINE/PubMed, IBECS, LILACS, and Web of Science. The final sample consisted of five studies, four clinical studies and one preclinical. Critical appreciation and narrative synthesis of the findings were carried out. RESULTS the Cavilon™ skin protector was more effective than Sorbolene (cream with 10% glycerin) and less effective than Mometasone Furoate cream. Calendula officinalis was more effective than Trolamine and essential fatty acids and less effective than Ching Wan Hung® for prevention and treatment of radiodermatitis. CONCLUSION data confirm the potential of Calendula officinalis for prevention and treatment of radiodermatitis and point to promising results regarding skin protector use; however, there is a need for further testing as to the effectiveness of such products.
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Affiliation(s)
| | - Valdete Oliveira Santos
- Instituto Nacional de Câncer José Alencar Gomes da Silva. Rio de Janeiro, Rio de Janeiro, Brazil
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Siddiquee S, McGee MA, Vincent AD, Giles E, Clothier R, Carruthers S, Penniment M. Efficacy of topical Calendula officinalis on prevalence of radiation-induced dermatitis: A randomised controlled trial. Australas J Dermatol 2020; 62:e35-e40. [PMID: 32965030 DOI: 10.1111/ajd.13434] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/06/2020] [Accepted: 07/11/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A randomised controlled trial was undertaken to compare the efficacy of topical Calendula officinalis (Calendula) versus standard of care (Sorbolene: 10% glycerine in cetomacragol cream) in reducing the prevalence of radiation-induced dermatitis in women undergoing breast cancer radiotherapy. METHODS A total of 271 women were screened and 82 were randomised. The primary outcome was prevalence of acute radiation-induced dermatitis (RTOG grade 2+) assessed at multiple skin sites. A chi-squared test was conducted for the primary outcome with a worst-case scenario imputation. RESULTS The recruitment target (n = 178) was not achieved. A total of n = 81 participants were analysed (n = 40 Calendula; n = 41 Sorbolene). There was no detectable difference in prevalence of radiation-induced dermatitis grade 2+ between the Calendula (53%) and Sorbolene (62%) groups (primary analysis OR = 0.87, 95% CI: [0.36, 2.09], P = 0.92; covariate adjusted complete case analysis OR 0.40, 95% CI: [0.13, 1.20], P = 0.10). CONCLUSION This randomised controlled trial showed no difference between Calendula and standard of care (Sorbolene) for the prevention of radiation-induced dermatitis. However, the study was underpowered (limited recruitment) for the primary comparison.
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Affiliation(s)
- Shihab Siddiquee
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Margaret A McGee
- Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, Australia
| | - Andrew D Vincent
- Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, Australia
| | - Eileen Giles
- Department of Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Robyn Clothier
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia
| | - Scott Carruthers
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia
| | - Michael Penniment
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia
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Lee J, Jeong MI, Kim HR, Park H, Moon WK, Kim B. Plant Extracts as Possible Agents for Sequela of Cancer Therapies and Cachexia. Antioxidants (Basel) 2020; 9:E836. [PMID: 32906727 PMCID: PMC7555300 DOI: 10.3390/antiox9090836] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/04/2020] [Accepted: 09/04/2020] [Indexed: 02/07/2023] Open
Abstract
Cancer is a leading cause of the death worldwide. Since the National Cancer Act in 1971, various cancer treatments were developed including chemotherapy, surgery, radiation therapy and so forth. However, sequela of such cancer therapies and cachexia are problem to the patients. The primary mechanism of cancer sequela and cachexia is closely related to reactive oxygen species (ROS) and inflammation. As antioxidant properties of numerous plant extracts have been widely reported, plant-derived drugs may have efficacy on managing the sequela and cachexia. In this study, recent seventy-four studies regarding plant extracts showing ability to manage the sequela and cachexia were reviewed. Some plant-derived antioxidants inhibited cancer proliferation and inflammation after surgery and others prevented chemotherapy-induced normal cell apoptosis. Also, there are plant extracts that suppressed radiation-induced oxidative stress and cell damage by elevation of glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and regulation of B-cell lymphoma 2 (BcL-2) and Bcl-2-associated X protein (Bax). Cachexia was also alleviated by inhibition of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1) by plant extracts. This review focuses on the potential of plant extracts as great therapeutic agents by controlling oxidative stress and inflammation.
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Affiliation(s)
- Jinjoo Lee
- College of Korean Medicine, Kyung Hee University, Hoegi-dong Dongdaemun-gu, Seoul 05253, Korea; (J.L.); (M.I.J.); (H.-R.K.); (H.P.); (W.-K.M.)
| | - Myung In Jeong
- College of Korean Medicine, Kyung Hee University, Hoegi-dong Dongdaemun-gu, Seoul 05253, Korea; (J.L.); (M.I.J.); (H.-R.K.); (H.P.); (W.-K.M.)
| | - Hyo-Rim Kim
- College of Korean Medicine, Kyung Hee University, Hoegi-dong Dongdaemun-gu, Seoul 05253, Korea; (J.L.); (M.I.J.); (H.-R.K.); (H.P.); (W.-K.M.)
| | - Hyejin Park
- College of Korean Medicine, Kyung Hee University, Hoegi-dong Dongdaemun-gu, Seoul 05253, Korea; (J.L.); (M.I.J.); (H.-R.K.); (H.P.); (W.-K.M.)
| | - Won-Kyoung Moon
- College of Korean Medicine, Kyung Hee University, Hoegi-dong Dongdaemun-gu, Seoul 05253, Korea; (J.L.); (M.I.J.); (H.-R.K.); (H.P.); (W.-K.M.)
| | - Bonglee Kim
- College of Korean Medicine, Kyung Hee University, Hoegi-dong Dongdaemun-gu, Seoul 05253, Korea; (J.L.); (M.I.J.); (H.-R.K.); (H.P.); (W.-K.M.)
- Department of Pathology, College of Korean Medicine, Kyung Hee University, Hoegi-dong Dongdaemun-gu, Seoul 05253, Korea
- Korean Medicine-Based Drug Repositioning Cancer Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-dong Dongdaemun-gu, Seoul 05253, Korea
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Ingargiola R, De Santis MC, Iacovelli NA, Facchinetti N, Cavallo A, Ivaldi E, Dispinzieri M, Franceschini M, Giandini C, Romanello DA, Di Biaso S, Sabetti M, Locati L, Alfieri S, Bossi P, Guglielmo M, Macchi F, Lozza L, Valdagni R, Fallai C, Pignoli E, Orlandi E. A monocentric, open-label randomized standard-of-care controlled study of XONRID®, a medical device for the prevention and treatment of radiation-induced dermatitis in breast and head and neck cancer patients. Radiat Oncol 2020; 15:193. [PMID: 32791985 PMCID: PMC7427075 DOI: 10.1186/s13014-020-01633-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/04/2020] [Indexed: 12/26/2022] Open
Abstract
Background This study was an open-label, 2-arms, monocentric, randomized clinical trial comparing Xonrid®, a topical medical device, versus standard of care (SOC) in preventing and treating acute radiation dermatitis (ARD) in Head and Neck Cancer (HNC) and Breast Cancer (BC) patients undergoing radiotherapy (RT). Methods Eligible HNC and BC patients were randomized 1:1 to receive Xonrid® + SOC or SOC during RT. Patients were instructed to apply Xonrid® on the irradiated area three times daily, starting on the first day of RT and until 2 weeks after RT completion or until the development of grade ≥ 3 skin toxicity. The primary endpoint was to evaluate the proportion of patients who developed an ARD grade < 2 at the 5th week in both groups. Secondary endpoints were median time to grade 2 (G2) skin toxicity onset; changes in skin erythema and pigmentation and trans-epidermal water loss (TEWL); patient-reported skin symptoms. All patients were evaluated at baseline, weekly during RT and 2 weeks after treatment completion. The evaluation included: clinical toxicity assessment; reflectance spectrometry (RS) and TEWL examination; measurement of patients’ quality of life (QoL) through Skindex-16 questionnaire. Results Eighty patients (40 for each cancer site) were enrolled between June 2017 and July 2018. Groups were well balanced for population characteristics. All BC patients underwent 3-Dimensional Conformal RT (3D-CRT) whereas HNC patients underwent Volumetric-Modulated Arc Therapy (VMAT). At week 5 the proportion of BC patients who did not exhibit G2 ARD was higher in Xonrid® + SOC group (p = 0.091). In the same group the onset time of G2 ARD was significantly longer than in SOC-alone group (p < 0.0491). For HNC groups there was a similar trend, but it did not reach statistical significance. For both cancer sites, patients’ QoL, measured by the Skindex-16 score, was always lower in the Xonrid® + SOC group. Conclusion Despite the failure to achieve the primary endpoint, this study suggests that Xonrid® may represent a valid medical device in the prevention and treatment of ARD at least in BC patients, delaying time to develop skin toxicity and reducing the proportion of patients who experienced G2 ARD during RT treatment and 2 weeks later. Trial registration The study was approved by the Ethical Committee of Fondazione IRCCS Istituto Nazionale dei Tumori di Milano (INT 52/14 - NCT02261181). Registered on ClinicalTrial.gov on 21st August 2017.
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Affiliation(s)
- Rossana Ingargiola
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy
| | - Maria Carmen De Santis
- Radiation Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Nicola Alessandro Iacovelli
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy.
| | - Nadia Facchinetti
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy
| | - Anna Cavallo
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Eliana Ivaldi
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy.,Radiotherapy Department, Sassari Hospital, University of Sassari, Sassari, Italy
| | - Michela Dispinzieri
- Radiation Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Marzia Franceschini
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy
| | - Carlotta Giandini
- Radiation Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Domenico Attilio Romanello
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy.,School of Medicine, University of Milan-Bicocca, Milan, Italy
| | - Simona Di Biaso
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.,Post Graduation School in Medical Physics, University of Milan, Milan, Italy
| | - Michela Sabetti
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.,Post Graduation School in Medical Physics, University of Milan, Milan, Italy
| | - Laura Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Salvatore Alfieri
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Paolo Bossi
- Medical Oncology, University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | - Mauro Guglielmo
- Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | - Laura Lozza
- Radiation Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Riccardo Valdagni
- Radiation Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Carlo Fallai
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy
| | - Emanuele Pignoli
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Ester Orlandi
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy.,Radiation Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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Ashack KA, Kuritza V, Visconti MJ, Ashack L. Dermatologic Sequelae Associated with Radiation Therapy. Am J Clin Dermatol 2020; 21:541-555. [PMID: 32410134 DOI: 10.1007/s40257-020-00519-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Radiation therapy is a mainstay for the treatment of primary malignancies and metastatic disease and is associated with several dermatological adverse events that are underreported in the literature. The objective of this paper was to review the literature regarding cutaneous manifestations associated with radiation therapy in order to promote awareness of the cutaneous radiation therapy-associated adverse effects. This extensive literature review was performed using the Pubmed and Embase databases. Studies were reviewed for relevance and critical evidence pertaining to cutaneous manifestations of radiation therapy. The most commonly reported cutaneous sequelae associated with radiation therapy include radiation dermatitis, non-melanoma skin cancer, radiation-associated angiosarcoma, morphea, bullous pemphigoid, lymphangioma circumscriptum, and pseudosclerodermatous panniculitis. For many of these conditions, only case reports or case series exist and there is an absence of large-scale cohort studies. Despite these limitations, this review describes the wide range of dermatological adverse events associated with radiation therapy.
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Iacovelli NA, Torrente Y, Ciuffreda A, Guardamagna VA, Gentili M, Giacomelli L, Sacerdote P. Topical treatment of radiation-induced dermatitis: current issues and potential solutions. Drugs Context 2020; 9:dic-2020-4-7. [PMID: 32587626 PMCID: PMC7295106 DOI: 10.7573/dic.2020-4-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 02/08/2023] Open
Abstract
Approximately 95% of patients receiving radiotherapy (RT) will ultimately develop radiation-induced dermatitis (RID) during or after the course of treatment, with major consequences on quality of life and treatment outcomes. This paper reviews the pathophysiology of RID and currently used topical products for the prevention and treatment of RID. Although there is no consensus on the appropriate management, recent evidence suggests that the use of topical products supports to protect and promote tissue repair in patients with RID. Basic recommendations include advice to wear loose clothing, using electric razors if necessary, and avoiding cosmetic products, sun exposure or extreme temperatures. Based on mechanisms involved and on the clinical characteristics of oncological patients, the profile of the ideal topical product for addressing RID can be designed; it should have limited risk of adverse events, systemic adsorption and drug–drug interactions, should be characterized by multiple clinical activities, with a special focus on localized pain, and should have a careful formulation as some vehicles can block the RT beam.
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Affiliation(s)
| | - Yvan Torrente
- Stem Cell Laboratory, Department of Pathophysiology and Transplantation, Universitá degli Studi di Milano, Milan, Italy.,Unit of Neurology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Centro Dino Ferrari, Milan, Italy
| | - Adriana Ciuffreda
- Medico Chirurgo, Specialista in Dermatologia e Venereologia, Dermatologia Pediatrica, Milan, Italy
| | - Vittorio A Guardamagna
- Division of Palliative Care and Pain Therapy, IRCCS Istituto Europeo di Oncologia IEO, Milan, Italy.,Director of ESMO, Designated Center of Integrated Oncology and Palliative Care, Milan, Italy
| | | | - Luca Giacomelli
- Polistudium SRL, Milan, Italy.,Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Paola Sacerdote
- Department of Pharmacological and Biomolecular Science, University of Milano, Milan, Italy
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Robijns J, Lodewijckx J, Bensadoun RJ, Mebis J. A Narrative Review on the Use of Photobiomodulation Therapy for the Prevention and Management of Acute Radiodermatitis: Proposed Mechanisms, Current Clinical Outcomes, and Preliminary Guidance for Clinical Studies. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:332-339. [DOI: 10.1089/photob.2019.4761] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Jolien Robijns
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Hasselt, Belgium
| | - Joy Lodewijckx
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Hasselt, Belgium
| | | | - Jeroen Mebis
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Hasselt, Belgium
- Limburg Oncology Center, Jessa Hospital, Hasselt, Belgium
- Division of Medical Oncology, Jessa Hospital, Hasselt, Belgium
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De Ruysscher D, Faivre-Finn C, Nackaerts K, Jordan K, Arends J, Douillard J, Ricardi U, Peters S. Recommendation for supportive care in patients receiving concurrent chemotherapy and radiotherapy for lung cancer. Ann Oncol 2020; 31:41-49. [DOI: 10.1016/j.annonc.2019.10.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/06/2019] [Accepted: 10/08/2019] [Indexed: 12/13/2022] Open
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Jaiswal I, Talapatra K, Singh P, Rais S, Pandey S. Radiation dermatitis: A narrative review of the Indian perspective. CANCER RESEARCH, STATISTICS, AND TREATMENT 2020. [DOI: 10.4103/crst.crst_209_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hegedus F, Schwartz RA. Cutaneous radiation damage: updating a clinically challenging concern. GIORN ITAL DERMAT V 2019; 154:550-556. [PMID: 31042858 DOI: 10.23736/s0392-0488.19.06338-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cutaneous radiation damage, commonly referred to as radiation dermatitis, is a finding of considerable concern. The exposure is often from radiation therapy, a double-edged sword, removing malignant cancer cells and improving the lives of countless patients, yet being locally destructive and potentially premalignant. Among its negative consequences and complications, radiation dermatitis, a potentially severe skin reaction that occurs after the receipt of radiation therapy, presents a clinical challenge today. There are two types of cutaneous radiation dermatitis: acute and chronic. Acute radiation dermatitis manifests within 90 days after the induction of radiation therapy while chronic radiation dermatitis develops beyond 90 days of radiation. There are many risk factors associated with radiation dermatitis which can be characterized as intrinsic, extrinsic, or both. Intrinsic risk factors include concurrent chemotherapy and targeted therapy, connective tissue and skin disorders, genetic and personal factors such as age, sex, smoking habits, and nutritional status. Extrinsic factors are mainly related to the type and dose of the radiation received. Treatment options have been enhanced in the last decade, providing patients with better outcomes and improved quality of life. Such treatments include topical ointments and therapies, oral enzymes, wound dressings and surgical treatments. This article aims to review the current medical understanding of radiation dermatitis, its risk factors, pathophysiology, and treatment options.
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Affiliation(s)
- Fanni Hegedus
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
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