Ultrasonographic Evaluation of Skin Toxicity Following Radiotherapy of Breast Cancer: A Systematic Review

Abstract

The present review aimed to systematically review skin toxicity changes following breast cancer radiotherapy (RT) using ultrasound (US). PubMed and Scopus databases were searched according to PRISMA guidelines. The characteristics of the selected studies, measured parameters, US skin findings, and their association with clinical assessments were extracted. Seventeen studies were included with a median sample size of 29 (range 11–166). There were significant US skin changes in the irradiated skin compared to the nonirradiated skin or baseline measurements. The most observed change is skin thickening secondary to radiation-induced oedema, except one study found skin thinning after pure postmastectomy RT. However, eight studies reported skin thickening predated RT attributed to axillary surgery. Four studies used US radiofrequency (RF) signals and found a decrease in the hypodermis’s Pearson correlation coefficient (PCC). Three studies reported decreased dermal echogenicity and poor visibility of the dermis–subcutaneous fat boundary (statistically analysed by one report). The present review revealed significant ultrasonographic skin toxicity changes in the irradiated skin most commonly skin thickening. However, further studies with large cohorts, appropriate US protocol, and baseline evaluation are needed. Measuring other US skin parameters and statistically evaluating the degree of the association with clinical assessments are also encouraged.

Hybrid Treatment Planning for Chest Wall Irradiation Utilizing Three-Dimensional Conformal Radiotherapy (3DCRT), Intensity-Modulated Radiation Therapy (IMRT), and Volumetric Modulated Arc Therapy (VMAT): A Systematic Review

“…Furthermore, it has been observed that the incidence of coronary events increases by 7.4 per 1 Gy increase in the mean heart dose [33]. In most studies, hybrid techniques (H-VMAT, H-IMRT) had lower heart doses than VMAT or IMRT [13][14][15][16][17][18]20], but some studies reported no statistically significant difference [25,27]. However, these latter studies included both breast and chest wall patients, which could affect the final result.…”

“…This approach was specifically designed to address the crucial concern regarding the protection of OARs, while ensuring optimal treatment plan quality. The strategic integration of these modalities offers potential treatment optimization, particularly in cases related to the breast and the chest wall [ 13 , 14 ]. It is important to acknowledge that each modality has inherent advantages and disadvantages.…”

The Applications of High-Intensity Focused Ultrasound (HIFU) Ablative Therapy in the Treatment of Primary Breast Cancer: A Systematic Review

“…The systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines [8] and followed previous studies [9][10][11][12][13][14][15][16]. The PICOS criteria were used to determine the inclusion and exclusion criteria for the article selection based on population, intervention, comparison, outcome, and study design, as in Table 1.…”

Functional Alteration in the Brain Due to Tumour Invasion in Paediatric Patients: A Systematic Review

“…Two independent researchers conducted a systematic search using the National Centre for Biotechnology Information (PubMed) electronic database. The preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) [ 16 ] and previous studies [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ] were used as the reporting guidelines ( Figure 1 ). The search was performed to identify studies reporting functional magnetic resonance imaging (fMRI) and brain tumours in paediatric patients below 18 years old.…”