三乙醇胺治疗乳腺癌术后放射性皮炎
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摘要
目的:观察三乙醇胺乳膏在治疗乳腺癌根治术后放疗导致的皮肤损伤的效果。方法:收集2015年1月至2017年12月的296例乳腺癌根治术后患者。观察组159例:IGRT放疗+外用三乙醇胺乳膏,三乙醇胺乳膏从放疗第一天开始使用,至放疗结束后一周。对照组137例:单纯行IGRT放疗。结果:使用了乳膏的患者发生放射性皮炎的时间明显延迟。33. 96%(54/159)的患者在放疗第三周开始后发生放射性皮炎,而未使用乳膏的患者为21. 90%(30/137)。从放疗第二、三、四、五周观察统计可见,使用乳膏后,发生放射性皮炎的严重程度也明显减轻,未使用乳膏的患者发生Ⅲ-Ⅳ级放射性皮炎的几率明显高于观察组。在放疗期间因放射性皮肤损伤导致放疗中断,观察组有1例,对照组6例,两组有统计学差异(P <0. 05)。在放疗结束后恢复阶段,使用了乳膏的患者恢复明显较对照组快,差异有显著统计学意义(P <0. 01)。结论:三乙醇胺乳膏可有效减轻放射性皮炎发生的严重程度,可有效延缓放射性皮炎发生的时间,可减少因放射性皮炎引起的非计划性放疗中断发生率,可加快放射性皮炎的恢复速度,增加患者放疗的依从性,减少因治疗给患者带来的痛苦,值得临床推广应用。
Objective:To observe the clinical efficacy of biafute cream in the treatment of radiodermatitis after radical mastectomy.Methods:296 patients who underwent radical mastectomy from January 2015 to December 2017 were collected.Observation group(159 cases):IGRT+biafute cream.Biafute cream was used from the first day of radiotherapy until the week after the end of the radiotherapy.Control group(137 cases):IGRT alone.Results:The time of radiodermatitis was significantly delayed in patients who used cream.33.96%(54/159) of the patients developed radiodermatitis after third weeks of radiotherapy,while 21.90%(30/137) were unused.From the observation of the second,third,fourth and five weeks of radiotherapy,the severity of radioactive dermatitis was obviously reduced after the use of cream.The patients who did not use cream were significantly higher than the observation group.There were 1 case in the observation group and 6 cases in the control group were interrupted by dermal injury during radiotherapy.There was a significant difference between the two groups(P<0.05).In the recovery stage after radiotherapy,the patients who used cream had a faster recovery than the control group(P<0.01).Conclusion:Biafute cream can effectively reduce the severity of radioactive dermatitis,effectively delay the occurrence time of radioactive dermatitis,reduce the unplanned interruption of radiotherapy incidence,speed up the recovery of radioactive dermatitis,increase patient compliance of radiotherapy treatment,and reduce medical pain to patients.It is worthy of clinical application.
Objective:To observe the clinical efficacy of biafute cream in the treatment of radiodermatitis after radical mastectomy.Methods:296 patients who underwent radical mastectomy from January 2015 to December 2017 were collected.Observation group(159 cases):IGRT+biafute cream.Biafute cream was used from the first day of radiotherapy until the week after the end of the radiotherapy.Control group(137 cases):IGRT alone.Results:The time of radiodermatitis was significantly delayed in patients who used cream.33.96%(54/159) of the patients developed radiodermatitis after third weeks of radiotherapy,while 21.90%(30/137) were unused.From the observation of the second,third,fourth and five weeks of radiotherapy,the severity of radioactive dermatitis was obviously reduced after the use of cream.The patients who did not use cream were significantly higher than the observation group.There were 1 case in the observation group and 6 cases in the control group were interrupted by dermal injury during radiotherapy.There was a significant difference between the two groups(P<0.05).In the recovery stage after radiotherapy,the patients who used cream had a faster recovery than the control group(P<0.01).Conclusion:Biafute cream can effectively reduce the severity of radioactive dermatitis,effectively delay the occurrence time of radioactive dermatitis,reduce the unplanned interruption of radiotherapy incidence,speed up the recovery of radioactive dermatitis,increase patient compliance of radiotherapy treatment,and reduce medical pain to patients.It is worthy of clinical application.
引文
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[15] Liu Xiaoping,Liu Rui,Su Jin,et al.Clinical observation of trolamine cream in the prevention and treatment of acute radioactive dermatitis[J].Modern Oncology,2014,22(06):170-180.[刘小平,刘锐,苏进,等.三乙醇胺乳膏防治急性放射性皮炎的疗效观察[J].现代肿瘤医学,2014,22(06):1441-1442.]
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[3] Yang JF,Lee MS,Lin CS,et al.Long-term breast cancer patient outcomes after adjuvant radiotherapy using intensity-modulated radiotherapy or conventional tangential radiotherapy[J].Medicine (Baltimore),2016,95(11):e3113.
[4] Speers C,Pierce LJ.Postoperative radiotherapy after breast-conserving surgery for early-stage breast cancer:A review[J].JAMA Oncol,2016:2(8):1075-1082.
[5] Vaidya JS,Wenz F,Bulsara M,et al.An international randomised controlled trial to compare TARGeted intraoperative radiotherapy(TARGIT) with conventional postoperative radiotherapy after breast-conserving surgery for women with early-stage breast cancer(the TARGIT-A trial)[J].Health Technol Assess,2016,20(73):1-188.
[6] Wang LH,Zhu GY.Tumor radiotherapy[M].Beijing:People's Medical Publishing House,2016:242-264.[王绿化,朱广迎.肿瘤放射治疗学[M].北京:人民卫生出版社,2016:242-264.]
[7] Fiorentino A,Mazzola R,Ricchetti F,et al.Intensity modulated radiation therapy with simultaneous integrated boost in early breast cancer irradiation.Report of feasibility and preliminary toxicity[J].Cancer Radiother,2015,19(5):289-294.
[8] Morgan K.Radiotherapy-induced skin reactions:Prevention and cure.[J].Br J Nurs,2014,23(16):S24,S26-32.
[9] Li XP,Fu QT,Xue YB,et al.Clinical efficacy of trolamine cream in the treatment of laser wound surface[J].Journal of Clinical Rational Drug use,2013,6(25):36-37.[李雪萍,富秋涛,薛艳斌,等.三乙醇胺乳膏治疗激光术后创面的临床疗效观察[J].临床合理用药杂志,2013,6(25):36-37.]
[10] Batar B,Mutlu T,Bostanci M,et al.DNA repair and apoptosis:Roles in radiotherapy-related acute reactions in breast cancer patients[J].Cell Mol Biol(Noisy-le-grand),2018,64(4):64-70.
[11] Baines CR,McGuiness W,O' Rourke GA,et al.An integrative review of skin assessment tools used to evaluate skin injury related to external beam radiation therapy[J].J Clin Nurs,2016,26(7-8):1137-1144.
[12] Zhao Y,Qiu J,Li Z,et al.An Experimental and theoretical study on the unexpected catalytic activity of triethanolamine for the carboxylative cyclization of propargylic amines with CO2[J].Chem Sus Chem,2017,10(9):2001-2007.
[13] Ryu MY,Jang HK,Lee KJ,et al.Triethanolamine doped multilayer MoS2 field effect transistors[J].Phys Chem Chem Phys,2017,19(20):13133-13139.
[14] Mohapatra R,Senapati S,Sahoo C,et al.Transcorneal permeation of diclofenac as a function of temperature from film formulation in presence of triethanolamine and benzalkonium chloride[J].Colloids Surf B Biointerfaces,2014,123(1):170-180.
[15] Liu Xiaoping,Liu Rui,Su Jin,et al.Clinical observation of trolamine cream in the prevention and treatment of acute radioactive dermatitis[J].Modern Oncology,2014,22(06):170-180.[刘小平,刘锐,苏进,等.三乙醇胺乳膏防治急性放射性皮炎的疗效观察[J].现代肿瘤医学,2014,22(06):1441-1442.]