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Burnett LR, Hughes RT, Rejeski AF, Moffatt LT, Shupp JW, Christy RJ, Winkfield KM. Review of the Terminology Describing Ionizing Radiation-Induced Skin Injury: A Case for Standardization. Technol Cancer Res Treat 2021; 20:15330338211039681. [PMID: 34613833 PMCID: PMC8504211 DOI: 10.1177/15330338211039681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Ionizing radiation causes injury to the skin that produces a complex clinical presentation that is managed by various paradigms without clear standards. The situation is further complicated by the fact that clinicians and researchers often use different terms and billing codes to describe the spectrum of cutaneous injury. There is, however, general agreement between the two most commonly-used diagnostic scales, the Radiation Therapy Oncology Group and the Common Terminology Criteria for Adverse Events, and in their use to describe skin injury following radiation therapy. These scales are typically used by radiation oncologists to quantify radiation dermatitis, a component of the radiation-related disorders of the skin and subcutaneous tissue family of diagnoses. In rare cases, patients with severe injury may require treatment by wound care or burn specialists, in which case the disease is described as a “radiation burn” and coded as a burn or corrosion. Further compounding the issue, most US government agencies use the term Cutaneous Radiation Injury to indicate skin damage resulting from large, whole-body exposures. In contrast, the US Food and Drug Administration approves products for radiation dermatitis or “burns caused by radiation oncology procedures.” A review of the literature and comparison of clinical presentations shows that each of these terms represents a similar injury, and can be used interchangeably. Herein we provide a comparative review of the commonly used terminology for radiation-induced skin injury. Further, we recommend standardization across clinicians, providers, and researchers involved in the diagnosis, care, and investigation of radiation-induced skin injury. This will facilitate collaboration and broader inclusion criteria for grant-research and clinical trials and will assist in assessing therapeutic options particularly relevant to patient skin pigmentation response differences.
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Affiliation(s)
| | - Ryan T Hughes
- 12279Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Lauren T Moffatt
- 121577MedStar Health Research Institute, Washington, DC, USA.,12230Georgetown University School of Medicine, Washington, DC, USA
| | - Jeffrey W Shupp
- 121577MedStar Health Research Institute, Washington, DC, USA.,12230Georgetown University School of Medicine, Washington, DC, USA.,8405MedStar Washington Hospital Center, Washington, DC, USA
| | - Robert J Christy
- 110230US Army Institute for Surgical Research, San Antonio Texas, USA
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Temnov A, Astrelina T, Rogov K, Moroz B, Lebedev V, Nasonova T, Lyrshchikova A, Dobrynina O, Deshevoy Y, Melerzanov A, Bader A, Mishra A, Giri S, Boyarintsev V, Trofimenko A, Bushmanov A, Samoylov A. Use of paracrine factors from stem cells to treat local radiation burns in rats. Stem Cells Cloning 2018; 11:69-76. [PMID: 30464536 PMCID: PMC6208552 DOI: 10.2147/sccaa.s164630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Mesenchymal stem cells based paracrine bioactive factors that deploy their task as an essential mechanism, but their efficiency for skin regeneration still requires clarification. Methods The mesenchymal stem cell-based paracrine factors were administered by subcutaneous injection of 0.5 mL peptides (general protein 8 mg/mL). These were performed after radiation on different days like the first, third, sixth, eighth, and 10th. To determine the consequences, we performed photography, planimetry, and preclinical test each week after 15 days of radiation. MSC-based peptides were injected into a rat that had radiation burns, and its observation encouraged cell-free therapeutic remedies to regenerate skin. Both control and experimental groups were exposed to 110 Gy of X-rays, which resulted in the formation of localized radiation burns on the skin (S=6 cm2) 15 days later. Thirty days after radiation, the wound stabilized (surface of the wound was S=2.2±0.2 cm2) and fluctuated throughout the course of the pathological process. Results The wounded area on the skin from the 15th to the 29th day after radiation was practically the same in both groups. The wounded area gradually reduced by 6.1±0.4 cm2 (experimental group) and 5.9±0.6 cm2 (control group) 15 days after radiation up to 2.2±0.3 cm2 (in both control and experimental groups) on the 29th day after radiation. However, starting from the 36th day, there was a constant reduction in the burn area in the experimental group up to 0.2±0.1 cm2 till the 71st day after radiation. Conclusion In the control group, the area of the lesion ranged from 1.4±0.6 cm2 on the 50th day to 1.9±0.8 cm2 on the 71st day. During the 57th to the 71st day, the difference between the affected area in the experimental and control groups was 1:8. The experimental group has a significantly higher level of skin regeneration and significant decrease in the level of leukocyte infiltration, thereby reducing necrosis.
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Affiliation(s)
- Andrey Temnov
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Tatyana Astrelina
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Konstantin Rogov
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Boris Moroz
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Vladimir Lebedev
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Tamara Nasonova
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Alla Lyrshchikova
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Olga Dobrynina
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Yury Deshevoy
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Alexander Melerzanov
- Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Augustinus Bader
- Applied Stem Cell Biology and Cell Technology, Biomedical and Biotechnological Center, Leipzig University, Leipzig, Germany,
| | - Apurva Mishra
- Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Shibashish Giri
- Applied Stem Cell Biology and Cell Technology, Biomedical and Biotechnological Center, Leipzig University, Leipzig, Germany, .,Department of Plastic and Hand Surgery, University Hospital Rechts der Isar, Munich Technical University, Munich, Germany,
| | - Valeriy Boyarintsev
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Alexander Trofimenko
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Andrey Bushmanov
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
| | - Alexander Samoylov
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (SRC-FMBC), Moscow, Russia.,Research Institute of Human Morphology, Russian Academy of Medical Science, Moscow, Russia.,Faculty of Biological and Medical Physics. Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia
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