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Clinical analysis of the treatment and severity classification in radiation ulcer patients
YANG Fei, XIE Weiguo, ZHANG Wei, et al
2022, 18 (1):
62.
Objective To analyze the clinical characteristics and treatment effects of different degrees radiation ulcers according to the self-defined classification standard. Methods The main factors affecting the severity of radiation ulcers were scored according to different weighting, which were defined as mild, moderate, and severe. Based on this standard, the patients of radiation ulcer admitted to our hospital from April 2014 to September 2020 were analyzed retrospectively, in addition, the treatment and follow-up results of patients with different severity and different primary diseases were grouped and compared. Results A total of 31 patients were enrolled in this study. There were 3 cases (10.7%) of mild type, 12 cases (38.7%) of moderate type and 16 cases (51.6%) of severe type. Among the patients, 9 cases (29.0%) were repaired with conservative treatment, 14 cases (45.2%) were repaired with local pedicle flaps, and 8 cases (25.8%) were repaired with free flaps. In these three types of patients, the more severe the classification, the longer the course of the ulcer, the more flaps were used to repair, the higher the cost of treatment, and the longer the wound healing time (P<0.05). The clinical cure rates were 87.5%, 100%, and 100% in the mild, moderate, and severe groups respectively, and the ulcer recurrence rates were 33.3%, 25.0%, and 21.4% respectively, with no significant difference (P>0.05). The primary causes of radiotherapy included breast cancer in 12 cases (38.7%), malignant tumors of the reproductive system in 5 cases (16.1%), cutaneous squamous cell carcinoma in 4 cases (12.9%), angiopathy in 4 cases (12.9%), dermatofibrosarcoma in 3 cases (9.7%), nasopharyngeal carcinoma in 2 cases (6.5%), and lymphoma in 1 case (3.2%). The severity of ulcers varied in patients with different primary causes (P<0.05), but there was no significant difference in the clinical recovery rate and ulcer recurrence rate (P>0.05). Conclusion There are statistical differences in the ulcer course, treatment methods, wound healing time and treatment costs among patients with radiation ulcers of different severity. Moreover, this classification standard has a guiding effect on the disease judgment and clinical treatment.
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