Radiotherapy and wound healing

Dormand, Emma-Louise; Banwell, Paul E.; Goodacre, Tim

doi:10.1111/j.1742-4801.2005.00079.x

Cited by 267 publications

(210 citation statements)

References 176 publications

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“…48% whereas the present series had a complication rate of only 28%. 14 The number of cases in their study was quite high i.e. 229 against the present 25.…”

Section: Discussionmentioning

confidence: 93%

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A study of the effect of pre-radiation on healing of surgical wounds in the treatment of cancers of the head and neck

Dasgupta

Sen

et al. 2016

Int J Res Med Sci

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INTRODUCTIONModern multimodal treatment for cancer which comprise principally of surgery with radiation and chemotherapy has improved the prospect of quality and quantity of life for the unfortunate patients suffering from head and neck cancer. The combined use of radiation and surgery has been practiced for a considerable time period and of late ABSTRACT Background: Radiation therapy is an established modality in the treatment of head and neck cancer patients. It is used alone or in combination with surgery and chemotherapy. Although radiotherapy is useful to affect tumour death, it also exerts a deleterious effect on surrounding normal tissues. These effects are either acute or can manifest months or years after the treatment. The chronic wounds are a result of impaired wound healing. Compromised wound healing in irradiated tissues is a common and challenging clinical problem. Methods: A prospective observational study was done in a tertiary care teaching institute, Kolkata. The effect of radiation on surgery of cancers of head and neck was studied in 50 patients. The patients were divided into 2 groups of 25 each. The cases in the first group were irradiated prior to surgery and those on the second group were operated upon without any pre-radiation. Results: The highest incidence of wound complications in those patients who were operated upon within 2 weeks to 6 months of completion of RT (83.33%). Patients who had their blood Hb level at or above 11 gm% developed less number of wound complications (34.78%) as compared to those who had their blood Hb level between 8-11 gm% where complication rate was 48.15%. Those patients who had their oral cavity or pharynx opened during surgery had a much higher incidence of wound complications (54.54%) than whose oral cavity or pharynx were not interfered with (17.64%). Wound infection was 36% in the irradiated group and 12% in the non-irradiated group. Separation of wound edges or skin necrosis followed in 28% cases in the pre-radiated group and in 8% cases in the non-pre-radiated group. Conclusions: Radiotherapy is an integral modality of head and neck cancer therapy. Compromised wound healing is an important side effect of radiation therapy. All sorts of local complications as wound infection and necrosis, or ocutaneous fistulae, carotid artery perforation etc. are more pronounced in patients, who received prior radiotherapy. The complication of surgery after radiotherapy was found to be more pronounced between 2 weeks to 6 months in this series.

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“…48% whereas the present series had a complication rate of only 28%. 14 The number of cases in their study was quite high i.e. 229 against the present 25.…”

Section: Discussionmentioning

confidence: 93%

“…Such ionizing radiation though required for tumour death, also causes damage to the surrounding normal tissue. 1,2 There have been tremendous refinement and improvement both in the fields of surgery and radiotherapy. Inspite of refinements radiation leaves behind noticeable and unnoticeable damage to the tissue.…”

mentioning

confidence: 99%

A study of the effect of pre-radiation on healing of surgical wounds in the treatment of cancers of the head and neck

Dasgupta

Sen

et al. 2016

Int J Res Med Sci

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“…The contactile activity of fibroblasts expressing low α-SMA can be enhanced by treatment with many substances that increase α-SMA level. 23 Radiation affects the process of wound closure by decreasing the regenerative competence of oral epithelium, 24 and subsequent injury to an irradiated site can trigger a sever uncontrolled reaction. 6 In this study, oral ulcer was induced in gamma-irradiated mice as a model of RCI.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic effect of Aloe vera and silver nanoparticles on acid-induced oral ulcer in gamma-irradiated mice

El-Batal

Ahmed

2018

Braz. oral res.

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Radiation combined injury, a life-threatening condition, has higher mortality than simple radiation injury. The aim of the present study was to analyze the efficiency of Aloe vera and silver nanoparticles in improving the healing of ulcerated oral mucosa after irradiation. Thirty male Albino mice were divided into five groups: control, radiation, Aloe vera (AV), silver nanoparticles (NS), and AV+NS. The mice were exposed to whole body 6Gy gamma-radiation. After one hour, 20% acetic acid was injected into the submucosal layer of the lower lip for ulcer induction. The animals received topical treatment with the assigned substances for 5 days. Lip specimens were subjected to hematoxylin and eosin and anti alpha-smooth muscle actin immunohistochemical staining. Results demonstrated occurance of ulcer three days post irradiation in all groups except in the AV+NS group where only epithelial detachment was developed. After seven days, data revealed persistent ulcer in radiation group, and almost normal epithelium in the AV+NS group. A significant reduction of epithelial thickness was detected in all groups at the third day as compared to control. At the seventh day, only the AV+NS group restored the epithelial thickness. Area percent of alpha-smooth muscle actin expression was significantly decreased in radiation group at the third day followed by significant increase at the seventh day. However, all treatment groups showed significant increase in alpha-smooth muscle actin at the third day, which decreased to normal level at the seventh day. Our study demonstrated the efficiency of Aloe vera and silver nanoparticles in enhancing ulcer healing after irradiation.

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“…it leads to a decrease in white blood cell numbers. On the other hand, radiotherapy results in irradiation injury, which in the early phase is visible as inhibited circulation in the irradiated area [5,[12][13][14][15][16][17]. These side effects of chemo-and radiotherapy may be followed by a decrease in growth factors present at the postoperative site in patients with breast cancer, colorectal cancer or stomach cancer, treated with neoadjuvant therapy prior to surgery.…”

Section: Wound Healing -Stages and Critical Factorsmentioning

confidence: 99%

“…In order to minimize the side effects of preoperative radio-and chemotherapy, the best time for surgery was established at 4 to 6 weeks after neoadjuvant treatment. Nevertheless, this treatment protocol does not fully prevent wound healing disturbances, especially after radiotherapy [5,[12][13][14][15][16][17]19].…”

Section: Oncological Treatmentmentioning

confidence: 99%

Wound healing complications in oncological patients: perspectives for cellular therapy

Deptuła

Zieliński

Wardowska

et al. 2019

pdia

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A b s t r a c tVarious types of cancer are nowadays a serious medical and social problem and a great challenge for modern medicine. The majority of anticancer therapy is based on traditional chemotherapy and radiotherapy. Both of these highly non-specific types of treatment have a number of serious side effects including wound healing complications. Radiotherapy and chemotherapy mostly affect rapidly dividing skin cells (e.g. keratinocytes), as well as fibroblasts, melanocytes, endothelial and immune cells. Currently, there are many strategies to improve wound healing in oncological patients, including various types of dressings, biomaterials, growth factors, and cell therapies.

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Radiotherapy and wound healing

Cited by 267 publications

References 176 publications

A study of the effect of pre-radiation on healing of surgical wounds in the treatment of cancers of the head and neck

A study of the effect of pre-radiation on healing of surgical wounds in the treatment of cancers of the head and neck

Therapeutic effect of Aloe vera and silver nanoparticles on acid-induced oral ulcer in gamma-irradiated mice

Wound healing complications in oncological patients: perspectives for cellular therapy

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