Prognostic factors for acute and late skin reactions in radiotherapy patients
Prognostic factors for acute and late skin reactions in radiotherapy patients
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DOI：
10.1016/s0360-3016(96)00426-9
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发表时间：
1996-12-01
影响因子：
7
通讯作者：
Oden, A
中科院分区：
文献类型：
--
作者：
Turesson, I;Nyman, J;Oden, A
目的：接受相同放疗方案治疗的患者在急性和晚期正常组织反应的程度上存在显著差异。为了确定任何可能的影响因素，这种现象，我们分析了402乳腺癌patients.Methods和材料的治疗：1972年和1985年之间的患者接受辅助术后放疗，并已随访至今。以峰值反射红斑和峰值急性反应评分作为急性反应的终点，以毛细血管扩张的进展率和毛细血管扩张评分作为晚期反应的终点，进行多变量分析。测试了20个患者和治疗相关因素，如年龄、绝经状态、血红蛋白水平、血清钙、吸烟习惯、甲状腺功能减退、糖尿病、高血压、血压、心血管和自身免疫性疾病、激素治疗和化疗的影响、治疗前反射值、急性皮肤反应、辐射质量、个体剂量、双侧射野、结果：总效应（TE）是所有终点的强预后因子。除TE外，血压对反射分光光度法测量的峰值红斑具有预测作用，治疗前反射值对急性评分具有预测作用。唯一的独立预后因素，发现皮肤毛细血管扩张和毛细血管扩张评分的进展，除了TE是个人剂量和急性皮肤reactions.Conclusions：这些因素解释了最多约30%的方差描述总的患者到患者的变异性为每个端点。其余的变异性仍然无法解释，但可能与细胞辐射敏感性的个体差异有关，部分由遗传变异决定，部分由未知的表观遗传因素决定。版权所有（C）1996 Elsevier Science Inc.
Purpose: Patients treated with identical radiotherapy schedules show a substantial variation in the degree of acute and late normal tissue reactions. To identify any possible contributing factors to this phenomenon, we have analyzed the treatments of 402 breast cancer patients.Methods and Materials: The patients received adjuvant postoperative radiotherapy between 1972 and 1985 and have been followed up since then. Multivariate analyses were performed with peak reflectance erythema and peak acute reaction score as endpoints for the acute reactions, and with progression rate of telangiectasia as well as telangiectasia score as endpoints for the late reactions. Twenty patient- and treatment-related factors were tested such as age, menopausal status, hemoglobin level, serum calcium, smoking habits, hypothyroidism, diabetes, hypertension, blood pressure, cardiovascular and autoimmune disease, the influence of hormone therapy and chemotherapy, pretreatment reflectance value, acute skin reactions, radiation quality, individual dose, bilateral fields, and the total effect (TE) for the dose schedule applied.Results: The TE was a strong prognostic factor for all endpoints. In addition to TE, blood pressure was prognostic for the peak erythema measured by reflectance spectrophotometry, and the pretreatment reflectance value was prognostic for the acute score. The only independent prognostic factors found for the progression of skin telangiectasia and telangiectasia score except for TE were the individual dose and the acute skin reactions.Conclusions: These factors explained at most about 30% of the variance describing the total patient-to-patient variability for each endpoint. The remaining variability is still unexplained but may be related to individual differences in cellular radiosensitivity, partly determined by genetic variations and partly by unknown epigenetic factors. Copyright (C) 1996 Elsevier Science Inc.