A Systematic Review of Patient-Rated Measures of Radiodermatitis in Breast Cancer Radiotherapy

Schnur, Julie B.; Love, Bianca; Scheckner, Bari; Green, Sheryl; Wernicke, A. Gabriella; Montgomery, Guy H.

doi:10.1097/coc.0b013e3181e84b36

Cited by 46 publications

(41 citation statements)

References 48 publications

(46 reference statements)

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“…Shoulder dysfunction in survivors of breast cancer can be caused by a number of pathologic conditions [1]. In the acute treatment setting, the effects of breast surgery, axillary dissection, and radiation dermatitis can cause pain and a subsequent disincentive for patients to move their arm [27]. Postsurgical pain (postmastectomy or reconstruction, both immediate or delayed), scar tissue formation, nerve dysfunction, and protective posturing may lead to shortening of soft tissues in the anterior chest wall, including the pectoralis major and minor muscles [28].…”

Section: Musculoskeletal Disordersmentioning

confidence: 99%

Upper Body Pain and Functional Disorders in Patients With Breast Cancer

Stubblefield

Keole

2013

PM&R

150

127

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Upper body pain and dysfunction are common in survivors of breast cancer. Disorders of the upper body can result directly from breast cancer or from the surgery, chemotherapy, radiotherapy, or hormonal therapies used in its treatment. Although considerable information is available regarding impairments such as pain and restricted shoulder range of motion associated with breast cancer and its treatment, relatively little information is available about the specific neuromuscular, musculoskeletal, lymphovascular, and other diagnostic entities that underlie those impairments. This article will detail the common and specific causes of upper body pain and dysfunction in breast cancer survivors, including postsurgical pain, rotator cuff disease, adhesive capsulitis, arthralgias, cervical radiculopathy, brachial plexopathy, mononeuropathy, postmastectomy pain syndrome, lymphedema, axillary web syndrome, deep vein thrombosis, and cellulitis. Diagnostic specificity is a key first step to safely and effectively restore function and quality of life to breast cancer survivors.

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Section: Musculoskeletal Disordersmentioning

confidence: 99%

Upper Body Pain and Functional Disorders in Patients With Breast Cancer

Stubblefield

Keole

2013

PM&R

150

127

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“…The distress and unfavourable impact of RD on quality of life is also an important area of assessment (21,40,50,51). Radiation dermatitis can have a significant effect on patients' Qol and can determine the prescribed therapeutic radiation dose (6,40,49).…”

Section: Discussionmentioning

confidence: 99%

Topical Management of Acute Radiation Dermatitis in Breast Cancer Patients: A Systematic Review and Meta-Analysis

Haruna

Lipsett

Marignol

2017

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(OR: 0.29; p<0.0001) and reducing the mean RD score p<0.00001 Radiation induces damage to the skin, activating inflammatory pathways and causing cytokines overproduction (1, 2). Radiation dermatitis is a common acute side-effect that occurs within hours to weeks after the start of radiotherapy (3, 4) and affects more than 87% of patients (2, 5). Radiation dermatitis can limit the therapeutic dose delivered to patients and can, sometimes, lead to a break in treatment, thus potentially compromising local control and survival outcome (1, 6). It can also have a considerable impact on patients' quality of life (7,8). Despite significant development in radiotherapy techniques, efficacious interventions in the prevention of acute skin reactions is still lacking and current evidence is unable to provide adequate guidelines for the management of this sideeffect (9, 10). Studies have examined numerous topical agents such as Aloe Vera, aqueous cream, Calendula, petrolatum and sulcrafate cream as a means to reducing the dehydrating effects of radiation dermatitis (6,11,12). However, the results in terms of managing radiation dermatitis and treatment related pain have not been clinically significant (13,14). Corticosteroids have anti-inflammatory properties and are known to down-regulate cytokine gene expression, making them ideal for managing radiation dermatitis (15-17). A systematic review by Bolderston et al. concluded that there is limited evidence to support or oppose the use of topical agents for the management of acute radiation dermatitis (18).Skin care advice given to breast cancer patients varies among institutions (19). No gold-standard for the appropriate management of this side-effect exists and in most cases the decision of care is left at the discretion of the health care professional rather than clinical evidence (20,21). Clinical advice is often given based on anecdotal evidence (22).The present systematic review and meta-analysis was conducted to assess the potential efficacy of corticosteroids in the management of RD and its impact on pain and quality of life in female breast cancer patients. However, the anticipated adverse effect associated with steroids is not evaluated and is beyond the scope of this review. We restricted our review to one site only due to radiotherapy dose variations used in different sites. Materials and MethodsSearch strategy for identification of studies. The electronic literature search was conducted up to and including March 2017. The search terms used were corticosteroid, radiation dermatitis, breast cancer, management, and prevention. The reference lists of potentially eligible studies were subsequently hand searched to identify 5343

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“…Among patients who have received concurrent radiochemotherapy, the radiodermatitis occurrence rate is relatively high and can reach 46% 4 . This adverse reaction not only leads to an increased risk of local skin lesions, pain, and infection, but can also result in ulceration and delayed healing if not treated in a timely manner.…”

Section: Introductionmentioning

confidence: 99%