Research progress of radiodermatitis assessment tools and nursing intervention in patients with cancer
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摘要: 放射治疗是肿瘤患者重要的治疗手段之一,然而射线在照射肿瘤细胞的同时,正常组织细胞也会发生放射性损伤。放射性皮炎是肿瘤放射治疗常见的并发症之一,其发生率约为50%~90%,主要表现为红斑、脱屑以及溃疡等,严重影响患者的生活质量,甚至还会导致部分患者终止放射治疗,因此,采用合适的评估工具对放射性皮炎进行早期评估及识别,并进行积极的护理干预尤为重要。目前可以用来评估放射性皮炎的评估工具及护理干预的措施较多,而鲜有关于放射性皮炎的评估工具以及护理干预措施的综述。鉴于此,本文对放射治疗肿瘤组织分级系统(RTOG)、急性放射性皮炎反应评估量表(RISRAS)、通用不良事件术语标准(CTCAE)以及皮肤毒性评估工具(STAT)4种放射性皮炎的评估工具进行综述,并对皮肤清洗、软聚硅酮敷料和银离子敷料等新型敷料、皮质醇类和金盏花等外用制剂以及其他相关护理措施进行综述,并在此基础上进行展望,旨在为今后肿瘤患者放射性皮炎的护理及科研提供借鉴,提高患者的生活质量。Abstract: Radiation therapy is one of the most important treatment methods for patients with cancer. However, when radiation irradiates tumour cells, normal tissue cells will undergo radiation damage. Radiation dermatitis is one of the most common complications of tumour radiation therapy, with an incidence rate of about 50% to 90%, and mainly manifests as erythema, desquamation and ulcers. It seriously affects the quality of life of patients and even lead to termination of radiotherapy in some patients. Therefore, appropriate assessment tools should be used for early assessment and identification of radiation dermatitis and for carrying out active nursing interventions. Currently, many assessment tools and nursing intervention measures can be used to assess radiation dermatitis, but related review works are few. This article reviewed four radiodermatitis assessment tools: radiation therapy oncology group (RTOG), radiation-induced skin reaction assessment Scale (RISRAS), common terminology criteria for adverse events (CTCAE) and skin toxicity assessment tool (STAT). New dressings, such as skin cleansing, soft silicone dressings and silver ion dressings, topical preparations, such as cortisol and calendula, and other related care measures were also summarised. This work provided reference for the nursing and scientific research of patients with tumour and radioactive dermatitis in the future and improved their quality of life.
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Key words:
- Radiodermatitis /
- Skin care /
- Assessment /
- Nursing /
- Review
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[1] YU H B, HAN B J, CAO H J. Prevention of radiodermatitis with topical Chinese herbal medicine: a systematic review and meta-analysis[J]. Front Pharmacol, 2022, 13: 819733. DOI: 10.3389/fphar.2022.819733. [2] ROBIJNS J, LODEWIJCKX J, MEBIS J. Photobiomodulation therapy for acute radiodermatitis[J]. Curr Opin Oncol, 2019, 31(4): 291-298. doi: 10.1097/CCO.0000000000000511 [3] YANG X, REN H, GUO X, et al. Radiation-induced skin injury: pathogenesis, treatment, and management[J]. Aging(Albany NY), 2020, 12(22): 23379-23393. https://pubmed.ncbi.nlm.nih.gov/33202382/ [4] BACKLER C, BRUCE S D, SUAREZ L, et al. Radiodermatitis: clinical summary of the ONS GuidelinesTM for cancer treatment-related radiodermatitis[J]. Clin J Oncol Nurs, 2020, 24(6): 681-684. doi: 10.1188/20.CJON.681-684 [5] SEITÉ S, BENSADOUN R J, MAZER J M. Prevention and treatment of acute and chronic radiodermatitis[J]. Breast Cancer(Dove Med Press), 2017, 9: 551-557. [6] BEAMER L C, GRANT M. Skin-related quality of life among midwestern US community-based women with breast cancer experiencing radiodermatitis[J]. Asia Pac J Oncol Nurs, 2019, 6(1): 50-56. doi: 10.4103/apjon.apjon_40_18 [7] PERRAUD A L, RAO D M, KOSMACEK E A, et al. The ion channel, TRPM2, contributes to the pathogenesis of radiodermatitis[J]. Radiat Environ Biophys, 2019, 58(1): 89-98. doi: 10.1007/s00411-018-0769-y [8] BONTEMPO P S M, CIOL M A, MENÊSES A G, et al. Acute radiodermatitis in cancer patients: incidence and severity estimates[J]. Rev Esc Enferm USP, 2021, 55: e03676. DOI: 10.1590/S1980-220X2019021703676. [9] 张倩玉, 许斌, 金伟, 等. 柚皮素对于急性放射性皮炎的影响[J]. 生物学杂志, 2020, 37(4): 79-84. https://www.cnki.com.cn/Article/CJFDTOTAL-SWXZ202004017.htmZHANG Q Y, XU B, JIN W, et al. The influence of naringenin on acute radiation-induced skin reaction[J]. Journal Of Biology, 2020, 37(4): 79-84. https://www.cnki.com.cn/Article/CJFDTOTAL-SWXZ202004017.htm [10] COX J D, STETZ J, PAJAK T F. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)[J]. Int J Radiat Oncol Biol Phys, 1995, 31(5): 1341-1346. doi: 10.1016/0360-3016(95)00060-C [11] NOBLE-ADAMS R. Radiation-induced skin reactions. 2: development of a measurement tool[J]. Br J Nurs, 1999, 8(18): 1208-1211. doi: 10.12968/bjon.1999.8.18.6490 [12] DE LA ROSA OLIVA F, MENESES GARCÍA A, RUIZ CALZADA H, et al. Effects of omega-3 fatty acids supplementation on neoadjuvant chemotherapy-induced toxicity in patients with locally advanced breast cancer: a randomized, controlled, double-blinded clinical trial[J]. Nutr Hosp, 2019, 36(4): 769-776. [13] BERTHELET E, TRUONG P T, MUSSO K, et al. Preliminary reliability and validity testing of a new Skin Toxicity Assessment Tool (STAT) in breast cancer patients undergoing radiotherapy[J]. Am J Clin Oncol, 2004, 27(6): 626-631. doi: 10.1097/01.coc.0000138965.97476.0f [14] 王盈, 强万敏, 李静, 等. 皮肤清洁对癌症患者放射性皮炎影响效果的系统评价[J]. 护士进修杂志, 2020, 35(5): 426-432. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX202005009.htmWANG Y, QIANG W M, LI J, et al. Skin cleanness for radiation induced skin reaction in cancer patients: a systematic review[J]. Journal Of Nurse Trainning, 2020, 35(5): 426-432. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX202005009.htm [15] CAMPBELL I R, ILLINGWORTH M H. Can patients wash during radiotherapy to the breast or chest wall?A randomized controlled trial[J]. Clin Oncol(R Coll Radiol), 1992, 4(2): 78-82. doi: 10.1016/S0936-6555(05)80971-9 [16] 丁炎明. 伤口护理学[M]. 北京: 人民卫生出版社, 2017: 352-353.DING Y M. Wound Care[M]. Beijing: People's Medical Publishing House, 2017: 352-353. [17] M∅LLER P K, OLLING K, BER M, et al. Breast cancer patients report reduced sensitivity and pain using a barrier film during radiotherapy: a Danish intra-patient randomized multicentre study[J]. Tech Innov Patient Support Radiat Oncol, 2018, 7: 20-25. doi: 10.1016/j.tipsro.2018.05.004 [18] WOODING H, YAN J, YUAN L, et al. The effect of Mepitel Film on acute radiation-induced skin reactions in head and neck cancer patients: a feasibility study[J]. Br J Radiol, 2018, 91(1081): 20170298. DOI: 10.1259/bjr.20170298. [19] 诸晓璇, 郑美春, 覃惠英. 自黏性软聚硅酮薄膜敷料用于防治放射性皮肤损伤效果的Meta分析[J]. 中华现代护理杂志, 2019, 25(31): 3997-4002.CHU X Y, ZHENG M C, TAN H Y. Meta-analysis of self-adhesive soft silicone film dressings on preventing and treating radioactive skin lesion[J]. Chinese Journal of modern nursing, 2019, 25(31): 3997-4002. [20] YAN J, YUAN L, WANG J, et al. Mepitel Film is superior to Biafine cream in managing acute radiation-induced skin reactions in head and neck cancer patients: a randomised intra-patient controlled clinical trial[J]. J Med Radiat Sci, 2020, 67(3): 208-216. doi: 10.1002/jmrs.397 [21] MARTÍN F C, CUADRADO P S, HERNÁNDEZ F R. Collagen powder: hydrocolloidal dressings. Their effectiveness in radiodermatitis[J]. Rev Enferm, 2004, 27(5): 17-22. [22] ROSENTHAL A, ISRAILEVICH R, MOY R. Management of acute radiation dermatitis: a review of the literature and proposal for treatment algorithm[J]. J Am Acad Dermatol, 2019, 81(2): 558-567. doi: 10.1016/j.jaad.2019.02.047 [23] UYSAL B, GAMSIZ H, DINCOGLAN F, et al. Comparative evaluation of topical corticosteroid and moisturizer in the prevention of radiodermatitis in breast cancer radiotherapy[J]. Indian J Dermatol, 2020, 65(4): 279-283. doi: 10.4103/ijd.IJD_607_18 [24] ULFF E, MAROTI M, SERUP J, et al. Prophylactic treatment with a potent corticosteroid cream ameliorates radiodermatitis, independent of radiation schedule: a randomized double blinded study[J]. Radiother Oncol, 2017, 122(1): 50-53. doi: 10.1016/j.radonc.2016.11.013 [25] SCHNEIDER F, DANSKI M T, VAYEGO S A. Usage of calendula officinalis in the prevention and treatment of radiodermatitis: a randomized double-blind controlled clinical trial[J]. Rev Esc Enferm USP, 2015, 49(2): 221-228. doi: 10.1590/S0080-623420150000200006 [26] SIMÕES F V, SANTOS V O, SILVA R N D, et al. Effectiveness of skin protectors and calendula officinalis for prevention and treatment of radiodermatitis: an integrative review[J]. Rev Bras Enferm, 2020, 73(suppl 5): e20190815. DOI: 10.1590/0034-7167-2019-0815. [27] SCHMIDT F M Q, GONZÁLEZ C V S, MATTAR R C, et al. Topical cream containing nanoparticles with vitamin E to prevent radiodermatitis in women with breast cancer: a clinical trial protocol[J]. J Wound Care, 2021, 30(Sup6): S44-S50. doi: 10.12968/jowc.2021.30.Sup6.S44 [28] PRESTA G, PULIATTI A, BONETTI L. Effectiveness of hyaluronic acid gel (Jalosome soothing gel) for the treatment of radiodermatitis in a patient receiving head and neck radiotherapy associated with cetuximab: a case report and review[J]. Int Wound J, 2019, 16(6): 1433-1439. doi: 10.1111/iwj.13210 [29] CUI Z, XIN M, YIN H, et al. Topical use of olive oil preparation to prevent radiodermatitis: results of a prospective study in nasopharyngeal carcinoma patients[J]. Int J Clin Exp Med, 2015, 8(7): 11000-11006. [30] ZHOU J, FANG L, XIE H, et al. A pilot study using the Chinese herbal paste Liu-He-Dan to manage radiodermatitis associated with breast cancer radiotherapy[J]. Curr Oncol, 2015, 22(6): e453-e456. doi: 10.3747/co.22.2725 [31] PARK J H, BYUN H J, LEE J H, et al. Feasibility of photobiomodulation therapy for the prevention of radiodermatitis: a single-institution pilot study[J]. Lasers Med Sci, 2020, 35(5): 1119-1127. doi: 10.1007/s10103-019-02930-1 [32] ESPENEL S, RAFFOUX C, VALLARD A, et al. Hyperbaric oxygen and radiotherapy: from myth to reality[J]. Cancer Radiother, 2016, 20(5): 416-421. [33] 徐娟. 局部给氧预防及治疗放射性皮炎的效果研究[D]. 济南: 山东大学, 2011.XU J. A study on the efficiency of local oxygen therapy in the prevention and treatment of radioactive dermatitis[D]. Jinan: Shan Dong University, 2011. [34] 钟宇玲, 杨秋燕, 陈小梅, 等. 冰敷联合芦荟外敷防治鼻咽癌放射性皮炎的效果观察[J]. 护理实践与研究, 2017, 14(1): 139-141. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ201701059.htmZHONG Y L, YANG Q Y, CHENG X M, et al. Effect of ice compressing combined with external application of aloe on the prevention of nasopharyngeal carcinoma radioactive dermatitis[J]. Nursing Practice And Research, 2017, 14(1): 139-141. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ201701059.htm [35] RODENBURG-VANDENBUSSCHE S, CARLIER I, VAN VLIET I, et al. Patients ' and clinicians ' perspectives on shared decision-making regarding treatment decisions for depression, anxiety disorders, and obsessive-compulsive disorder in specialized psychiatric care[J]. J Eval Clin Pract, 2020, 26(2): 645-658. [36] BYKERK V P. Patient-reported outcomes measurement information system versus legacy instruments: are they ready for prime time?[J]. Rheum Dis Clin North Am, 2019, 45(2): 211-229. [37] 孙振晓, 刘化学, 焦林瑛, 等. 医院焦虑抑郁量表的信度及效度研究[J]. 中华临床医师杂志(电子版), 2017, 11(2): 198-201. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLYD201702005.htmSUN Z X, LIU H X, JIAO L Y, et al. Reliability and validity of hospital anxiety and depression scale[J]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(2): 198-201. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLYD201702005.htm
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