Iervolino V, Di Costanzo G, Azzaro R, Diodato AM, Di Macchia CA, Di Meo T, Petruzziello A, Loquercio G, Muto P, Apice G, Cacciapuoti C, et al.
Supportive care in cancer : official journal of the Multinational Association of Supportive Car.... Date of publication 2013 Jan 1;volume 21(1):287-93.
1. Support Care Cancer. 2013 Jan;21(1):287-93. doi: 10.1007/s00520-012-1635-0. Epub
2012 Nov 13.
Platelet gel in cutaneous radiation dermatitis.
Iervolino V(1), Di Costanzo G, Azzaro R, Diodato AM, Di Macchia CA, Di Meo T,
Petruzziello A, Loquercio G, Muto P, Apice G, Cacciapuoti C.
Author information:
(1)Transfusion Service, Department of Haematology, Istituto Nazionale
Tumori-Fondazione G. Pascale, Naples, Italy.
INTRODUCTION: Radiotherapy, alone or in combination with chemotherapy and/or
surgery, is a fundamental and irreplaceable method of treating tumours.
Nonetheless, although the technological advances made during recent years and the
associated improvements in this type of treatment have reduced the incidence of
complications, 5-15 % of patients still experience damage to the healthy tissues
exposed to radiation. Cutaneous and mucosal lesions are severe collateral effects
of radiotherapy that have an enormous impact on a patient's quality of life.
Unfortunately, however, the efficacy of conventional treatments, while
demonstrably useful in acute lesions, remains disputed in chronic cases.
Nevertheless, numerous studies and clinical findings have demonstrated that
topical, non-transfusional plasma-rich platelet gel is able to accelerate the
regeneration and repair of tissues through the action of the various growth
factors contained within the alpha granules of platelets. We therefore set out to
evaluate the efficacy of autologous platelet gel, chosen for its limited cost and
ease of preparation, in chronic cutaneous radiation dermatitis.
METHODS: "Home-made" platelet gel was produced by treating platelets with
autologous thrombin. The safety of the product was ensured by microbiological
tests. The autologous platelet gel was applied topically once a week, for a mean
duration of 35 days, to chronic third- and fourth-degree (European Pressure Ulcer
Advisory Panel classification and Common Terminology Criteria for Adverse Events
score) cutaneous radiation dermatitis in a group of ten patients previously
treated for moderate-to-high grade (histology G2-G3) limb sarcoma by tumour
excision and post-surgical radiotherapy (dose 50-64 Gy). The radiation dermatitis
had appeared at different intervals after treatment and had all proved resistant
to conventional treatments.
RESULTS: The autologous platelet gel was found to be successful in seven out of
the ten patients treated. The various phases of the healing process were observed
in all cases. Platelet gel application was suspended in three patients: in one
patient after one application due to tumour progression, in another patient after
two applications due to development of distant metastases and in the third after
six applications with only partial tissue response. At 5-year follow-up, six of
the seven successfully treated patients remained free of both disease and lesion,
while the remaining patient, the eldest, had passed away in the interim due to
extraneous causes.
CONCLUSION: Platelet gel treatment could therefore be used to bring about healing
in chronic cutaneous radiation dermatitis, lending itself to better patient
compliance and a favourable cost/benefit ratio, due to a reduction in the number
of medications and hospital visits required.
DOI: 10.1007/s00520-012-1635-0
PMID: 23150187 [Indexed for MEDLINE]
