Observation on the Therapeutic Effects of Qingre Shengji Ointment(清热生肌膏)on Acute Radiation Dermatitis After Modified Radical Mastectomy

Objective:To observe the curative effect of Qingre Shengji Ointment(清热生肌膏)on acute radiation dermatitis caused by radiotherapy after modified radical mastectomy.Methods:100 patients with radiotherapy after modified radical mastectomy in our hospital from June 2019 to December 2020 were randomly divided into treatment group and control group,with 50 cases in each group.The treatment group was given Qingre Shengji Ointment(清热生肌膏)on the basis of routine nursing,and the intervention began until one week after radiotherapy,while the control group was given routine nursing.Observe and record the occurrence time of acute radiation dermatitis,the degree of acute radiation dermatitis,changes of skin erythema,pruritus,pain,changes of interleukin-6(IL-6)and curative effect were evaluated.The degree of dermatitis was evaluated by RTOG grading standard,the erythema was evaluated by TCM symptom score,and pruritus and pain were evaluated by visual analogue scale(VAS).Blood routine,liver and kidney function,electrocardiogram and other safety indicators and adverse reactions were recorded before and after the study.Results:The time of acute radiation dermatitis was 6-11 days(median 8 days)in the treatment group and 8-14 days(median 10 days)in the control group(P<0.01).The degree and probability of acute radiation dermatitis in the treatment group were 82%(41/50)in grade I,16%(8/50)in grade II and 2%(1/50)in grade III.The degree and probability of acute radiation dermatitis in the control group were 54%(27/50)in grade I,40%(20/50)in grade II and 6%(3/50)in grade III(P<0.05).The highest TCM symptom score of skin erythema in the treatment group was lower than that in the control group(P<0.01).The results of generalized estimation equation show that,The VAS scores of pruritus and pain were(1.34±0.01)and(2.08±0.02)(Waldχ^(2)=1198.123,P<0.01)in the treatment group and(2.08±1.74)(Wald^(2)=1547.804,P<0.01)in the control group,respectively.Compared with the control group,the VAS scores of pruritus and pain were(1.14±0.01)and(2.08±1.74)(Wald^(2)=1547.804,P<0.01)in the treatment group.After observation,the curative effect of the treatment group was better than that of the control group(P<0.05),and the subjective symptoms of patients were obviously improved.After treatment,the level of IL-6 in the treatment group was significantly lower than that before treatment,and was lower than that in the control group(P<0.01).Conclusion:Qingre Shengji Ointment(清热生肌膏)can prevent and treat acute radiation dermatitis to some extent,and its mechanism may be to inhibit the release of inflammatory cytokines,reduce the degree of dermatitis,improve the quality of life of patients,and its safety is good.VAS score can subjectively evaluate the changes of itching and pain,and it is easy to use,so it is worthy of clinical application.

Heijiangdan Ointment(黑绛丹膏)Relieves Oxidative Stress from Radiation Dermatitis Induced by ^(60)Co γ-Ray in Mice

Objective：To investigate the effects of Heijiangdan Ointment（黑绛丹膏,HJD） on oxidative stress in （60）Co γ-ray radiation-induced dermatitis in mice.Methods：Female Wistar mice with grade 4 radiation dermatitis induced by ^（60）Co γ-rays were randomly divided into four groups（n=12 per group）;the HJD-treated,recombinant human epidermal growth factor（rhEGF）-treated,Trolox-treated,and untreated groups,along with a negative control group.On the 11 th and 21 st days after treatment,6 mice in each group were chosen for evaluation.The levels of superoxide dismutase（SOD）,malondialdehyde（MDA）,and lactate dehydrogenase（LDH） were detected using spectrophotometric methods.The fibroblast mitochondria were observed by transmission electron microscopy（TEM）.The expressions of fibroblast growth factor 2（FGF-2） and transforming growth factor β1（TGF-β1） were analyzed by western blot.Results：Compared with the untreated group,the levels of SOD,MDA and LDH,on the 11 th and 21 st days after treatment showed significant difference（P〈0.05）.TEM analysis indicated that fibroblast mitochondria in the untreated group exhibited swelling and the cristae appeared fractured,while in the HJD group,the swelling of mitochondria was limited and the rough endoplasmic reticulum appeared more relaxed.The expressions of FGF-2 and TGF-β1 increased in the untreated group compared with the negative control group（P〈0.05）.After treatment,the expression of FGF-2,rhEGF and Trolox in the HJD group were significantly increased compared with the untreated group（P〈0.05）,or compared with the negative control group（P〈0.05）.The expression of TGF-β1 showed significant difference between untreated and negative control groups（P〈0.05）.HJD and Trolox increased the level of TGF-β1 and the difference was marked as compared with the untreated and negative control groups（P〈0.05）.Conclusion：HJD relieves oxidative stress-induced injury,increases the antioxidant activity,mitigates the fibroblast mitochondrial damage,up-regulates the expression of growth factor,and promotes mitochondrial repair in mice.

Radiation recall dermatitis with dabrafenib and trametinib: A case report

BACKGROUND Radiation recall dermatitis has been defined as the "recalling" by skin of previous radiation exposure in response to the administration of certain response-inducing drugs. Although the phenomenon is relatively well known in the medical world,an exact cause has not been documented.CASE SUMMARY Here, we report the rare occurrence of radiation recall dermatitis after palliative radiotherapy for bone metastases in a metastatic melanoma patient treated with a combination of dabrafenib and trametinib.CONCLUSION We present a case of radiation recall dermatitis after completion of palliative radiotherapy while being treated with a combination of dabrafenib and trametinib. This is a very rare toxic event, and there is insufficient data to describe prevention strategies. Increased awareness and reporting of cases will help to better explain the association between targeted therapy and the radiation recall phenomenon.