- 期刊
放射線誘發性皮膚炎處置原則
Principles of the Management of Radiation-Induced Dermatitis
摘要
雖然癌症治療已進入多元模式， 有越來越多藥物研發上市，但放射線治療（radiation therapy, RT）在疾病治療上仍有其不可取代的地位。可惜RT可能誘發皮膚炎（radiation-induced dermatitis, RID），至今卻沒有標準化治療指南可供依循。RID是RT後常見的不良反應，RT完成後大約1/3病人會發展成慢性RID，甚至在10年後仍有機會發生。選擇RID用藥時，可選具level 1 evidence實證等級之corticosteroid。如有必要也可併用金盞花、β-sitosterol、hyaluronic acid、statins、silver sulfadiazine、兒茶素、ranulocyte-macrophage colony-stimulating factor及epidermal growth factor等製劑，以減少過度使用類固醇帶來的不良影響。由於蘆薈、洋甘菊、ascorbic acid、pantothenic acid、trolamine和sucralfate等製劑效果仍有爭議，建議小心使用。本文彙整相關製劑試驗結果，討論其作用機轉並提供放射性皮膚炎日常照護的依據。期盼合理使用藥物，讓藥物選擇更具實證基礎也更加科學化。
並列摘要
Despite the development of a variety of cancer treatments, radiation therapy (RT) remains an essential component of cancer treatment. Radiation-induced dermatitis (RID) is a common adverse reaction to RT. About 1/3 of patients may develop chronic RID after the completion of RT, and it may even occur as late as ten years later. There is no standard treatment guideline for RID, but corticosteroids are the first-line therapy (level 1 evidence). Corticosteroids are effective in reducing RID symptoms, but they can also have side effects. In some cases, corticosteroids can be used in combination with other agents, such as calendula, β -sitosterol, hyaluronic acid, statins, silver sulfadiazine, catechin, granulocyte-macrophage colony-stimulating factor, and epidermal growth factor. These agents may help to reduce the need for corticosteroids and their side effects. Aloe vera, chamomile, ascorbic acid, pantothenic acid, trolamine, and sucralfate have also been studied for the treatment of RID, but their effectiveness is still controversial. This review summarizes the clinical evidence for the treatment of RID. The goal is to provide clinicians with guidance for the rational use of drugs for RID and to promote the development of more effective and safer treatments.