| 周严红,耿文慧,李萌萌,等.皮肤温度监测在女性乳腺癌术后放疗期间放射性皮炎风险预警中的应用[J].中华放射医学与防护杂志,2024,44(2):127-132.Zhou Yanhong,Geng Wenhui,Li Mengmeng,et al.Application of skin temperature monitoring in early warning of radiodermatitis risks during postoperative radiotherapy for female breast cancer[J].Chin J Radiol Med Prot,2024,44(2):127-132 |
| 皮肤温度监测在女性乳腺癌术后放疗期间放射性皮炎风险预警中的应用 |
| Application of skin temperature monitoring in early warning of radiodermatitis risks during postoperative radiotherapy for female breast cancer |
| 投稿时间：2023-05-15 |
| DOI：10.3760/cma.j.cn112271-20230515-00145 |
| 中文关键词: 乳腺癌 放射治疗 皮肤温度 急性放射性皮炎 预测 |
| 英文关键词:Breast cancer Radiotherapy Skin temperature Acute radiodermatitis Prediction |
| 基金项目:河北省卫生健康委2023年医学科学研究课题计划(20230887) |
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| 中文摘要: |
| 目的 分析放射区皮肤温度变化与乳腺癌术后放疗期间放射性皮炎发生的相关性,探讨皮肤温度监测在放射性皮炎风险预警中的应用价值。方法 连续收集2022年5月至11月河北医科大学第四医院接受三维适形放疗的乳腺癌根治术后患者103例,每周记录放射区皮肤温度及放射性皮炎情况。比较皮肤相对温差和不同级别放射性皮炎的关系。计算发生2级及以上放射性皮炎的最佳截断值,采用受试者工作特征曲线(ROC)评价其预测效果。应用二元logistic回归比较不同皮肤温度与放射性皮炎发生的风险。结果 放射野区皮肤温度与放射性皮炎级别呈正相关。胸壁平均值(40 Gy/20次)、胸壁最大值(40 Gy/20次)、锁上值(30 Gy/15次)的最佳截断值分别为0.45、0.55、0.15℃。分别用最佳截断值将受试者分为低、高危风险组,高危风险组发生2级及以上放射性皮炎的风险分别是低危风险组的5.71、4.29、5.15倍(OR=5.71,95％CI 1.81~17.99,P=0.003;OR=4.29,95％CI 1.65~11.12,P=0.003;OR=5.15,95％CI 2.16~12.31,P＜0.001)。结论 皮肤温度监测能够较好地预测2级及以上放射性皮炎的发生,应密切观察放疗区域皮肤温度,放疗40 Gy/20次时胸壁的平均值、最大值相对温差分别升高0.45、0.55℃或者放疗30 Gy/15次锁上相对温差升高0.15℃时,2级及以上放射性皮炎发生风险增加。 |
| 英文摘要: |
| Objective To analyze the correlation between the skin temperature changes in the radiation area and the occurrence of radiodermatitis during postoperative radiotherapy for female breast cancer and to explore the application value of skin temperature monitoring in the early warning of radiodermatitis risks. Methods A total of 103 patients who received three-dimensional conformal radiotherapy after radical mastectomy in the Fourth Hospital of Hebei Medical University were continuously enrolled from May to November, 2022 in this study. Their skin temperature in the radiation area and radiodermatitis were recorded weekly. The relationships between relative skin temperature differences and different grades of radiodermatitis were determined. The optimal cut-off values for grade ≥ radiodermatitis were calculated, and the predictive effect was evaluated using the receiver operating characteristic (ROC) curve. Furthermore, the radiodermatitis risks under different skin temperatures were compared using binary logistic regression. Results There was a positive correlation between the skin temperature in the radiation field and the grade of radiodermatitis. The optimal cut-off values for the average relative skin temperature difference of the chest wall (under 40 Gy/20 fractions), the maximum relative skin temperature difference of the chest wall (under 40 Gy/20 fractions), and the relative skin temperature difference of the supraclavicular block (under 30 Gy/15 fractions) were 0.45℃, 0.55℃, 0.15℃, respectively. The patients were divided into low- and high-risk groups based on the optimal cut-off values (0.45℃, 0.55℃, and 0.15℃). Binary logistic regression result showed that the risks of grade ≥ 2 radiodermatitis in the high-risk group were 5.71, 4.29, and 5.15 times those in the low-risk group, respectively (OR = 5.71, 95%CI 1.81-17.99, P = 0.003; OR = 4.29, 95%CI 1.65-11.12, P = 0.003; OR = 5.15, 95%CI 2.16-12.31, P < 0.001). Conclusions Skin temperature monitoring using medical infrared thermometers can be used to effectively predict the occurrence of grade ≥ 2 radiodermatitis. The skin temperature changes in the radiotherapy area should be closely observed. The risk of grade ≥ 2 radiodermatitis will increase when the mean and maximum relative temperature differences of the chest wall increase by 0.45℃ and 0.55℃, respectively under 40 Gy/20 fractions of radiotherapy or when the relative temperature differences of the supraclavicular block increases by 0.15℃ under 30 Gy/15 fractions of radiotherapy. |
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