Quantification of patient to patient variation of skin erythema developing as a response to radiotherapy.
A method is described to determine accurately skin redness during a course of radiotherapy using reflectance spectroscopy utilizing information from across the visible spectrum according to the L*a*b* color coordinate system. The method was used to quantify the development of skin erythema during and after electron beam irradiation of the chest wall following mastectomy. A number of factors were identified which could influence the wide variation in response seen between patients. These were: intra- and inter-observer variation; intra- and inter-patient variation and variation in the actual dose delivered. Statistical analysis, including an analysis of variance of inter- and intra-patient variation, revealed that the major factor that accounts for the observed difference between patients is a true inter-patient variation, with a coefficient of variation, corrected for intra-patient variation, of 43%. Within the narrow dose range administered in this study, there was no demonstrable dose-effect relationship, raising questions about the role of cell death in the basal layer of the epidermis in the pathogenesis of radiation induced erythema.
Russell
N S
NS
Department of Radiotherapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoekhuis, Amsterdam.
Knaken
H
H
Bruinvis
I A
IA
Hart
A A
AA
Begg
A C
AC
Lebesque
J V
JV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D004890:Erythema / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D015588:Observer Variation; D011832:Radiation Injuries / Q000209:etiology* / Q000473:pathology; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted; D012867:Skin / Q000473:pathology / Q000528:radiation effects*; D012880:Skin Pigmentation / Q000528:radiation effects