ABSTRACT
INTRODUCTION: Radio-induced dermatitis is one of the most frequent side effects of radiotherapy. Among the commercially available products for the care of irradiated skin is a hydrating lotion containing 3% urea, polidocanol and hyaluronic acid. Its effectiveness for preventing the appearance of radiodermatitis or reducing its severity has been studied on a number of occasions. OBJECTIVE: To evaluate the effectiveness of "intensive use" of the lotion containing 3% urea, polidocanol and hyaluronic acid for preventing the appearance of acute radiodermatitis and controlling its severity. MATERIAL AND METHODS: Prospective observational study in 98 patients with breast cancer with a 10-week follow-up period. Skin toxicity (RTOG/EORTC scale) was evaluated weekly. To study the effectiveness we compared incidence and grade of toxicity with a sample of 174 breast cancer patients (control sample) treated in our centre during 2006 who used skin-support measures at the start of the radiotherapy or the occurrence of radiodermatitis. RESULTS: The proportion of patients who did not develop radiodermatitis was significantly higher in the intensive use group (27.6% vs. 15.5%; p<0.05; OR: 2.07). Compared with the same lotion in standard conditions, the intensive use group showed lower incidence of radiodermatitis (p<0.01), lower grade of toxicity (p<0.001) and lower proportion of radiodermatitis grade 2 or higher (p<0.01). CONCLUSIONS: Intensive use of the lotion doubles the likelihood that breast cancer patients will not develop radiodermatitis during radiotherapy. Furthermore, compared with standard use, intensive use is more effective in reducing the incidence of skin toxicity and skin toxicity grade 2 or higher (AU)
Subject(s)
Humans , Female , Middle Aged , Breast Neoplasms/epidemiology , Breast Neoplasms/surgery , Emollients/administration & dosage , Radiodermatitis/pathology , Preventive Medicine/methods , Radiodermatitis/drug therapy , Radiodermatitis/prevention & control , Urea/administration & dosage , Administration, Topical , Breast Neoplasms/drug therapy , Breast Neoplasms/radiotherapy , Combined Modality Therapy , Emollients/chemistry , Follow-Up Studies , Radiodermatitis/epidemiology , Radiotherapy, Adjuvant/adverse effects , Severity of Illness Index , Treatment OutcomeABSTRACT
A 64-year-old male patient was studied for repeated right basal pneumonia of long duration. A computed tomography scan showed a cholecystitis of concealed evolution. Surgery revealed fistulization toward the thorax, with the passage of multiple calculi of a biliary origin to the chest cavity. We report the first described case to our knowledge of cholecyst-thoracic fistula secondary to cholecystitis of long evolution.
