目的:放射性皮炎(RD)是放射治疗(RT)的常见副作用。虽然目前使用许多不同的治疗策略来解决RD,缺乏共识,在过去10年中,RD预防和管理指南基本保持不变。这篇综述旨在通过比较几个组织在2010年至2021年之间发布的RD临床实践指南来制定明确的支持性护理干预措施:跨国癌症支持护理协会(MASCC)。不列颠哥伦比亚省癌症管理局(BCCA)癌症护理曼尼托巴省(CCMB),肿瘤护理学会(ONS),放射技师学会(SCoR),和国际癌症护理护士协会(ISNCC)。
方法:在MASCC中评估了协议和不一致的区域,BCCA,CCMB,ONS,SCoR,和ISNCC指南。
结果:已经总结了针对急性RD和慢性RT引起的皮肤毒性的指南中的治疗建议。指南中关于局部使用皮质类固醇的协议最强,磺胺嘧啶银,washing,和除臭剂。所有指南都推荐使用外用皮质类固醇,用水和肥皂洗涤是一贯的支持。对于用于RD预防或管理的最佳敷料或阻隔膜存在最小的共识。MASCC弱推荐预防性使用磺胺嘧啶银来降低RD,而BCCA,CCMB,SCoR建议在感染迹象时使用。MASCC和CCMB建议使用长脉冲染料激光来管理毛细血管扩张,RT的后期效果。
结论:鉴于指南建议之间的不一致程度,建议进一步研究以建立RD预防和管理的最佳治疗方法.
OBJECTIVE: Radiation dermatitis (RD) is a common side effect of radiation therapy (RT). While many different treatment strategies are currently used to address RD, there is a lack of
consensus and RD prophylaxis and management
guidelines have remained largely unchanged over the last 10 years. This review aims to formulate unambiguous supportive care interventions by comparing RD clinical practice guidelines published between 2010 and 2021 by several organizations: Multinational Association for Supportive Care in Cancer (MASCC), British Columbia Cancer Agency (BCCA), Cancer Care Manitoba (CCMB), Oncology Nursing Society (ONS), Society and College of Radiographers (SCoR), and International Society of Nurses in Cancer Care (ISNCC).
METHODS: Areas of agreement and discordance were assessed among the MASCC, BCCA, CCMB, ONS, SCoR, and ISNCC guidelines.
RESULTS: Treatment recommendations across
guidelines for acute RD and chronic RT-induced skin toxicities have been summarized. The strongest agreement among the guidelines exists for the use of topical corticosteroids, silver sulfadiazine, washing, and deodorant. All guidelines recommend the use of topical corticosteroids, and washing with water and soap is consistently supported. There is minimal
consensus on an optimal dressing or barrier film for RD prophylaxis or management. MASCC weakly recommends prophylactic use of silver sulfadiazine to reduce RD, while BCCA, CCMB, and SCoR recommend its use upon signs of infection. MASCC and CCMB recommend the use of a long-pulsed dye laser to manage telangiectasia, a late effect of RT.
CONCLUSIONS: Given the extent of discordance among
guideline recommendations, further research is recommended to establish optimal treatments for RD prophylaxis and management.