Supportive Care in Cancer

, Volume 21, Issue 1, pp 287–293 | Cite as

Platelet gel in cutaneous radiation dermatitis

  • Vincenzo Iervolino
  • Gaetano Di Costanzo
  • Rosa Azzaro
  • Anna Maria Diodato
  • Catia Addolorata Di Macchia
  • Tommaso Di Meo
  • Arnolfo Petruzziello
  • Giovanna Loquercio
  • Paolo Muto
  • Gaetano Apice
  • Carmela Cacciapuoti
Short Communication

Abstract

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.

Keywords

Cutaneous radiotherapy lesions Growth factors Platelet gel Supportive care 

Notes

Conflict of interest

The funding source had no role in the design, execution, analysis, interpretation of the study or in the decision to submit the results for publication. Dr. Loquercio has full access to the data presented in the study and is available upon request to the journal for purposes of reviewing this paper

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Vincenzo Iervolino
    • 1
  • Gaetano Di Costanzo
    • 1
  • Rosa Azzaro
    • 1
  • Anna Maria Diodato
    • 1
  • Catia Addolorata Di Macchia
    • 1
  • Tommaso Di Meo
    • 1
  • Arnolfo Petruzziello
    • 2
  • Giovanna Loquercio
    • 2
    • 5
  • Paolo Muto
    • 3
  • Gaetano Apice
    • 4
  • Carmela Cacciapuoti
    • 1
  1. 1.Transfusion Service, Department of HaematologyIstituto Nazionale Tumori-Fondazione G. PascaleNaplesItaly
  2. 2.Laboratory of Virology and Molecular Biology “V. Tridente”-Transfusion Service, Department of HaematologyIstituto Nazionale Tumori-Fondazione G. PascaleNaplesItaly
  3. 3.Dipartimento di Diagnostica per Immagini, Terapia Radiante e MetabolicaIstituto Nazionale Tumori-Fondazione G. PascaleNaplesItaly
  4. 4.Dipartimento Melanoma, Tessuti molli, Muscolo-Scheletrico e Testa-ColloIstituto Nazionale Tumori-Fondazione G. PascaleNaplesItaly
  5. 5.Istituto Nazionale Tumori-Fondazione G. PascaleNaplesItaly

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