Skin reactions after breast-conserving therapy and prediction of late complications using physiological functions

Shinmoto, Hiroshi; Kobayashi, Masao; Honda, Chikara; Aoki, Manabu; Nakagawa, Masayuki; Kanehira, Chihiro

doi:10.1007/bf02967446

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…Also, recovery from the acute phase reaction of radiodermatitis was verified at 1M. According to a previous study by Sekine et al, dTemp for patients 12 months after radiotherapy was 1˚C or higher, and dTemp finally dropped to below 1˚C after 24 months (12). In the current study, dTemp peaked at 6M with TJ in vivo 34: 3013-3021 (2020) consumption and was above 1˚C.…”

Section: Discussionsupporting

confidence: 72%

Tomato Juice Consumption Could Improve Breast Skin Adverse Effects of Radiotherapy in Breast Cancer Patients

Fukushi

Mariya²,

Yamada³

et al. 2020

In Vivo

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Background/Aim: We investigated the beneficial effects of drinking tomato juice (TJ) rich in antioxidant carotenoids on irradiated skin following radiotherapy (RT) in breast cancer patients. Patients/Methods: Twenty-three patients agreed to drink TJ (160 g/day for six months) after the completion of RT. Early and late adverse events (AEs) of irradiated skin were evaluated according to the Common Terminology Criteria for AEs and the European Organization for Research and Treatment of Cancer Global Cosmetic Rating System, respectively. Results: With regard to early AEs, acute radiodermatitis of grade 1 was observed in most patients (22/23) at the end of RT. However, the grade of radiodermatitis rapidly changed to 0, 1 month after RT and starting TJ consumption. With regard to late AEs, most patients were in good or excellent dermal condition. Conclusion: TJ consumption could help in relieving and recovering from early AEs and decreasing the severity of late AEs of irradiated skin. The living body is exposed to radiation in cancer radiotherapy to target and damage cancer cells. There are two known routes to express the effects of radiotherapy (1). One is the direct action of radiation directly damaging the target molecules, and the other is the indirect action. The effectiveness is 30% for the former and 70% for the latter (1). In the indirect action, radiation first acts on water, which makes up about 60-80% of the body producing reactive oxygen species (ROS) that damage DNA (1). Oxidative stress represented by ROS continuously occurs under physiological conditions. However, ROS can also be caused by factors such as smoking, strenuous exercise, radiation, ultraviolet light and air pollutants. In vivo, ROS has the role of removing foreign substances such as bacteria in addition to being associated with an antitumor effect (2). On the other hand, when ROS is produced in excess, it is known to react with biopolymers such as DNA, lipids and proteins and cause dysfunction and canceration of normal cells in the living body (2, 3). Therefore, a mechanism to efficiently eliminate ROS is also important. In vivo, an antioxidant network exists to protect healthy tissues from oxidative stress (4). Antioxidants, such as vitamin C, vitamin E, and carotenoids, one of the antioxidant networks, scavenges free radicals. Ingestion of antioxidants that constitute the antioxidant network into the body is believed to have a positive effect on the oxidative stress state in vivo. Recently, carotenoids in particular, have attracted attention among antioxidants (2). Carotenoids have been reported to be associated with the reduction in the risk of chronic diseases such as cardiovascular disease, metabolic syndrome and cancer (2). Proactive intake of carotenoids is believed to have beneficial effects on health. Among carotenoids, lycopene has a particularly potent ability to eliminate singlet oxygen, which is a type of ROS. The potency is said to be 3013 This article is freely accessible online.

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Section: Discussionsupporting

confidence: 72%

Tomato Juice Consumption Could Improve Breast Skin Adverse Effects of Radiotherapy in Breast Cancer Patients

Fukushi

Mariya²,

Yamada³

et al. 2020

In Vivo

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“…There is a possibility that results differ by subjective evaluation (by the investigator or by the time of evaluation); therefore, follow-up of the patient requires an objective evaluation. Some investigators reported an objective assessment for radiation-induced skin reactions; for example, skin blood flow using a laser flow meter [13] [14], skin temperature by thermography [15], electrical resistance analysis [15], skin color by L*a*b* values [16], and moisture analyses by Corneometer® [16].…”

Section: Discussionmentioning

confidence: 99%

Quantitative Assessment of Chronic Skin Reactions Including Erythema and Pigmentation after Breast Conserving Therapy

Kawashima¹,

Nozaki²,

Komazaki³

et al. 2016

ABCR

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Purpose: To evaluate long-term skin reactions following breast-conserving therapy by using the melanin-erythema index meter. Patients and Methods: 164 patients were followed for at least three years after breast-conserving therapy. For both the erythema and the melanin indices, the ratio of the irradiated-side index to the non-irradiated-side index was calculated. The time course of index ratios alternation was examined. Influences from additional therapies and patients' age were also evaluated. Result: Both erythema and melanin index ratios of the breast skin were recovered to pre-radiation level three years after radiotherapy. However, both index ratios of the area administrated with 10-Gy boost irradiation were still high even after five years after radiotherapy. Endocrine therapy, chemotherapy and age had no significant influence on skin color reactions three years after radiotherapy. Conclusion: Quantitative assessment using the melaninerythema index meter demonstrated that chronic skin reactions following breast conserving therapy had recovered to pre-radiation level for three years after irradiation except for the 10-Gy boost irradiated area.

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“…These non-subjective symptoms were observed in the acute phase and were evaluated by visual inspection and/or palpation. In this study, the severity of each symptom was evaluated qualitatively and in consensus using a 5-point scale (no change [0], minimum [1], mild [2], moderate [3], and severe [4]). Each patient was evaluated by an experienced radiation oncologist who was blinded to the results of the skin biophysical measurements.…”

Section: Qualitative Evaluation and Quantitative Measurements For Thementioning

confidence: 99%

“…The quantitative measures included skin temperature, erythema, pigmentation, and the parameters related to skin barrier function: transepidermal water loss (TEWL) and the skin surface moisture level (capacitance). These biophysical parameters were selected because they were expected to change in response to RD, as noted in previous studies [1][2][3][4][5][6][7]. Irradiated and contralateral non-irradiated areas of skin were measured non-invasively using a Multi-Display Device MDD4 (Courage + Khazaka Electronic GmbH, Cologne, Germany) connected with the following probes: A Corneometer to detect the relative water content of the stratum corneum, measured the capacitance of the dielectric medium; skin hydration was measured in relative units on a scale from 0 to 120 [10].…”

Section: Qualitative Evaluation and Quantitative Measurements For Thementioning

confidence: 99%

Non-invasive quantitative measures of qualitative grading effectiveness as the indices of acute radiation dermatitis in breast cancer patients

et al. 2020

Self Cite

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Background Recent improvement of machinery evaluation for the skin changes in various therapies enabled us to evaluate fine changes quantitatively. In this study, we performed evaluation of the changes in radiation dermatitis (RD) using quantitative and qualitative methods, and verified the validity of the conventional qualitative assessment for clinical use. Methods Forty-three breast cancer patients received conventional fractionated radiotherapy to whole breast after breastconserving surgery. Erythema, pigmentation and skin dryness were evaluated qualitatively, and biophysical parameters of RD were measured using a Multi-Display Device MDD4 with a Corneometer for capacitance, a Tewameter for transepidermal water loss (TEWL), a Mexameter for erythema index and melanin index. Measurements were performed periodically until 1 year. Results The quantitative manifestations developed serially from skin erythema followed by dryness and pigmentation. Quantitative measurements detected the effects of irradiation earlier than that of qualitative indices. However, the grades of the domains in RD by qualitative and quantitative assessment showed similar time courses and peak periods. However, no significant correlation was observed between the skin dryness grade and skin barrier function. In contrast to serial increase in pigmentation grades, melanin index showed initial decrease followed by marked increase with significant correlation with pigmentation grades. Conclusion Subjectively and objectively measured results of RD were almost similar course and peak points through the study. Therefore, validity of the conventional qualitative scoring for RD is confirmed by the present quantitative assessments. Instrumental evaluations revealed the presence of modest inflammatory changes before radiotherapy and long-lasting skin dryness, suggesting indication of intervention for RD.

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Skin reactions after breast-conserving therapy and prediction of late complications using physiological functions

Abstract: Impairment of sweating may play an important role in skin damage after irradiation. Although glandular tissue is not usually radiosensitive, the results of our functional assessment suggest that sweat glands are more radiosensitive than expected.

Cited by 5 publications

References 10 publications

Tomato Juice Consumption Could Improve Breast Skin Adverse Effects of Radiotherapy in Breast Cancer Patients

Tomato Juice Consumption Could Improve Breast Skin Adverse Effects of Radiotherapy in Breast Cancer Patients

Quantitative Assessment of Chronic Skin Reactions Including Erythema and Pigmentation after Breast Conserving Therapy

Non-invasive quantitative measures of qualitative grading effectiveness as the indices of acute radiation dermatitis in breast cancer patients

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