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Malignant Neoplasms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
For individuals in the postoperative phase of cancer care, postsurgical management involves care initially for the surgical incision, followed by subsequent management of scar tissue, and recovery of incised tissues in the surgical region. For individuals receiving medical oncology interventions, managing medication side effects is most critical for maintaining quality of life and functional mobility. Certain classes of chemotherapeutics are known to cause chemotherapy-induced peripheral neuropathy, such as the Taxanes and Vinca alkaloids, and others are known to be cardiotoxic, such as doxorubicin (Adriamycin) and trastuzumab (Herceptin). Endocrine therapy, also known as hormone therapy, includes the use of medications such as aromatase inhibitors for hormonally driven tumors such as breast cancer. These medications can potentially cause myalgias, arthralgias, and bone loss. For individuals in treatment for radiation therapy, monitoring for radiation dermatitis in the treatment field, or skin irritation to the dermal level commonly seen from external beam radiation therapy, is an important role for treating clinicians. It is critical for any practitioner rehabilitating cancer survivors to be aware of the cancer treatment history, especially treatments in combination which can compound risks for side effects. For example, lymph node status, as well as lymphatic system surgical and radiation therapy history is not only indicative of a patient’s cancer stage but also the risk of lymphedema (see lymphedema addressed in Chapter 17).
Radiation Damage of Skin and Mucous Membrane
Published in Kedar N. Prasad, Handbook of RADIOBIOLOGY, 2020
The radiation responses of skin are referred to as radiation dermatitis. The intensity of radiation dermatitis varies, depending upon the radiation factors used. The various phases of radiation dermatitis are discussed here under the following arbitrary conditions for radiation therapy.10 These include 250-kVp X-irradiation, half-value layer (HVL) 1.0 mm copper, field size 15 × 15 cm, daily skin dose 200 rads to a total skin dose of 4000 rads in 4 weeks or 60Co-irradiation with bolus, daily skin dose of 250 rads, and a maximal skin dose of 5000 rads in 4 weeks.
Micronutrients in Protecting Against Lethal Doses of Ionizing Radiation
Published in Kedar N. Prasad, Micronutrients in Health and Disease, 2019
The acute radiation responses to the skin are referred to as radiation dermatitis. The chronic responses to the skin may include development of necrosis that may occur following infection or high radiation doses that can damage blood vessels and connective tissues. Radiation-induced necrotic ulcer is difficult to heal because of damage to the blood vessels and connective tissues that interfere with the regeneration of epithelial cells. The hair follicles are very sensitive to radiation. During radiation therapy involving head region, loss of hair frequently occurs.
Prophylactically applied Hydrofilm polyurethane film dressings reduce radiation dermatitis in adjuvant radiation therapy of breast cancer patients
Published in Acta Oncologica, 2018
Leonard Christopher Schmeel, David Koch, Sabina Stumpf, Christina Leitzen, Birgit Simon, Heinrich Schüller, Susanne Vornholt, Felix Schoroth, Thomas Müdder, Fred Röhner, Stephan Garbe, Frederic Carsten Schmeel, Hans Heinz Schild, Timo Martin Wilhelm-Buchstab
Advantages of this study are the highly uniform treatment site and no varying fractionation schedules as measurements were exclusively performed following 50 Gy/25 fx. The intra-patient randomization design excludes other variables (like patient-related aspects) possibly influencing our findings. And particularly the use of validated scoring and objective technical measurement instruments render the data quite robust. However, because of the visibility of Hydrofilm on the skin-surface, a blinding of both patients and health care providers was not feasible, which might have biased the physician-assessed dermatitis scorings. Another limitation is that no measurements were performed at the expected dermatitis peak 1–2 weeks after therapy completion in order to ensure reliability of the obtained data because 19/62 patients received a local boost radiotherapy of up to 66 Gy. In conclusion, our study demonstrates that Hydrofilm significantly reduced radiation induced skin injury when applied prophylactically. We observed a significant beneficial effect on the maximum severity of radiation dermatitis, erythema as well as subjective itching and pain experience. Adverse reactions were only minor. In view of a favorable cost–benefit ratio and the (mostly) easy and quick application, a prophylactic application of Hydrofilm polyurethane dressings in adjuvant radiotherapy of breast cancer patients seems to be justified.
Mechanisms of inflammatory responses to radiation and normal tissues toxicity: clinical implications
Published in International Journal of Radiation Biology, 2018
Masoud Najafi, Elahe Motevaseli, Alireza Shirazi, Ghazale Geraily, Abolhasan Rezaeyan, Farzad Norouzi, Saeed Rezapoor, Hamid Abdollahi
Radiation dermatitis (also known as radiodermatitis or radiation skin burning) is associated with epidermal basal cell and endothelial cell damage, commonly occurs following radiotherapy. Radiodermatitis can be divided into acute and chronic dermatitis. The most important changes associated with acute dermatitis are erythema, dry desquamation, and moist desquamation that result in epidermal necrosis, fibrinous exudates, pain, and ulcer. Chronic detrimental changes induced by IR may develop during months to years after exposure. These pathological changes commonly included are hypopigmentation or hyperpigmentation, damage to hair follicles and sebaceous glands, persistent telangiectasia, and fibrosis. The most serious chronic complication of radiation therapy on the skin is the development of ulceration during months to years after the end of treatment (Hymes et al. 2006; Salvo et al. 2010).
Fluorescence of radiation-induced tissue damage
Published in International Journal of Radiation Biology, 2018
Irina Raznitsyna, Polina Kulikova, Dmitry Rogatkin, Dmitry Kulikov, Oleg Bychenkov, Yuliya Chursinova, Maksim Bobrov, Alexey Glazkov
The results of the histological examination showed that in some animals, there were reliable histological signs of radiation dermatitis. It was observed that animals had mild inflammatory changes at the Day 1. At Day 3, there was a dramatic nonspecific inflammatory response, while at Days 8 and 13, specific abnormalities were seen typical for radiation dermatitis (as lichenoid dermatitis). At the end of the study (Day 49), the predominant morphological signs were nonspecific chronic dermatitis with reactive hyperplasia of epidermis, dermal fibrosis and regenerative changes (Figure 6).