A range of acute skin reactions can be seen in patients receiving radiotherapy to the breast for treatment of breast carcinoma. Here, we have applied the techniques of lightguide spectrophotometry (LS) and laser Doppler imaging (LDI) to investigate changes in oxygen saturation (SO2) and blood flow induced by the early radiation reaction in the breast during and after a standard radiotherapy technique.
An EMPHO II micro-lightguide spectrophotometer (BGT, Überlingen, Germany) was used to measure the SO2 profiles and histograms in the skin within control and treatment areas. LDI was performed using an LDI 1.0 instrument (Moor Instruments, Axminster, UK). A dose of 45 Gray was administered in 20 fractions over 4 weeks. To date, measurements have been made on 8 patients at selected sites before the first fraction, after 5, 10 and 20 fractions, and (in 6 patients) at 3 months follow-up.
Clear changes were observed in SO2 (p < 0.001) and the LDI images at all sites after only 5 fractions and persisted up to the 3 month stage. Except at 20 fractions, there were also significant differences between the changes in the medial and lateral sides of the treated breasts (p < 0.001).
The results indicate that long-lasting changes in SO2 and perfusion patterns occur as a result of radiotherapy. The use of the techniques described may enable the early detection of skin damage so that interventions may be tested to minimise severe acute and late reactions. We are most grateful to Professor Jill Belch and Dr Faisel Khan, Dept. of Medicine, University of Dundee, for use of the LDI equipment.
Harrison DK, Harrison EM, Newton DJ, Windsor PM. Oxygen supply and perfusion in breast skin during radiotherapy treatment. Journal of Vascular Research, 36, 323 (1999).
Dr. David K. Harrison, Durham Unit, Durham. Tel: +44 (0)191-333-2215.
Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
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