Hydrofilm Polyurethane Films Reduce Radiation Dermatitis Severity in Hypofractionated Whole-Breast Irradiation: An Objective, Intra-Patient Randomized Dual-Center Assessment.

Autor: Schmeel LC; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Koch D; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Schmeel FC; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Bücheler B; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Leitzen C; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Mahlmann B; Radiotherapy Bonn-Rhein-Sieg, Practice at academic St. Marien Hospital, Robert-Koch-Str. 1, 53115 Bonn, Germany., Kunze D; Radiotherapy Bonn-Rhein-Sieg, Practice at academic St. Marien Hospital, Robert-Koch-Str. 1, 53115 Bonn, Germany., Heimann M; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Brüser D; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Abramian AV; Department of Gynecology and Obstetrics, Division of Senology, University Hospital Bonn, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany., Schoroth F; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Müdder T; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Röhner F; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Garbe S; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Baumert BG; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.; Institute of Radiation Oncology, Graubuenden Cantonal Hospital, Loestr. 170, 7000 Chur, Switzerland., Schild HH; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany., Wilhelm-Buchstab TM; Department of Radiology and Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.; Radiotherapy Bonn-Rhein-Sieg, Practice at academic Protestant Johanniter Clinics Bonn, Waldstr. 73, 53177 Bonn, Germany.
Jazyk: angličtina
Zdroj: Polymers [Polymers (Basel)] 2019 Dec 16; Vol. 11 (12). Date of Electronic Publication: 2019 Dec 16.
DOI: 10.3390/polym11122112
Abstrakt: Radiation-induced skin injury represents the most frequent side effect in breast cancer patients undergoing whole-breast irradiation (WBI). Numerous clinical studies on systemic and topical treatments for radiation dermatitis have failed to provide sustainable treatment strategies. While protective skin products such as dressings are undoubtedly the standard of care in wound care management, their utilization as preventive treatment in radiotherapy has been somewhat neglected in recent years. In this prospective, intra-patient randomized observational study, Hydrofilm polyurethane films were prophylactically applied to either the medial or lateral breast-half of 74 patients with breast cancer undergoing hypofractionated whole-breast irradiation following breast-preserving surgery. Maximum radiation dermatitis severity was assessed using Common Terminology Criteria for Adverse Events (CTCAE) v4.03 toxicity scores, photospectrometric erythema and pigmentation measurements and patient-assessed modified Radiation-Induced Skin Reaction Assessment Scale (RISRAS) scale. Phantom studies revealed a clinically negligible dose build-up of less than 0.1% with Hydrofilm. Compared to the control compartments physician-assessed radiation dermatitis severity was reduced in the hydrofilm compartments (mean 0.54 vs. 1.34; p = < 0.001). Objective photospectrometric skin measurements showed decreased erythema ( p = 0.0001) and hyperpigmentation ( p = 0.002) underneath Hydrofilm. Hydrofilm also completely prevented moist desquamation, and significantly reduced patients' treatment-related symptoms of itching, burning, pain, and limitations of day-to-day-activities. Significant beneficial effects were observed in terms of radiation dermatitis severity, erythema, hyperpigmentation as well as subjective treatment-related symptom experiences, while adverse reactions were rare and minor. Therefore, a prophylactic application of Hydrofilm polyurethane films can be suggested in hypofractionated WBI.
Databáze: MEDLINE
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