三乙醇胺乳膏对乳腺癌术后胸壁照射皮肤损伤防治作用的临床观察

Clinical research of trolamine cream in the prevention and treatment of radioactive dermatitis in patients with breast cancer after modified radical mastectomy

目的 观察三乙醇胺乳膏在预防乳腺癌患者术后胸壁照射急性皮肤损伤中的作用.方法 乳腺癌改良根治术后6 MeV电子线胸壁照射的80例患者,其中40例在放疗开始时预防性应用三乙醇胺乳膏（用药组）,40例采用常规处理（对照组）.结果 用药组1、2、3级放射性皮肤损伤发生率分别为70.0％（28/40）、22.5 ％（9/40）、7.5 ％（3/40）,对照组分别为52.5 ％（21/40）、32.5％（13/40）、15.0％（6/40）,差异有统计学意义（均P＜ 0.05）.用药组发生1、2、3级皮肤损伤的照射剂量分别为（21.91±4.39）、（37.43±6.50）、（46.14±6.50） Gy,对照组分别为（12.67±2.16）、（22.61 ±3.51）、（42.71 ±8.11）Gy,差异有统计学意义（均P＜0.05）.在累积照射剂量10 Gy及25 Gy时,用药组放射性皮肤损伤的发生率分别为22.5 ％（9/40）、47.5 ％（19/40）,对照组分别为40.0％（16/40）、62.5％（25/40）,差异有统计学意义（均P＜0.05）.结论 三乙醇胺乳膏能有效减少乳腺癌患者术后胸壁照射1、2、3级急性放射性皮肤损伤的发生、延缓皮肤损伤的发生时间,适于在术后胸壁放疗患者中应用.

Objective To evaluate the efficacy of trolamine cream in the prevention and treatment of acute radioactive dermatitis in patients with breast cancer after modified radical mastectomy.Methods 80 breast cancer patients who received postmastectomy chest-wall irradiation by 6-MeV electron beam were included.40 cases in the treatment group were given trolamine cream combined with the conventional nursing care during radiotherapy,while another 40 cases in the control group were treated with the conventional nursing care.Results In the treatment group,the rates of radiation dermatitis of grade 1,2 and 3 were 70.0 % （28/40）,22.5 %（9/40）,and 7.5 % （3/40）,respectively,while they were 52.5 % （21/40）,32.5 % （13/40） and 15.0 % （6/40）,respectively,in control group （P 〈 0.05）.Grade 1,2 and 3 radiation dermatitis appeared in treatment group when the radiation doses were （21.91±4.39） Gy,（37.43±6.50） Gy and （46.14±6.50）Gy,respectively,while in the control group,it was （12.67±2.16） Gy,（22.61±3.51） Gy,（42.71±8.11） Gy （P 〈 0.05）,respectively.With cumulative doses of 10 Gy and 25 Gy,the rates of radiation dermatitis in the treatment group were 22.5 % （9/40） and 47.5 % （19/40）,respectively,while they were 40.0 % （16/40） and 62.5 % （25/40）,respectively,in the control group （P 〈 0.05）.Conclusions Trolamine cream effectively alleviates radiation skin damage in breast cancer patients after modified mastectomy,thus it is suitable for use in patients with postoperative chest wall radiotherapy.