radiodermatitis

放射性皮炎
  • 文章类型: Journal Article
    在此案例报告中,作者总结了水凝胶联合藻酸盐敷料在4级急性放射性皮炎患者伤口护理中的应用经验。结合水凝胶和海藻酸盐敷料,作者实现了伤口的自溶清创,并创造了一个湿润的愈合环境,以促进伤口闭合。水凝胶有助于敷料更好地粘附在伤口床上,确保它在伤口愈合过程中不容易分离。它还消除了对用于固定的传统胶带的需求,从而避免在辐射场中损伤脆弱的皮肤。伤口从10×12厘米的面积逐渐减小,渗出物持续减少。伤口在20天内完全愈合,共更换了17次敷料。随着伤口逐渐愈合,患者的心理负担减轻,舒适度提高。患者对伤口逐渐愈合表示满意和希望。因此,水凝胶联合藻酸盐敷料治疗严重急性放射性皮炎效果显著,对齐非侵入性,低粘性,吸收剂,适形,优化伤口护理的舒适属性。这些经验为急性放射性皮炎的伤口处理提供了实践基础,并支持该方法的临床应用和推广。
    UNASSIGNED: In this case report, the authors summarize their experience of using hydrogel combined with alginate dressings in the wound care of a patient with grade 4 acute radiation dermatitis. With the combination of hydrogel and alginate dressings, the authors achieved autolytic debridement of the wound and created a moist healing environment to facilitate wound closure. Hydrogel helps the dressing adhere better to the wound bed, ensuring that it does not easily detach during the wound healing process. It also eliminates the need for traditional adhesive tapes for fixation, thus avoiding damage to the fragile skin in the radiation field.The wound gradually decreased in size from an area of 10 × 12 cm, and exudate decreased continuously. The wound completely healed in 20 days with a total of 17 dressing changes. As the wound gradually healed, the patient\'s psychological burden decreased and comfort level increased. The patient expressed satisfaction and hope for the gradual healing of the wound.Thus, the treatment of severe acute radiation dermatitis with hydrogel combined with alginate dressings yields remarkable results, aligning the noninvasive, low-adhesive, absorbent, conformable, and comfortable attributes of optimized wound care. This experience provides a practical foundation for wound management in acute radiation dermatitis and supports clinical application and promotion of the approach.
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  • 文章类型: Case Reports
    辐射回忆表现为由全身治疗引发的急性炎症反应,通常是化疗,并且通常限于先前被照射的区域。辐射回忆反应通常是自限性的,最常见于皮肤。已经描述了许多全身性药物引起辐射回忆反应,但确切的发病机制在很大程度上是未知的。这里,我们描述了首次报道的西妥昔单抗后放射性回忆性皮炎病例.虽然西妥昔单抗与其他皮肤反应有关,肿瘤学家不应排除放射性回忆性皮炎作为西妥昔单抗输注前放疗患者的潜在并发症,应特别注意皮肤在位置和时间上的变化模式。
    Radiation recall presents as an acute inflammatory reaction triggered by systemic therapy, usually chemotherapy, and is typically limited to an area that was previously irradiated. Radiation recall reactions are generally self-limiting and most commonly occur in the skin. Many systemic agents have been described to elicit a radiation recall reaction, but the exact pathogenesis is largely unknown. Here, we describe the first reported case of radiation recall dermatitis following cetuximab. While cetuximab is associated with other skin reactions, oncologists should not exclude radiation recall dermatitis as a potential complication of cetuximab infusion in patients with prior radiation, and special attention should be paid to the pattern of skin changes both in terms of location and chronology.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    多形性黄色星形细胞瘤(PXA)是一种罕见的2或3级脑肿瘤,通常发生在儿童和年轻人中。PXA的标准治疗是最大安全的切除,通常是辅助放射治疗,用于高级别肿瘤。BRAFV600E突变是这些肿瘤中最常见的分子改变之一。近70%的病例携带这种突变。尽管BRAF抑制剂在治疗进行性或难治性疾病方面显示出希望,它们的使用与各种不利影响有关,包括放射性皮炎,这是一个相对常见的并发症。本文介绍了一例16岁男性患者的BRAF突变的转移性PXA,在接受BRAF抑制剂并同时接受放射治疗后出现轻度放射性皮炎。
    Pleomorphic xanthoastrocytoma (PXA) is a rare type of grade 2 or 3 brain tumor that usually occurs in children and young adults. The standard treatment for PXA is maximally safe resection, usually with adjuvant radiation therapy, for high-grade tumors. BRAF V600E mutation is one of the most common molecular alterations in these tumors, with nearly 70% of cases carrying this mutation. Although BRAF inhibitors have shown promise in treating progressive or refractory disease, their use has been associated with various adverse effects, including radiodermatitis, which is a relatively common complication. This paper presents a case of a 16-year-old male patient with BRAF-mutated metastatic PXA, who developed mild radiodermatitis after receiving BRAF inhibitors with concurrent radiation therapy.
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  • 文章类型: Case Reports
    背景:急性放射性皮炎是癌症放疗的重要并发症,基于血小板的疗法正在成为潜在的新疗法。
    在本报告中,我们介绍了一例头颈部肿瘤患者接受放疗联合单克隆抗体西妥昔单抗治疗的病例.经过4周的治疗,患者出现皮肤放射性皮炎。尽管接受了皮质类固醇和润肤霜的标准治疗,病变没有改善。
    头颈部癌症患者皮肤放射性皮炎。
    在伤口上开始局部应用血小板凝胶。从放疗的第二周到第4周,使用绷带将同源的富含血小板的血浆应用于皮炎,一天四次。
    结果:使用同源血小板凝胶的局部治疗导致放射性皮炎完全愈合,包括表皮的修复,上皮再生,减少相关的疼痛。
    结论:同源血小板凝胶可能是放射性皮炎标准治疗的替代方法。
    BACKGROUND: Acute radiodermatitis is a significant complication of cancer radiotherapy, and platelet-based therapies are emerging as potential new treatments.
    UNASSIGNED: In this report, we present the case of a patient with head and neck cancer undergoing radiotherapy combined with the monoclonal antibody cetuximab. After 4 weeks of this treatment, the patient developed cutaneous radiation dermatitis. Despite receiving standard treatment with corticosteroids and emollient cream, the lesion did not improve.
    UNASSIGNED: cutaneous radiation dermatitis on head and neck cancer patient.
    UNASSIGNED: Topical application of platelet gel was initiated on the wound. From the second week of radiotherapy to the 4th week, homologous platelet-rich plasma was applied on the dermatitis using a bandage, 4 times a day.
    RESULTS: The topical treatment with homologous platelet gel resulted in complete healing of the radiodermatitis, including restoration of the epidermis, reepithelialization, and reduction in associated pain.
    CONCLUSIONS: homologous platelet gel might be an alternative to standard treatment of radiation dermatitis.
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  • 文章类型: Case Reports
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  • 文章类型: Review
    辐射回忆性皮炎是皮肤的炎症反应,可能很少发生在先前已接受放射疗法治疗的皮肤区域。这被认为是由于在放射治疗后施用的触发剂导致急性炎症反应。表现为皮疹。我们介绍了一个58岁的男性复发性舌鳞状细胞癌的病例,以前接受过化疗和放疗,他的病情进展。他接受了pembrolizumab治疗,随后在先前治疗的辐射领域出现了新的面部皮疹。皮疹的分布提示放射性回忆性皮炎。活检显示真皮坏死没有皮炎的迹象,血管炎,或感染过程。该病例强调了免疫检查点抑制剂治疗的罕见并发症的发生率,并强调需要仔细监测辐射召回性皮炎。
    Radiation recall dermatitis is an inflammatory reaction of the skin that may infrequently occur in areas of the skin that have been previously treated with radiation therapy. This is thought to be due to a triggering agent administered after radiation therapy which leads to an acute inflammatory reaction, manifesting as a skin rash. We present the case of a 58-year-old male with recurrent invasive squamous cell carcinoma of the tongue, previously treated with chemotherapy and radiation therapy, who presented with progression of his disease. He was treated with pembrolizumab and subsequently developed a new-onset facial rash over the previously treated radiation field. The distribution of the rash was suggestive of radiation recall dermatitis. A biopsy showed dermal necrosis without evidence of dermatitis, vasculitis, or infectious process. This case highlights the incidence of a rare complication of immune checkpoint inhibitor therapy and emphasizes the need for careful monitoring for radiation recall dermatitis.
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  • 文章类型: Systematic Review
    我们介绍了一例由顺铂化疗同时再放疗引发的轻度放射回忆性皮炎。皮炎面积与先前放射治疗的皮肤暴露有关,将反应清楚地描述为召回。顺铂尚未被认为是召回反应的潜在触发因素。尽管它是几种报道的多药触发剂组合的一部分,所有被称为顺铂的审查工作都没有可疑,建议组合伴侣作为效应器。我们进行了重点系统的文献综述,旨在重新评估顺铂作为(共同)触发因素的真正作用。总的来说,发现30例报告病例,90%由多种药物组合触发。后者往往会引起更严重的症状。除了支持20Gy阈值理论的发现,未发现辐射剂量与严重程度或患病率之间存在相关性.认识到顺铂是召回现象的触发因素及其支持性管理可能会防止不必要的全身化疗停止。将召回事件作为应用放射治疗的前瞻性临床试验的次要终点进行系统报告可以支持对召回现象的理解。
    We present a case of mild radiation recall dermatitis triggered by cisplatin chemotherapy given simultaneously to re-irradiation. The dermatitis area correlated to skin exposure of the previous radiation therapy, characterizing the reaction clearly as a recall. Cisplatin has not yet been recognized as a potential trigger for recall reactions. Although it was part of several reported multidrug trigger combinations, all review works referred to cisplatin as not suspicious, suggesting the combination partner as the effector. We performed a focused systematic literature review aiming to re-evaluate the real role of cisplatin as a (co-)triggering factor. In total, 30 reported cases were found, 90% triggered by multidrug combinations. The latter tended to cause more severe symptoms. Besides findings supporting the 20 Gy-threshold theory, no correlation between radiation dose and severity or prevalence was found. Recognition of cisplatin as a trigger of the recall phenomenon and its supportive management may prevent unnecessary cessation of systemic chemotherapy. Systematic reporting of recall events as a secondary endpoint of prospective clinical trials applying radiation therapy could support understanding the recall phenomenon.
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  • DOI:
    文章类型: Journal Article
    背景:辐射诱导的溃疡是放疗后用于癌症治疗的晚期皮肤反应。
    目的:本研究检查了使用单阶段重建程序来处理与辐射有关的伤口。
    方法:9例放射性慢性溃疡伴严重并发症患者入院,重建,2015年10月至2019年9月期间,越南国立烧伤医院再生中心。患者的年龄范围为49至77岁。并发症包括骨外露(n=1),暴露气管(n=1),暴露的颈动脉(n=2),暴露的腋窝动脉(n=2),胸膜外露(n=1),和暴露的心包(n=2)。清创术后用于实现缺陷覆盖的皮瓣类型对每位患者进行个体化治疗,并包括ALT,LD,SCA,和DIEP襟翼。此外,使用高密度聚乙烯重建气管,以恢复暴露气管的患者的呼吸功能。
    结果:所有皮瓣均获得完全存活。最重要的器官(气管,腋窝动脉,和颈动脉)被覆盖。住院时间为15至120天。
    结论:严重并发症患者的成功治疗表明,立即单阶段重建可能是治疗放射性溃疡的一个有价值的选择。
    Radiation-induced ulceration is a late-stage skin reaction after RT for cancer treatment.
    The present study examined the use of a single-stage reconstructive procedure to manage radiation-related wounds.
    Nine patients with radiation-induced chronic ulcer with accompanying severe complications were admitted to the Plastic, Reconstructive, and Regenerative Center of Viet Nam National Burn Hospital between October 2015 and September 2019. The patients ranged in age from 49 to 77 years. Complications included exposed cheekbone (n = 1), exposed trachea (n = 1), exposed carotid artery (n = 2), exposed axillary artery (n = 2), exposed pleura (n = 1), and exposed pericardium (n = 2). Flap type used to achieve defect coverage after debridement was individualized to each patient and included ALT, LD, SCA, and DIEP flaps. Additionally, a high-density polyethylene was used to reconstruct the trachea to recover breathing function in the patient with exposed trachea.
    Complete survival of all flaps was achieved. Most vital organs (the trachea, axillary artery, and carotid artery) were covered. Hospital length of stay ranged from 15 to 120 days.
    The successful management of patients with severe complications suggests that immediate single-stage reconstruction may be a valuable option for managing radiation-induced ulcers.
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  • DOI:
    文章类型: Case Reports
    荧光镜检查引起的慢性放射性皮炎(FICRD)是一种罕见但不断增加的并发症,由于其症状多样且发作延迟,诊断具有挑战性。通常在辐射暴露后几个月到几年。对于接受心导管检查的患者,放射性皮炎的高危因素包括肥胖,复杂或慢性完全闭塞病变的存在,使用固定的大光束角度,手术时间超过2小时。我们介绍了一个FICRD患者,该患者的背部斑块硬化了7年,以使医生熟悉高危人群并早期认识到该疾病。
    Fluoroscopy-induced chronic radiation dermatitis (FICRD) is an uncommon but increasing complication that is challenging to diagnose due to its varied symptoms and delayed onset, usually from months to years after radiation exposure. For patients undergoing cardiac catheterization, high-risk factors for radiodermatitis include obesity, the presence of complex or chronic total occlusion lesions, the use of a fixed large beam angulation, and a procedure time of more than 2 hours. We present an individual with FICRD that had an indurated plaque on his back for 7 years to familiarize physicians with high-risk groups and early recognition of the disease.
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