Permanent alopecia after cranial irradiation: Dose-response relationship
Permanent alopecia after cranial irradiation: Dose-response relationship
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DOI：
10.1016/j.ijrobp.2004.04.031
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发表时间：
2004-11-01
影响因子：
7
通讯作者：
Loeffler, JS
中科院分区：
文献类型：
--
作者：
Lawenda, BD;Gagne, HM;Loeffler, JS
目的：探讨颅脑照射后永久性脱发发生的剂量-反应关系，并分析可能导致这种不必要的、经常不可避免的治疗并发症的潜在混杂变量。方法与材料：纳入26例患者。三名评论者独立评估了61个头皮区域，并使用4分制为每个区域的脱发程度打分。通过患者问卷和门诊病历回顾收集患者和治疗数据。计算每个头皮区域的毛囊剂量，并与该区域的脱发评分相关。利用这些相关性的数据建立了剂量-反应关系。结果：永久性脱发与仅卵泡剂量显著相关（p < 0.001）。个人脱发史和化疗使用与永久性脱发相关，具有临界统计学意义（p = 0.059和p = 0.068）。患者年龄、秃顶家族史、性别、吸烟、糖尿病和光束能量与脱发无关。结论：我们报告了第一个人类剂量-反应关系，描述了毛囊剂量对颅骨照射后永久性头皮脱发的后续发展的影响。这些信息将有助于放射肿瘤学家、物理学家和剂量学家设计治疗方案，以最大限度地降低颅照射不良副作用的风险。(C) 2004爱思唯尔公司
Purpose: To develop a dose-response relationship for the occurrence of permanent alopecia after cranial irradiation and to analyze potential confounding variables that may contribute to this unwanted and often unavoidable complication of treatment.Methods and Materials: Twenty-six patients were enrolled in this study. Three reviewers independently assessed 61 scalp regions and assigned a score for the degree of alopecia in each region using a 4-point scale. Patient and treatment data were collected using a patient questionnaire and outpatient medical chart review. The hair follicle dose was calculated for each scalp region and correlated with the alopecia score for that region. A dose-response relationship was established using the data from these correlations.Results: Permanent alopecia correlated significantly with the follicle dose only (p < 0.001). A personal history of alopecia and the use of chemotherapy correlated with permanent alopecia with borderline statistical significance (p = 0.059 and p = 0.068, respectively). Patient age, family history of baldness, gender, tobacco use, diabetes, and beam energy did not correlate with alopecia.Conclusion: We report the first human dose-response relationship describing the effect of the follicle dose on the subsequent development of permanent scalp alopecia after cranial irradiation. This information will assist the radiation oncologist, physicist, and dosimetrist in designing a treatment plan that might minimize the risk of this untoward side effect of cranial irradiation. (C) 2004 Elsevier Inc.