背景:急性放射性皮炎(ARD)是最广泛报道的放疗引起的不良事件。目前,没有客观或可靠的方法来测量ARD。
目的:我们的主要目的是使用光学相干断层扫描(OCT)皮肤扫描的计算模型来识别和量化放射治疗的效果。次要目标包括确定不同放射治疗方案和辅助局部治疗的ARD影响。
方法:我们进行了前瞻性,在三级转诊中心对符合全乳放疗(WBRT)条件的乳腺癌患者进行单中心病例系列研究.
结果:根据放疗方案(15、20和25分)共纳入和分配了39名妇女。设计计算模型以定量分析OCT结果。放疗后,OCT扫描更敏感地显示了84.6%的患者的血管形成变化(对比69.2%的临床检查ARD患者)。OCT量化了WBRT结束时血管形成的增加(P<.05)和3个月后的减少(P=.032)。OCT显示的红斑性皮肤变化在25分方案中更为明显。
结论:OCT计算模型允许识别和量化辐照皮肤上的血管形成变化,即使在没有临床ARD的情况下。这可以允许设计超出所涉及的患者的肤色的ARD的标准化方案。
BACKGROUND: Acute radiation dermatitis (ARD) is the most widely reported radiotherapy-induced adverse event. Currently, there is no objective or reliable method to measure ARD.
OBJECTIVE: Our main objective was to identify and quantify the effects of radiotherapy with a computational model using optical coherence tomography (OCT) skin scanning. Secondary objectives included determining the ARD impact of different radiotherapeutic schemes and adjuvant topical therapies.
METHODS: We conducted a prospective, single-center case series study in a tertiary referral center of patients with breast cancer who were eligible for whole breast radiotherapy (WBRT).
RESULTS: A total of 39 women were included and distributed according to the radiotherapeutic schemes (15, 20, and 25 fractions). A computational model was designed to quantitatively analyze OCT findings. After radiotherapy, OCT scanning was more sensitive revealing vascularization changes in 84.6% of the patients (vs 69.2% of the patients with ARD by clinical examination). OCT quantified an increased vascularization at the end of WBRT (P<.05) and a decrease after 3 months (P=.032). Erythematous skin changes by OCT were more pronounced in the 25-fraction regime.
CONCLUSIONS: An OCT computational model allowed for the identification and quantification of vascularization changes on irradiated skin, even in the absence of clinical ARD. This may allow the design of standardized protocols for ARD beyond the skin color of the patients involved.