Nowadays radiotherapy is one of the main methods of cancer treatment. According to the WHO, more than 50% of patients with diagnosed malignancies need radiation therapy. However, there are a number of side effects of the latter, which are as much the task of the radiotherapist as the actual treatment of the tumor. Skin reactions are one of the most common side effects of radiation therapy, affecting up to 85-95% of patients. Radiation dermatitis is a unique pathology compared to other forms of skin damage, such as traumatic, because the radiation spreads from the epidermis to the deep tissue layers consistently. Such skin reactions can cause some discomfort in cancer patients and even real problems, including interruptions in treatment, decreased aesthetic appeal and decreased quality of life. Recent technological advances and new radiodermatitis treatment regimens represent an opportunity to alleviate the side effects of radiation therapy. Despite a variety of techniques for conservative treatment of radiation dermatitis, the most severe cases may require complex surgical reconstruction of the damaged skin, which is why correction and prevention of skin reactions is a priority in patient care. Despite the large number of trials in this area, there are few qualitative comparative studies that can provide a clear picture of the efficacy of individual radiodermatitis-relieving agents. This literature review reviews the current agents used to treat and prevent acute radiation dermatitis, as well as their mechanisms of action. Three electronic databases, including PubMed, Cochrane, and Embase, were used to find information for the systematic review.
Epstein-Barr virus (EBV) belonging to a family of herpesviruses (human herpesvirus 4) is the first virus that has been linked to the development of malignancies. EBV persists as a latent infection characterized by low viral copy number without cell destruction and periodically reactivates throughout the life since the infection. Currently, the crucial role of EBV in the development of multiple diseases (i.e., Hodgkin lymphoma, Burkitt lymphoma, gastric carcinoma, nasopharyngeal carcinoma, aggressive NK-cell lymphoma etc.) is generally accepted. Many of these disorders are characterized by the lack of early signs. As a result, it is clear that standard diagnostic tools are ineffective in a majority of these patients. Many healthcare professionals (e.g., virologists, immunologists, oncologists, infectious disease specialists etc.) increasingly face virusassociated cancers without significant immunodeficiency. This phenomenon entails in-depth molecular studies on EBV. A myriad of studies on diagnostic markers and other parameters to facilitate early diagnosis of precancerous conditions (including those that occur in EBV-infected individuals) are currently underway.
The processes that vary in nature and underlie the pathogenesis of malignant neoplasms (MNs) and immune-mediated inflammatory rheumatic diseases (RDs) share just the same some common features. Thus, many early-stage neoplasias can mask autoimmune diseases, requiring that physicians of various specialties should comply with the principle of cancer alertness. When specific cancer treatments (immunotherapy, cytostatic therapy, radiotherapy) are performed, there may be certain rheumatic syndromes (arthritis, myalgia, serositis, etc.) that require a differential diagnosis. At the same time, the course of a number of RDs (rheumatoid arthritis, Sjögren's syndrome, and polymyositis) can be accompanied by the development of MNs, which is relevant for real clinical practice and calls for further investigation.The community of etiological factors and a genetic predisposition in the development of RDs and MNs remain to be of no less importance. At the same time, therapists should pay attention to the presence of rheumatic masks in many MNs, which undoubtedly prolongs the time between onset of the first symptoms and correct diagnosis.
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