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At least 649 records · Page 36Linked to original sources
PubMed2000

The effects of hydrocolloid dressing and gentian violet on radiation-induced moist desquamation wound healing.

The aim of the study was to compare the effect of a gentian violet topical application with that of a moist dressing (hydrocolloid) on the rate and efficacy of radiotherapy-induced moist desquamation wound healing and the patients' satisfaction level with each method. This prospective randomized clinical trial used a stratified sampling design. A sample of 39 patients with 60 wounds had their wounds assessed on alternate days in terms of several wound-healing parameters including wound size, wound pain, incidence of infection, and time required for healing. Patient satisfaction with each treatment was evaluated at the completion of the study. Gentian violet significantly decreased wound size and reduced wound pain. However, this treatment received significantly lower ratings for dressing comfort and dressing aesthetic acceptance. Nevertheless, the time required for healing was not statistically different in the two groups. These findings suggest that the lower score of dressing satisfaction level in the gentian violet group may result from the skin discoloration and drying effects of the treatment, which renders patients unable to move or stretch their skin. Although the aim is to have complete wound healing, this may not be realistic for many lesions such as radiotherapy-induced moist desquamation wounds. The best evidence on which to make decisions about individual care can now be based on patients' own perception of quality.

Analysis of Variance↗
PubMed2002

A Phase III study on the efficacy of topical aloe vera gel on irradiated breast tissue.

The aim of the study was to see if topical aloe vera gel would be beneficial in reducing the identified skin side-effects of radiation therapy, including erythema, pain, itching, dry desquamation, and moist desquamation, when compared with aqueous cream. The secondary aim was to assess the effect of other factors known to predict severity of radiation skin reaction, ie, breast size, smoking habit, and one or more drainages of lymphocele after surgery, on other skin side effects. A Phase III study was conducted involving 225 patients with breast cancer after lumpectomy or partial mastectomy, who required a course of radiation therapy using tangential fields. Patients were randomized to either topical aloe vera gel or topical aqueous cream to be applied 3 times per day throughout and for 2 weeks after completion of radiation treatment. Weekly skin assessments were performed by nursing staff. Aqueous cream was significantly better than aloe vera gel in reducing dry desquamation and pain related to treatment. Subjects with D cup or larger size breasts experienced significantly more erythema, regardless of treatment arm. For subjects who had undergone lymphocele drainage, the aloe vera group experienced significantly more pain than the aqueous cream group. Within the aqueous cream arm, smokers were significantly more likely to experience itching within the treatment field than were nonsmokers. Within the aloe vera arm, subjects who had undergone one or more lymphocele drainages after surgery were significantly more likely to experience erythema and itching within the treatment field than those who did not have drainage. In this study, aloe vera gel did not significantly reduce radiation-induced skin side effects. Aqueous cream was useful in reducing dry desquamation and pain related to radiation therapy.

Actuarial Analysis↗
PubMedDate not supplied

The relationship between factors that impair wound healing and the severity of acute radiation skin and mucosal toxicities in head and neck cancer.

PURPOSE: To determine which wound-healing factors impact on the severity of radiation skin and oral mucosal reactions in head and neck cancer and to test modifications to the Radiation Therapy Oncology Group (RTOG) acute toxicity scoring system. METHODS: A consecutive sample of 53 head and neck cancer patients who were scheduled for curative or palliative radiation therapy. Therapy was planned using traditional computerized techniques. A new RTOG subscale for tongue reactions was developed. Information on potential predictors was collected during the first week of treatment. Reactions were observed and documented each week throughout treatment using the RTOG Acute Reaction Scoring System scores of acute oropharyngeal reactions and various personal factors. RESULTS: Significant relationships were found between severe skin and oral reactions and age, commencing radiation within 2 months of surgery and smoking. Significant relationships for severe oral mucosal reactions were found with weight at the commencement of treatment, inadequate or poor diet, having had mucositis with previous chemotherapy, and the use of a custom-made Perspex tongue immobilizer. CONCLUSIONS: Three conclusions can be derived from this study: (1) structures within the oral cavity should be considered separately for toxicity scoring, (2) the newly developed tongue RTOG subscale adds accuracy and specificity to the RTOG acute toxicity scoring system, and (3) wound healing factors are an important component of understanding risk for side effects in head and neck cancer treatment.

Adult↗
PubMedDate not supplied

A longitudinal study of symptoms and self-care activities in women treated with primary radiotherapy for breast cancer.

The purpose of this prospective longitudinal study was to describe the occurrence, severity, and pattern of symptoms experienced by women during and after primary radiation therapy for breast cancer. A convenience sample of 30 women was recruited from a community hospital. The Symptom Profile by King et al (Oncology Nursing Forum. 1985;12(4):55-61) was adapted to measure 11 symptoms, and the Profile of Mood States assessed psychological status. Data were collected weekly during radiation and monthly for 3 months after treatment. There was a pattern of increasing incidence during treatment for the most commonly reported symptoms: fatigue (33%-93%), skin changes (36%-100%), sensation changes (28%-79%), and breast swelling (11%-38%), with gradual improvement over the following 3 months. Sleep problems were reported by nearly half of the subjects during and after treatment. Severity ratings of symptoms were mild to moderate but significantly higher by the end of therapy (P </= .01). There were no significant differences in psychological mood states during or after treatment except for the fatigue subscale (P </= .05). These findings will assist the nurse in preparing women for predictable symptoms during and after a course of breast irradiation and direct assessment, and provide data to support evidence-based interventions to minimize symptom distress.

Activities of Daily Living↗
PubMedDate not supplied

A comparison of wound treatments in nasopharyngeal cancer patients receiving radiation therapy.

The purpose of this study was to compare the effectiveness of gentian violet and nonadherent absorbent dressing in the healing of postirradiation wounds in nasopharyngeal carcinoma patients. This was a randomized controlled trial. A sample of 146 nasopharyngeal carcinoma patients who had developed postirradiation wounds was assessed. Comparisons were made regarding parameters related to wound healing, including healing time, presence of infection, and wound pain, and also regarding the impact of wound on the patient, including mood changes, restriction of neck movement, social isolation, sleep problem, and disturbance in body image. The results showed that patients in the 2 groups did not have any significant difference on wound-healing time, disturbance in mood, sleep, social interaction, appearance, and neck mobility. However, there was a trend of higher wound pain score, not reaching statistical significance, in the gentian violet group.

Administration, Cutaneous↗
PubMed1987

Three-phase radionuclide bone scanning in evaluation of local radiation injury. A case report.

The management of local radiation injuries is influenced by the degree of vascular compromise within the skin and underlying tissues. Other authors have used thermography and angiography in assessing the blood flow to radiation damaged tissues. This report describes the use of radionuclide imaging in the evaluation of a patient who developed necrosis of his distal digits following a radiation accident. In addition to determining the vascular status of the hands, imaging helped indicate an appropriate level for amputation.

Accidents, Occupational↗
PubMed1995

Delayed massive soft tissue uptake of Tc-99m MDP after radiation therapy for cancer of the breast.

A patient with a history of breast cancer and known lung metastases was referred for a bone scan to investigate the cause of severe neck and right shoulder pain. The bone scan showed massive uptake of the radiopharmaceutical in the soft tissue surrounding the right shoulder. A review of the patient's history indicated that the patient had undergone radiation therapy to the right upper thorax and breast area 14 months previously and an acute radiation dermatitis of the proximal right arm and should had developed. This had long since resolved. Physical examination and plain radiographs of the right shoulder and humerus failed to demonstrate any abnormality.

Aged↗
PubMed1989

An overexposure in industrial radiography using an 192Ir radionuclide.

An industrial radiographer was accidentally exposed to a high dose of ionizing radiation from an 192Ir source during radiography of weldjoints in gas pipelines. Some symptoms of high radiation exposure occurred immediately after the incident. The clinical effect of skin erythema developed within 7 d, leading to progressive tissue deterioration. The dose to the body was estimated to be about 2-3 Gy, and the dose to the fingertips was approximately 24 Gy.

Dermatitis, Occupational↗
PubMed1997

Erythemally effective and actinic irradiance from a tungsten halogen lamp.

A protocol for assessment of biological hazard from ultraviolet radiation sources was developed. The protocol utilized both a ultraviolet radiation spectroradiometer and a broadband ultraviolet radiation meter for the determination of the erythemally effective irradiance and the actinic irradiance. A 250 W tungsten halogen lamp operating at 9.5 A was tested with this protocol. It was found that the erythemally effective irradiance varied from 41 microW cm(-2) at 10 cm to 1.5 microW cm(-2) at 50 cm. In the same range of distances, the actinic irradiance decreased from 23 to 0.5 microW cm(-2). The irradiance from the source was uniform within 30 degrees about the line perpendicular to the axis of the filament. Using the recommendation of the Australian radiation protection agency, the National Health and Medical Research Council, the maximum allowable exposure time at the distance of 50 cm in the direction perpendicular to the axis of the filament was about 33.3 minutes.

Erythema↗
PubMed1997

Accidental radiation injury to the hand: anatomical and physiological considerations.

A case study describing an accident in Mexico caused by failure to de-energize an x-ray spectrometer prior to repair is presented. The evolution, medical management, and outcome of the radiation injury to the hand are briefly reviewed. A discussion follows, with radiation injury and thermal burns compared and contrasted. The anatomy and physiology of thick skin and the vascular system of the hand are reviewed so that the reader will have a better understanding of the role of vascular injury in the pathological process that leads to tissue atrophy and radiation necrosis. Hyperbaric oxygen therapy, sympathectomy, and other techniques for improving circulation in involved areas are reviewed.

Adult↗
PubMedDate not supplied

Micronucleus frequency in peripheral lymphocytes for the differential diagnosis of radiation injuries combined with thermal burns.

An investigation was conducted to determine if any analysis of micronucleus frequency in human peripheral lymphocytes was useful to diagnostically differentiate radiation injuries in the presence of thermal burns. In the first part of the study, 27 patients with burns of various degrees were tested to determine if the peripheral lymphocytes stimulated in vitro for mitotic division would contain micronuclei--a type of chromosomal aberration inducible by many genotoxic substances. Data showed that the frequency of micronuclei did not increase with burn injury but did correlate with age. Therefore, it is suggested that in cases of radiation injuries combined with burns, the pathologic process related to the latter type of injury does not influence the differential diagnostic value of the micronucleus test. In the second part of the study, the validity of this hypothesis was tested in guinea pigs exposed to various doses of gamma-radiation (between 0.5 and 4.0 Gy) and then inflicted with thermal burns. The results confirmed that when radiation injuries and thermal burns coexist, the micronucleus test is a reliable biologic indicator of radiation injury.

Adult↗
PubMed1999

High-dose-rate brachytherapy for primary carcinomas of the oral cavity and oropharynx.

OBJECTIVE: Local control for patients treated with primary radiation therapy for tumors of the oral cavity is improved using low-dose-rate brachytherapy. Oropharyngeal carcinomas have also been treated with brachytherapy. The few reports in the literature regarding high-dose-rate brachytherapy (HDRBT) for head and neck cancer involve small numbers of patients and often contain a mix of palliative and curative cases. The purpose of this study is to evaluate the feasibility of HDRBT in the largest reported cohort of primary head and neck cancer patients treated with primary radiation therapy. STUDY DESIGN: This is a prospective nonrandomized study. METHODS: Fifty-five patients with primary untreated squamous cell carcinomas of the oral cavity and oropharynx were analyzed. There were 16 patients with T1, 26 with T2, 8 with T3, and 5 with T4 tumors. All patients received external-beam radiotherapy (EBRT) followed by HDRBT. Thirty-eight patients received hyperfractionated (twice daily) EBRT followed by HDRBT two or three times daily. Patients with cervical adenopathy also received hyperthermia and an electron boost to the site(s) of positive nodes. Median follow-up was 2.7 years. Toxicity and local control were analyzed. Data were analyzed by the Kaplan-Meier life-table method with statistical significance determined by the X2 and log-rank tests. RESULTS: High-dose-rate brachytherapy was extremely well tolerated. Only 9 patients (16%) developed a complication. Four patients developed osteoradionecrosis, and five developed soft tissue necrosis, all of which healed with conservative medical management. No complication required surgical intervention or hospitalization. Actuarial 2-year local control for the entire cohort was 79%. Local control was 87% for patients with T1 (15/16) and T2 (22/26) tumors versus 47% for T3 (5/8) and T4 (2/5) tumors (P < .01). CONCLUSIONS: High-dose-rate brachytherapy is feasible as a boost for patients with primary squamous cell carcinomas of the oral cavity and oropharynx. Patients with T1 and T2 tumors fared exceptionally well; those with advanced tumors may require more aggressive treatment, such as higher radiation doses, surgical resection, or systemic chemotherapy. The use of HDRBT both shortens the overall treatment time and limits the volume of tissue exposed to high doses of radiation therapy. In the future, as more patients treated with HDRBT are evaluable, we hope to identify potential factors that predict for local control so that we may select patients optimally for this treatment.

Adult↗
PubMed2003

Promoting healing with recombinant human platelet-derived growth factor--BB in a previously irradiated problem wound.

OBJECTIVES/HYPOTHESIS: Persistent, poorly healing wounds are a significant clinical problem in patients who have had previous irradiation. Despite current treatments, refractory nonhealing soft tissue wounds persist. The study described one of the earliest reported uses of recombinant human platelet-derived growth factor-BB (rhPDGF) gel to improve the healing of a previously irradiated refractory dermal wound to the neck that had been present for 12 years. STUDY DESIGN: Case report and literature review. METHODS: Review of local healing management of previously irradiated wounds and review of patients chart one year after follow-up treatment. RESULTS: A 47-year-old man had a 12-year history of a persistent, painful, nonhealing full-thickness dermal wound on the left side of his neck after radiation therapy and chemotherapy for a T2N2bM0 nasopharyngeal carcinoma. He had been tumor free for 12 years. Despite multiple modalities of therapy over a 1-year period (including moist hydrogel dressings, topical and oral antibiotics, serial debridement, and hyperbaric oxygen), the wound did not heal. After 6 months of topical rhPDGF gel treatment, sufficient granulation tissue developed within the dermal wound that a split-thickness skin graft was successfully performed. Symptomatically, the patient's continuous pain at the neck resolved after rhPDGF treatment. Serial histological biopsy specimens before and after rhPDGF treatment confirmed the wound transformation from a chronic state to a short-term healing state. CONCLUSION: In previously irradiated tissue, rhPDGF can be useful in helping refractory wounds to heal by inducing further granulation formation. If such treatment is planned, the patient should be informed of the possible theoretical risks of its use when it is in proximity to a previously treated neoplastic site.

Administration, Topical↗