Quantitative assessment of radiodermatitis through a non‑invasive objective procedure in patients with breast cancer

Kitajima,Maiko; Mikami,Kasumi; Noto,Yuka; Itaki,Chieko; Fukushi,Yasuyo; Hirota,Yoshiko; Mariya,Yasushi; Tsushima,Megumi; Kattou,Keiichi; Osanai,Tomohiro

doi:10.3892/mco.2019.1948

Quantitative assessment of radiodermatitis through a non‑invasive objective procedure in patients with breast cancer

Authors:
- Maiko Kitajima
- Kasumi Mikami
- Yuka Noto
- Chieko Itaki
- Yasuyo Fukushi
- Yoshiko Hirota
- Yasushi Mariya
- Megumi Tsushima
- Keiichi Kattou
- Tomohiro Osanai
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Affiliations: Department of Nursing Science, Hirosaki University Graduate School of Health Science, Hirosaki, Aomori 036‑8564, Japan, Department of Radiology, Mutsu General Hospital, Mutsu, Aomori 035‑8601, Japan, Hirosaki Central Hospital, Hirosaki, Aomori 036‑8188, Japan
Published online on: November 11, 2019 https://doi.org/10.3892/mco.2019.1948
Pages: 89-93

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Abstract

Assessment of skin condition is necessary for providing advice regarding skin self‑care to patients with breast cancer who have undergone radiation therapy. Acute and chronic phases of radiodermatitis were analyzed in patients using objective assessment tools in the present study. A total of 18 women who received radiation therapy for breast cancer were enrolled in the present study and their skin surface temperature (SST), hydration level of the skin surface (HL), melanin intensity (MI) and erythema intensity (EI) were measured prior to radiation therapy and six months thereafter. Furthermore, skin condition was assessed using the Common Terminology Criteria for Adverse Events (CTCAE). EI and MI levels at the irradiated site peaked upon the completion of radiation therapy and declined to baseline at 6 months. In contrast, SST levels were elevated at the irradiated site during radiation therapy (P<0.05) and plateaued after its completion. The same parameters in non‑irradiated control sites remained unchanged during the study period. HL reached the minimum in irradiated and non‑irradiated sites upon completion of radiation therapy. Although HL returned to baseline in the non‑irradiated site 6 months after radiation therapy, it remained low in the irradiated site. No relationship between the CTCAE and EI level was observed. In conclusion, the present study demonstrated that objective assessment tools, including SST and EI levels, were useful for assessing skin condition during radiodermatitis. The combination of the CTCAE and objective assessment tools will enable a more accurate assessment of radiodermatitis.

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1	Gordils-Perez J, Rawlins-Duell R and Kelvin JF: Advances in radiation treatment of patients with breast cancer. Clin J Oncol Nurs. 7:629–636. 2003. View Article : Google Scholar : PubMed/NCBI
2	Landberg T, Chavaudra J, Dobbs J, Gerard PJ, Hanks G, Horiot JC, Johansson KA, Möller T, Purdy J and Sunthara-lingam N: ICRU report62 (Supplement to ICRU report 50):International Commission on Radiation Units and Measurements. ICRU; Bethesda, USA: 1999
3	Early Breast Cancer Trialists' Collaborative Group (EBCTCG), ; Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, Cutter D, Davies C, Ewertz M, et al: Effect of radiation therapy after breast-consercing surgery on 10-year recurrence and 15-year breast cancer death: Meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 378:1707–1716. 2011. View Article : Google Scholar : PubMed/NCBI
4	De Conno F, Ventafridda V and Saita L: Skin problems in advanced and terminal cancer patients. J Pain Symptom Manage. 6:247–256. 1991. View Article : Google Scholar : PubMed/NCBI
5	Porock D and Kristjanson L: Skin reactions during radiation therapy for breast cancer: The use and impact of topical agents and dressings. Eur J Cancer Care (Engl). 8:143–153. 1999. View Article : Google Scholar : PubMed/NCBI
6	Dodd MJ: Managing the side effects of chemotherapy and radiation therapy2nd. UCSF Nursing Press; San Francisco, California, USA: 2001
7	US Department of Health and Human Services, . Common Terminology Criteria for Adverse Events (CTCAE). V4.03. 2010, https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03/CTCAE_4.03_2010-06-14_QuickReference_5×7.pdf
8	Fukushi Y, Kitajima M, Itaki C, Noto Y, Mikami K, Hirota Y, Katto K and Mariya Y: Changes in skin surface temperature and erythema intensity during and after radiation therapy for breast cancer patients. Radiat Emerg Med. 3:47–51. 2014.
9	Heinrich U, Koop U, Leneveu-Duchemin MC, Osterrieder K, Bielfeldt S, Chkarnat C, Degwert J, Häntschel D, Jaspers S, Nissen HP, et al: Multicentre comparison of skin hydration in terms of physical-, physiological- and product-dependent parameters by the capacitance method (Corneometer CM 825). Int J Cosmet Sci. 25:45–53. 2003. View Article : Google Scholar : PubMed/NCBI
10	Park ES, Na JI, Kim SO, Huh CH, Youn SW and Park KC: Application of a pigment measuring device-Mexameter-for the differential diagnosis of vitiligo and nevus depigmentosus. Skin Res Technol. 2:298–302. 2006. View Article : Google Scholar
11	Tamai Y, Tsuji M, Wada K, Nakamura K, Hayashi M, Takeda N, Yasuda K and Nagata C: Association of cigarette smoking with skin colour in Japanese women. Tob Control. 23:253–256. 2014. View Article : Google Scholar : PubMed/NCBI
12	Nagata C, Konish K, Tamura T, Wada K, Hayashi M, Takeda N and Yasuda K: Skin pigmentation is inversely associated with insulin resistance in healthy Japanese women. Diabetes Metab. 42:368–371. 2016. View Article : Google Scholar : PubMed/NCBI
13	Eaton L and Tipton J: Putting evidence into practice: Improving oncology patient outcomes1st. Oncol Nurs Society; Pittsburgh, PA, USA: 2009
14	Blackmar A: Radiation-induced skin alteration. Medsurg Nurs. 6:172–175. 1997.PubMed/NCBI
15	Knopf MT and Sun Y: A longitudinal study of symptoms and self-care activities in women treated with primary radiation therapy for breast cancer. Cancer Nurs. 28:210–218. 2005.PubMed/NCBI
16	Tanaka E, Yamazaki H, Yoshida K, Takenaka T, Masuda N, Kotsuma T, Yoshioka Y and Inoue T: Objective and longitudinal assessment of dermatitis after postoperative accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy in patients with breast cancer treated with breast-conserving therapy: Reduction of moisture deterioration by APBI. Int J Radiat Oncol Biol Phys. 81:1098–1104. 2011. View Article : Google Scholar : PubMed/NCBI
17	Sekiguchi K, Ogita M, Akahane K, Haga C, Ito R, Arai S, Ishida Y, Tsukada Y and Kawamori J: Randomized, prospective assessment of moisturizer efficacy for the treatment of radiation dermatitis following radiotherapy after breast-conserving surgery. Jpn J Clin Oncol. 45:1146–1153. 2015.PubMed/NCBI
18	Vicini FA, Beitsch PD, Quiet CA, Keleher A, Garcia D, Snider HC, Gittleman MA, Zannis VJ, Kuerer H, Whitacre EB, et al: First analysis of patient demographics, technical reproducibility, cosmesis, and early toxicity: Results of the American society of breast surgeouns mammosite breast brachytherapy trial. Cancer. 104:1138–1148. 2005. View Article : Google Scholar : PubMed/NCBI
19	Whelan JT, Levine M, Julian J, Kirkbride P and Skingley P: The effects of radiation therapy on quality of life of women with breast carcinoma: Results of a randomized trial. Ontario Clinical Oncology Group. Cancer. 88:2260–2266. 2000. View Article : Google Scholar : PubMed/NCBI
20	Partl R, Lehner J, Winkler P and Kapp KS: Testing the feasibility of augmented digital skin imaging to objectively compare the efficacy of topical treatments for radiodermatitis. PLoS One. 14:e02180182019. View Article : Google Scholar : PubMed/NCBI
21	Fuzissaki MA, Paiva CE, Gozzo TO, Maia MA, Canto PPL and Maia YCP: Is there agreement between evaluators that used two scoring systems to measure acute radiation dermatitis? Medicine (Baltimore). 98:e149172019. View Article : Google Scholar : PubMed/NCBI
22	Sehlen S, Hollenhorst H, Schymura B, Herschbach P, Aydemir U, Firsching M and Dühmke E: Psychosocial stress in cancer patients during and after radiotherapy. Strahlenther Onkol. 179:175–180. 2003. View Article : Google Scholar : PubMed/NCBI
23	Soh SJ, Schnur JB, Sucala M, David D, Winkel G and Montgomery GH: Distress and emotional well-being in breast cancer patients prior to radiotherapy: An expectancy-based model. Psychol Health. 27:347–361. 2012. View Article : Google Scholar : PubMed/NCBI
24	Lester J, Crosthwaite K, Stout R, Jones NR, Holloman C, Shapiro C and Andersen LB: Women with breast cancer: Self-reported distress in early survivorship. Oncol Nurs Forum. 42:E17–E23. 2015. View Article : Google Scholar : PubMed/NCBI