Download PDF
Semin Plast Surg 2021; 35(03): 181-188
DOI: 10.1055/s-0041-1731464
Review Article

Radiation-Induced Tissue Damage: Clinical Consequences and Current Treatment Options

Hillary Nepon
1   Division of Experimental Surgery, McGill University, Montreal, Quebec, Canada
,
Tyler Safran
2   Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada
,
Edward M. Reece
3   Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
,
Amanda M. Murphy
2   Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada
,
Joshua Vorstenbosch
2   Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada
,
Peter G. Davison
2   Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Radiation therapy is a valuable tool in the treatment of numerous malignancies but, in certain cases, can also causes significant acute and chronic damage to noncancerous neighboring tissues. This review focuses on the pathophysiology of radiation-induced damage and the clinical implications it has for plastic surgeons across breast reconstruction, osteoradionecrosis, radiation-induced skin cancers, and wound healing. The current understanding of treatment modalities presented here include hyperbaric oxygen therapy, autologous fat grafting and stem cells, and pharmaceutical agents.

Keywords

radiation therapy - fibrosis - radiation damage


Publication History

Article published online:
10 September 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Mattiuzzi C, Lippi G. Current cancer epidemiology. J Epidemiol Glob Health 2019; 9 (04) 217-222
    CrossrefPubMedGoogle Scholar
  • 2 Delaney G, Jacob S, Featherstone C, Barton M. The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines. Cancer 2005; 104 (06) 1129-1137
    CrossrefPubMedGoogle Scholar
  • 3 Cho H, Mariotto AB, Schwartz LM, Luo J, Woloshin S. When do changes in cancer survival mean progress? The insight from population incidence and mortality. J Natl Cancer Inst Monogr 2014; 2014 (49) 187-197
    CrossrefPubMedGoogle Scholar
  • 4 Jaffray DA, Gospodarowicz MK. Radiation therapy for cancer. In: Gelband H, Jha P, Sankaranarayanan R, Horton S. eds. Cancer: Disease Control Priorities, Third ed. Vol. 3. Washington (DC): The International Bank for Reconstruction and Development/The World Bank; 2015
    CrossrefGoogle Scholar
  • 5 Baskar R, Lee KA, Yeo R, Yeoh KW. Cancer and radiation therapy: current advances and future directions. Int J Med Sci 2012; 9 (03) 193-199
    CrossrefPubMedGoogle Scholar
  • 6 Begg AC, Stewart FA, Vens C. Strategies to improve radiotherapy with targeted drugs. Nat Rev Cancer 2011; 11 (04) 239-253
    CrossrefPubMedGoogle Scholar
  • 7 Wang B, Wei J, Meng L. et al. Advances in pathogenic mechanisms and management of radiation-induced fibrosis. Biomed Pharmacother 2020; 121: 109560
    CrossrefPubMedGoogle Scholar
  • 8 Najafi M, Motevaseli E, Shirazi A. et al. Mechanisms of inflammatory responses to radiation and normal tissues toxicity: clinical implications. Int J Radiat Biol 2018; 94 (04) 335-356
    CrossrefPubMedGoogle Scholar
  • 9 Paris F, Fuks Z, Kang A. et al. Endothelial apoptosis as the primary lesion initiating intestinal radiation damage in mice. Science 2001; 293 (5528): 293-297
    CrossrefPubMedGoogle Scholar
  • 10 Straub JM, New J, Hamilton CD, Lominska C, Shnayder Y, Thomas SM. Radiation-induced fibrosis: mechanisms and implications for therapy. J Cancer Res Clin Oncol 2015; 141 (11) 1985-1994
    CrossrefPubMedGoogle Scholar
  • 11 Zhang H, Han G, Liu H. et al. The development of classically and alternatively activated macrophages has different effects on the varied stages of radiation-induced pulmonary injury in mice. J Radiat Res (Tokyo) 2011; 52 (06) 717-726
    CrossrefPubMedGoogle Scholar
  • 12 Yarnold J, Brotons MC. Pathogenetic mechanisms in radiation fibrosis. Radiother Oncol 2010; 97 (01) 149-161
    CrossrefPubMedGoogle Scholar
  • 13 Najafi M, Fardid R, Hadadi G, Fardid M. The mechanisms of radiation-induced bystander effect. J Biomed Phys Eng 2014; 4 (04) 163-172
    PubMedGoogle Scholar
  • 14 Hymes SR, Strom EA, Fife C. Radiation dermatitis: clinical presentation, pathophysiology, and treatment 2006. J Am Acad Dermatol 2006; 54 (01) 28-46
    CrossrefPubMedGoogle Scholar
  • 15 Mendelsohn FA, Divino CM, Reis ED, Kerstein MD. Wound care after radiation therapy. Adv Skin Wound Care 2002; 15 (05) 216-224
    CrossrefPubMedGoogle Scholar
  • 16 Castaneda SA, Strasser J. Updates in the treatment of breast cancer with radiotherapy. Surg Oncol Clin N Am 2017; 26 (03) 371-382
    CrossrefPubMedGoogle Scholar
  • 17 Recht A, Gray R, Davidson NE. et al. Locoregional failure 10 years after mastectomy and adjuvant chemotherapy with or without tamoxifen without irradiation: experience of the Eastern Cooperative Oncology Group. J Clin Oncol 1999; 17 (06) 1689-1700
    CrossrefPubMedGoogle Scholar
  • 18 Coles CE, Moody AM, Wilson CB, Burnet NG. Reduction of radiotherapy-induced late complications in early breast cancer: the role of intensity-modulated radiation therapy and partial breast irradiation. Part I--normal tissue complications. Clin Oncol (R Coll Radiol) 2005; 17 (01) 16-24
    CrossrefPubMedGoogle Scholar
  • 19 Agarwal S, Kidwell KM, Farberg A, Kozlow JH, Chung KC, Momoh AO. Immediate reconstruction of the radiated breast: recent trends contrary to traditional standards. Ann Surg Oncol 2015; 22 (08) 2551-2559
    CrossrefPubMedGoogle Scholar
  • 20 See MS, Farhadi J. Radiation therapy and immediate breast reconstruction: novel approaches and evidence base for radiation effects on the reconstructed breast. Clin Plast Surg 2018; 45 (01) 13-24
    CrossrefPubMedGoogle Scholar
  • 21 Classen J, Nitzsche S, Wallwiener D. et al. Fibrotic changes after postmastectomy radiotherapy and reconstructive surgery in breast cancer. A retrospective analysis in 109 patients. Strahlenther Onkol 2010; 186 (11) 630-636
    CrossrefPubMedGoogle Scholar
  • 22 Ho AL, Bovill ES, Macadam SA, Tyldesley S, Giang J, Lennox PA. Postmastectomy radiation therapy after immediate two-stage tissue expander/implant breast reconstruction: a University of British Columbia perspective. Plast Reconstr Surg 2014; 134 (01) 1e-10e
    CrossrefPubMedGoogle Scholar
  • 23 Ho AY, Patel N, Ohri N. et al. Bilateral implant reconstruction does not affect the quality of postmastectomy radiation therapy. Med Dosim 2014; 39 (01) 18-22
    CrossrefPubMedGoogle Scholar
  • 24 Alderman AK, Wilkins EG, Kim HM, Lowery JC. Complications in postmastectomy breast reconstruction: two-year results of the Michigan Breast Reconstruction Outcome Study. Plast Reconstr Surg 2002; 109 (07) 2265-2274
    CrossrefPubMedGoogle Scholar
  • 25 Krueger EA, Wilkins EG, Strawderman M. et al. Complications and patient satisfaction following expander/implant breast reconstruction with and without radiotherapy. Int J Radiat Oncol Biol Phys 2001; 49 (03) 713-721
    CrossrefPubMedGoogle Scholar
  • 26 Cordeiro PG, Snell L, Heerdt A, McCarthy C. Immediate tissue expander/implast breast reconstruction after salvage mastectomy for cancer recurrence following lumpectomy/irradiation. Plast Reconstr Surg 2012; 129 (02) 341-350
    CrossrefPubMedGoogle Scholar
  • 27 Tallet AV, Salem N, Moutardier V. et al. Radiotherapy and immediate two-stage breast reconstruction with a tissue expander and implant: complications and esthetic results. Int J Radiat Oncol Biol Phys 2003; 57 (01) 136-142
    CrossrefPubMedGoogle Scholar
  • 28 Cowen D, Gross E, Rouannet P. et al. Immediate post-mastectomy breast reconstruction followed by radiotherapy: risk factors for complications. Breast Cancer Res Treat 2010; 121 (03) 627-634
    CrossrefPubMedGoogle Scholar
  • 29 Eriksson M, Anveden L, Celebioglu F. et al. Radiotherapy in implant-based immediate breast reconstruction: risk factors, surgical outcomes, and patient-reported outcome measures in a large Swedish multicenter cohort. Breast Cancer Res Treat 2013; 142 (03) 591-601
    CrossrefPubMedGoogle Scholar
  • 30 Ricci JA, Epstein S, Momoh AO, Lin SJ, Singhal D, Lee BT. A meta-analysis of implant-based breast reconstruction and timing of adjuvant radiation therapy. J Surg Res 2017; 218: 108-116
    CrossrefPubMedGoogle Scholar
  • 31 Naoum GE, Salama L, Niemierko A. et al. Single stage direct-to-implant breast reconstruction has lower complication rates than tissue expander and implant and comparable rates to autologous reconstruction in patients receiving postmastectomy radiation. Int J Radiat Oncol Biol Phys 2020; 106 (03) 514-524
    CrossrefPubMedGoogle Scholar
  • 32 Nava MB, Pennati AE, Lozza L, Spano A, Zambetti M, Catanuto G. Outcome of different timings of radiotherapy in implant-based breast reconstructions. Plast Reconstr Surg 2011; 128 (02) 353-359
    CrossrefPubMedGoogle Scholar
  • 33 Lin AM, Christensen JM. et al. Postmastectomy Radiation Therapy on permanent implants or tissue expanders: which is better?. Ann Surg. 2019; DOI: 10.1097/SLA.0000000000003670.
    CrossrefPubMedGoogle Scholar
  • 34 Cordeiro PG, Albornoz CR, McCormick B. et al. What is the optimum timing of postmastectomy radiotherapy in two-stage prosthetic reconstruction: radiation to the tissue expander or permanent implant?. Plast Reconstr Surg 2015; 135 (06) 1509-1517
    CrossrefPubMedGoogle Scholar
  • 35 Lentz R, Ng R, Higgins SA, Fusi S, Matthew M, Kwei SL. Radiation therapy and expander-implant breast reconstruction: an analysis of timing and comparison of complications. Ann Plast Surg 2013; 71 (03) 269-273
    CrossrefPubMedGoogle Scholar
  • 36 Hoejvig JH, Pedersen NJ, Gramkow CS, Bredgaard R, Kroman N, Bonde CT. Delayed two-stage breast reconstruction: the impact of radiotherapy. J Plast Reconstr Aesthet Surg 2019; 72 (11) 1763-1768
    CrossrefPubMedGoogle Scholar
  • 37 Kim SW, Lee HK, Kang SM. et al. Short-term outcomes of immediate breast reconstruction using an implant or tissue expander after mastectomy in breast cancer patients. Breast Cancer 2016; 23 (02) 279-285
    CrossrefPubMedGoogle Scholar
  • 38 Roostaeian J, Sanchez I, Vardanian A. et al. Comparison of immediate implant placement versus the staged tissue expander technique in breast reconstruction. Plast Reconstr Surg 2012; 129 (06) 909e-918e
    CrossrefPubMedGoogle Scholar
  • 39 Safran T, Al-Halabi B, Viezel-Mathieu A, Boileau JF, Dionisopoulos T. Direct-to-implant, prepectoral breast reconstruction: a single-surgeon experience with 201 consecutive patients. Plast Reconstr Surg 2020; 145 (04) 686e-696e
    CrossrefPubMedGoogle Scholar
  • 40 Shammas RL, Ren Y, Thomas SM, Hollenbeck ST, Greenup RA, Blitzblau RC. Immediate breast reconstruction allows for the timely initiation of postmastectomy radiation therapy. Plast Reconstr Surg 2019; 144 (03) 347e-357e
    CrossrefPubMedGoogle Scholar
  • 41 Sbitany H, Gomez-Sanchez C, Piper M, Lentz R. Prepectoral breast reconstruction in the setting of postmastectomy radiation therapy: an assessment of clinical outcomes and benefits. Plast Reconstr Surg 2019; 143 (01) 10-20
    CrossrefPubMedGoogle Scholar
  • 42 Sigalove S. Prepectoral breast reconstruction and radiotherapy-a closer look. Gland Surg 2019; 8 (01) 67-74
    CrossrefPubMedGoogle Scholar
  • 43 Huang TT. Breast and subscapular pain following submuscular placement of breast prostheses. Plast Reconstr Surg 1990; 86 (02) 275-280
    CrossrefPubMedGoogle Scholar
  • 44 Pittman TA, Abbate OA, Economides JM. The P1 method: prepectoral breast reconstruction to minimize the palpable implant edge and upper pole rippling. Ann Plast Surg 2018; 80 (05) 487-492
    CrossrefPubMedGoogle Scholar
  • 45 Sinnott CJ, Persing SM, Pronovost M, Hodyl C, McConnell D, Ott Young A. Impact of postmastectomy radiation therapy in prepectoral versus subpectoral implant-based breast reconstruction. Ann Surg Oncol 2018; 25 (10) 2899-2908
    CrossrefPubMedGoogle Scholar
  • 46 Katzel EB, Koltz PF, Tierney R. et al. The impact of Smad3 loss of function on TGF-β signaling and radiation-induced capsular contracture. Plast Reconstr Surg 2011; 127 (06) 2263-2269
    CrossrefPubMedGoogle Scholar
  • 47 Headon H, Kasem A, Mokbel K. Capsular contracture after breast augmentation: an update for clinical practice. Arch Plast Surg 2015; 42 (05) 532-543
    Article in Thieme ConnectPubMedGoogle Scholar
  • 48 Haran O, Bracha G, Tiosano A. et al. Postirradiation capsular contracture in implant-based breast reconstruction: management and outcome. Plast Reconstr Surg 2021; 147 (01) 11-19
    CrossrefPubMedGoogle Scholar
  • 49 Lardi AM, Ho-Asjoe M, Junge K, Farhadi J. Capsular contracture in implant based breast reconstruction-the effect of porcine acellular dermal matrix. Gland Surg 2017; 6 (01) 49-56
    CrossrefPubMedGoogle Scholar
  • 50 Spear SL, Seruya M, Clemens MW, Teitelbaum S, Nahabedian MY. Acellular dermal matrix for the treatment and prevention of implant-associated breast deformities. Plast Surg Nurs 2017; 37 (02) 76-87
    CrossrefPubMedGoogle Scholar
  • 51 Moyer HR, Pinell-White X, Losken A. The effect of radiation on acellular dermal matrix and capsule formation in breast reconstruction: clinical outcomes and histologic analysis. Plast Reconstr Surg 2014; 133 (02) 214-221
    CrossrefPubMedGoogle Scholar
  • 52 Salzberg CA, Ashikari AY, Berry C, Hunsicker LM. Acellular dermal matrix-assisted direct-to-implant breast reconstruction and capsular contracture: a 13-year experience. Plast Reconstr Surg 2016; 138 (02) 329-337
    CrossrefPubMedGoogle Scholar
  • 53 Basu CB, Leong M, Hicks MJ. Acellular cadaveric dermis decreases the inflammatory response in capsule formation in reconstructive breast surgery. Plast Reconstr Surg 2010; 126 (06) 1842-1847
    CrossrefPubMedGoogle Scholar
  • 54 Martin S, Cai L, Beniwal A, Tevlin R, Lee G, Nazerali RS. Autologous fat grafting and the occurrence of radiation-induced capsular contracture. Ann Plast Surg 2021; 86 (5S, suppl 3): S414-S417
    CrossrefPubMedGoogle Scholar
  • 55 El-Sabawi B, Sosin M, Carey JN, Nahabedian MY, Patel KM. Breast reconstruction and adjuvant therapy: a systematic review of surgical outcomes. J Surg Oncol 2015; 112 (05) 458-464
    CrossrefPubMedGoogle Scholar
  • 56 Rogers NE, Allen RJ. Radiation effects on breast reconstruction with the deep inferior epigastric perforator flap. Plast Reconstr Surg 2002; 109 (06) 1919-1924 , discussion 1925–1926
    CrossrefPubMedGoogle Scholar
  • 57 Spear SL, Ducic I, Low M, Cuoco F. The effect of radiation on pedicled TRAM flap breast reconstruction: outcomes and implications. Plast Reconstr Surg 2005; 115 (01) 84-95
    CrossrefPubMedGoogle Scholar
  • 58 Tran NV, Chang DW, Gupta A, Kroll SS, Robb GL. Comparison of immediate and delayed free TRAM flap breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg 2001; 108 (01) 78-82
    CrossrefPubMedGoogle Scholar
  • 59 Carlson GW, Page AL, Peters K, Ashinoff R, Schaefer T, Losken A. Effects of radiation therapy on pedicled transverse rectus abdominis myocutaneous flap breast reconstruction. Ann Plast Surg 2008; 60 (05) 568-572
    CrossrefPubMedGoogle Scholar
  • 60 Patel KM, Albino F, Fan KL, Liao E, Nahabedian MY. Microvascular autologous breast reconstruction in the context of radiation therapy: comparing two reconstructive algorithms. Plast Reconstr Surg 2013; 132 (02) 251-257
    CrossrefPubMedGoogle Scholar
  • 61 Yun JH, Diaz R, Orman AG. Breast reconstruction and radiation therapy. Cancer Contr 2018; 25 (01) 1073274818795489
    CrossrefPubMedGoogle Scholar
  • 62 Chatterjee JS, Lee A, Anderson W. et al. Effect of postoperative radiotherapy on autologous deep inferior epigastric perforator flap volume after immediate breast reconstruction. Br J Surg 2009; 96 (10) 1135-1140
    CrossrefPubMedGoogle Scholar
  • 63 Mirzabeigi MN, Smartt JM, Nelson JA, Fosnot J, Serletti JM, Wu LC. An assessment of the risks and benefits of immediate autologous breast reconstruction in patients undergoing postmastectomy radiation therapy. Ann Plast Surg 2013; 71 (02) 149-155
    CrossrefPubMedGoogle Scholar
  • 64 Billig J, Jagsi R, Qi J. et al. should immediate autologous breast reconstruction be considered in women who require postmastectomy radiation therapy? A prospective analysis of outcomes. Plast Reconstr Surg 2017; 139 (06) 1279-1288
    CrossrefPubMedGoogle Scholar
  • 65 Wang TH, Liu CJ, Chao TF, Chen TJ, Hu YW. Risk factors for and the role of dental extractions in osteoradionecrosis of the jaws: a national-based cohort study. Head Neck 2017; 39 (07) 1313-1321
    CrossrefPubMedGoogle Scholar
  • 66 Buglione M, Cavagnini R, Di Rosario F. et al. Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: xerostomia and trismus (part 2). Literature review and consensus statement. Crit Rev Oncol Hematol 2016; 102: 47-54
    CrossrefPubMedGoogle Scholar
  • 67 Moon DH, Moon SH, Wang K. et al. Incidence of, and risk factors for, mandibular osteoradionecrosis in patients with oral cavity and oropharynx cancers. Oral Oncol 2017; 72: 98-103
    CrossrefPubMedGoogle Scholar
  • 68 Rivero JA, Shamji O, Kolokythas A. Osteoradionecrosis: a review of pathophysiology, prevention and pharmacologic management using pentoxifylline, α-tocopherol, and clodronate. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124 (05) 464-471
    CrossrefPubMedGoogle Scholar
  • 69 Frankart AJ, Frankart MJ, Cervenka B, Tang AL, Krishnan DG, Takiar V. Osteoradionecrosis: exposing the evidence not the bone. Int J Radiat Oncol Biol Phys 2021; 109 (05) 1206-1218
    CrossrefPubMedGoogle Scholar
  • 70 Nabil S, Samman N. Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review. Int J Oral Maxillofac Surg 2011; 40 (03) 229-243
    CrossrefPubMedGoogle Scholar
  • 71 Owosho AA, Tsai CJ, Lee RS. et al. The prevalence and risk factors associated with osteoradionecrosis of the jaw in oral and oropharyngeal cancer patients treated with intensity-modulated radiation therapy (IMRT): the Memorial Sloan Kettering Cancer Center experience. Oral Oncol 2017; 64: 44-51
    CrossrefPubMedGoogle Scholar
  • 72 Oh HK, Chambers MS, Martin JW, Lim HJ, Park HJ. Osteoradionecrosis of the mandible: treatment outcomes and factors influencing the progress of osteoradionecrosis. J Oral Maxillofac Surg 2009; 67 (07) 1378-1386
    CrossrefPubMedGoogle Scholar
  • 73 Lee M, Chin RY, Eslick GD, Sritharan N, Paramaesvaran S. Outcomes of microvascular free flap reconstruction for mandibular osteoradionecrosis: a systematic review. J Craniomaxillofac Surg 2015; 43 (10) 2026-2033
    CrossrefPubMedGoogle Scholar
  • 74 Kim JW, Hwang JH, Ahn KM. Fibular flap for mandible reconstruction in osteoradionecrosis of the jaw: selection criteria of fibula flap. Maxillofac Plast Reconstr Surg 2016; 38 (01) 46
    CrossrefPubMedGoogle Scholar
  • 75 Milam EC, Rangel LK, Pomeranz MK. Dermatologic sequelae of breast cancer: From disease, surgery, and radiation. Int J Dermatol 2021; 60 (04) 394-406
    CrossrefPubMedGoogle Scholar
  • 76 Cuperus E, Leguit R, Albregts M, Toonstra J. Post radiation skin tumors: basal cell carcinomas, squamous cell carcinomas and angiosarcomas. A review of this late effect of radiotherapy. Eur J Dermatol 2013; 23 (06) 749-757
    CrossrefPubMedGoogle Scholar
  • 77 Shore RE. Radiation-induced skin cancer in humans. Med Pediatr Oncol 2001; 36 (05) 549-554
    CrossrefPubMedGoogle Scholar
  • 78 Karagas MR, McDonald JA, Greenberg ER. et al; For The Skin Cancer Prevention Study Group. Risk of basal cell and squamous cell skin cancers after ionizing radiation therapy. J Natl Cancer Inst 1996; 88 (24) 1848-1853
    CrossrefPubMedGoogle Scholar
  • 79 Walsh NM, Cerroni L. Merkel cell carcinoma: a review. J Cutan Pathol 2021; 48 (03) 411-421
    CrossrefPubMedGoogle Scholar
  • 80 Harper JL, Franklin LE, Jenrette JM, Aguero EG. Skin toxicity during breast irradiation: pathophysiology and management. South Med J 2004; 97 (10) 989-993
    CrossrefPubMedGoogle Scholar
  • 81 Denham JW, Hauer-Jensen M. The radiotherapeutic injury--a complex ‘wound’. Radiother Oncol 2002; 63 (02) 129-145
    CrossrefPubMedGoogle Scholar
  • 82 Johnson MB, Pang B, Gardner DJ. et al. Topical fibronectin improves wound healing of irradiated skin. Sci Rep 2017; 7 (01) 3876
    CrossrefPubMedGoogle Scholar
  • 83 Lehnhardt M, Daigeler A, Hauser J. et al. The value of expert second opinion in diagnosis of soft tissue sarcomas. J Surg Oncol 2008; 97 (01) 40-43
    CrossrefPubMedGoogle Scholar
  • 84 Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. 1980. Clin Orthop Relat Res 2003; (415) 4-18
    CrossrefPubMedGoogle Scholar
  • 85 Chao AH, Mayerson JL, Chandawarkar R, Scharschmidt TJ. Surgical management of soft tissue sarcomas: extremity sarcomas. J Surg Oncol 2015; 111 (05) 540-545
    CrossrefPubMedGoogle Scholar
  • 86 Slump J, Bastiaannet E, Halka A. et al. Risk factors for postoperative wound complications after extremity soft tissue sarcoma resection: a systematic review and meta-analyses. J Plast Reconstr Aesthet Surg 2019; 72 (09) 1449-1464
    CrossrefPubMedGoogle Scholar
  • 87 Sanniec KJ, Swanson S, Casey III WJ, Schwartz A, Bryant L, Rebecca AM. Predictive factors of wound complications after sarcoma resection requiring plastic surgeon involvement. Ann Plast Surg 2013; 71 (03) 283-285
    CrossrefPubMedGoogle Scholar
  • 88 Abouarab MH, Salem IL, Degheidy MM. et al. Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy. Int Wound J 2018; 15 (01) 148-158
    CrossrefPubMedGoogle Scholar
  • 89 LeBrun DG, Guttmann DM, Shabason JE, Levin WP, Kovach SJ, Weber KL. Predictors of wound complications following radiation and surgical resection of soft tissue sarcomas. Sarcoma 2017; 2017: 5465130
    CrossrefPubMedGoogle Scholar
  • 90 Kirby JP. Hyperbaric oxygen therapy and radiation-induced injuries. Mo Med 2019; 116 (03) 198-200
    PubMedGoogle Scholar
  • 91 Bennett MH, Feldmeier J, Hampson NB, Smee R, Milross C. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database Syst Rev 2016; 4: CD005005
    PubMedGoogle Scholar
  • 92 Oscarsson N, Ny L, Mölne J. et al. Hyperbaric oxygen treatment reverses radiation induced pro-fibrotic and oxidative stress responses in a rat model. Free Radic Biol Med 2017; 103: 248-255
    CrossrefPubMedGoogle Scholar
  • 93 Romero-Valdovinos M, Cárdenas-Mejía A, Gutiérrez-Gómez C, Flisser A, Kawa-Karasik S, Ortiz-Monasterio F. Keloid skin scars: the influence of hyperbaric oxygenation on fibroblast growth and on the expression of messenger RNA for insulin like growth factor and for transforming growth factor. In Vitro Cell Dev Biol Anim 2011; 47 (07) 421-424
    CrossrefPubMedGoogle Scholar
  • 94 Cooper JS, Hanley ME, Hendriksen S, Robins M. Hyperbaric Treatment of Delayed Radiation Injury. Treasure Island (FL): StatPearls; 2021
    Google Scholar
  • 95 Rice N, Polyzois I, Ekanayake K, Omer O, Stassen LF. The management of osteoradionecrosis of the jaws--a review. Surgeon 2015; 13 (02) 101-109
    CrossrefPubMedGoogle Scholar
  • 96 Annane D, Depondt J, Aubert P. et al. Hyperbaric oxygen therapy for radionecrosis of the jaw: a randomized, placebo-controlled, double-blind trial from the ORN96 study group. J Clin Oncol 2004; 22 (24) 4893-4900
    CrossrefPubMedGoogle Scholar
  • 97 Shaw R, Forner L, Butterworth C. et al. Randomised controlled trials in HBO: “a call to arms” for HOPON & DAHANCA-21. Br J Oral Maxillofac Surg 2011; 49 (01) 76-77
    CrossrefPubMedGoogle Scholar
  • 98 Spruijt NE, van den Berg R. The effect of hyperbaric oxygen treatment on late radiation tissue injury after breast cancer: a case-series of 67 patients. Diving Hyperb Med 2020;50(03):
    PubMedGoogle Scholar
  • 99 Rigotti G, Marchi A, Galiè M. et al. Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 2007; 119 (05) 1409-1422
    CrossrefPubMedGoogle Scholar
  • 100 Garza RM, Paik KJ, Chung MT. et al. Studies in fat grafting: Part III. Fat grafting irradiated tissue--improved skin quality and decreased fat graft retention. Plast Reconstr Surg 2014; 134 (02) 249-257
    CrossrefPubMedGoogle Scholar
  • 101 Fukuba M, Uozaki H, Komuro Y. Effectiveness of the combination of fat grafting and injection on radiation ulcer healing. J Plast Surg Hand Surg 2020; 54 (01) 24-28
    CrossrefPubMedGoogle Scholar
  • 102 Panettiere P, Marchetti L, Accorsi D. The serial free fat transfer in irradiated prosthetic breast reconstructions. Aesthetic Plast Surg 2009; 33 (05) 695-700
    CrossrefPubMedGoogle Scholar
  • 103 Salgarello M, Visconti G, Barone-Adesi L. Fat grafting and breast reconstruction with implant: another option for irradiated breast cancer patients. Plast Reconstr Surg 2012; 129 (02) 317-329
    CrossrefPubMedGoogle Scholar
  • 104 Serra-Renom JM, Muñoz-Olmo JL, Serra-Mestre JM. Fat grafting in postmastectomy breast reconstruction with expanders and prostheses in patients who have received radiotherapy: formation of new subcutaneous tissue. Plast Reconstr Surg 2010; 125 (01) 12-18
    CrossrefPubMedGoogle Scholar
  • 105 Rinker BD, Vyas KS. Do stem cells have an effect when we fat graft?. Ann Plast Surg 2016; 76 (Suppl. 04) S359-S363
    CrossrefPubMedGoogle Scholar
  • 106 Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 2006; 118 (3, suppl) 108S-120S
    CrossrefPubMedGoogle Scholar
  • 107 Conci C, Bennati L, Bregoli C. et al. Tissue engineering and regenerative medicine strategies for the female breast. J Tissue Eng Regen Med 2020; 14 (02) 369-387
    CrossrefPubMedGoogle Scholar
  • 108 Cao Y, Sun Z, Liao L, Meng Y, Han Q, Zhao RC. Human adipose tissue-derived stem cells differentiate into endothelial cells in vitro and improve postnatal neovascularization in vivo. Biochem Biophys Res Commun 2005; 332 (02) 370-379
    CrossrefPubMedGoogle Scholar
  • 109 Zuk PA, Zhu M, Mizuno H. et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng 2001; 7 (02) 211-228
    CrossrefPubMedGoogle Scholar
  • 110 Arshad Z, Halioua-Haubold CL, Roberts M. et al. Adipose-derived stem cells in aesthetic surgery: a mixed methods evaluation of the current clinical trial, intellectual property, and regulatory landscape. Aesthet Surg J 2018; 38 (02) 199-210
    CrossrefPubMedGoogle Scholar
  • 111 Rowan BG, Gimble JM, Sheng M. et al. Human adipose tissue-derived stromal/stem cells promote migration and early metastasis of triple negative breast cancer xenografts. PLoS One 2014; 9 (02) e89595
    CrossrefPubMedGoogle Scholar
  • 112 Eterno V, Zambelli A, Pavesi L. et al. Adipose-derived mesenchymal stem cells (ASCs) may favour breast cancer recurrence via HGF/c-Met signaling. Oncotarget 2014; 5 (03) 613-633
    CrossrefPubMedGoogle Scholar
  • 113 Mestak O, Hromadkova V, Fajfrova M, Molitor M, Mestak J. Evaluation of oncological safety of fat grafting after breast-conserving therapy: a prospective study. Ann Surg Oncol 2016; 23 (03) 776-781
    CrossrefPubMedGoogle Scholar
  • 114 Petit JY, Maisonneuve P, Rotmensz N. et al. Safety of lipofilling in patients with breast cancer. Clin Plast Surg 2015; 42 (03) 339-344
    CrossrefPubMedGoogle Scholar
  • 115 Kronowitz SJ, Mandujano CC, Liu J. et al. Lipofilling of the breast does not increase the risk of recurrence of breast cancer: a matched controlled study. Plast Reconstr Surg 2016; 137 (02) 385-393
    CrossrefPubMedGoogle Scholar
  • 116 Delanian S, Porcher R, Balla-Mekias S, Lefaix JL. Randomized, placebo-controlled trial of combined pentoxifylline and tocopherol for regression of superficial radiation-induced fibrosis. J Clin Oncol 2003; 21 (13) 2545-2550
    CrossrefPubMedGoogle Scholar
  • 117 Patel S, Patel N, Sassoon I, Patel V. The use of pentoxifylline, tocopherol and clodronate in the management of osteoradionecrosis of the jaws. Radiother Oncol 2021; 156: 209-216
    CrossrefPubMedGoogle Scholar
  • 118 Patel V, Gadiwalla Y, Sassoon I, Sproat C, Kwok J, McGurk M. Prophylactic use of pentoxifylline and tocopherol in patients who require dental extractions after radiotherapy for cancer of the head and neck. Br J Oral Maxillofac Surg 2016; 54 (05) 547-550
    CrossrefPubMedGoogle Scholar
  • 119 Patel V, Gadiwalla Y, Sassoon I, Sproat C, Kwok J, McGurk M. Use of pentoxifylline and tocopherol in the management of osteoradionecrosis. Br J Oral Maxillofac Surg 2016; 54 (03) 342-345
    CrossrefPubMedGoogle Scholar
  • 120 Patel V, McGurk M. Use of pentoxifylline and tocopherol in radiation-induced fibrosis and fibroatrophy. Br J Oral Maxillofac Surg 2017; 55 (03) 235-241
    CrossrefPubMedGoogle Scholar
  • 121 Jacobson G, Bhatia S, Smith BJ, Button AM, Bodeker K, Buatti J. Randomized trial of pentoxifylline and vitamin E vs standard follow-up after breast irradiation to prevent breast fibrosis, evaluated by tissue compliance meter. Int J Radiat Oncol Biol Phys 2013; 85 (03) 604-608
    CrossrefPubMedGoogle Scholar
  • 122 Kaidar-Person O, Marks LB, Jones EL. Pentoxifylline and vitamin E for treatment or prevention of radiation-induced fibrosis in patients with breast cancer. Breast J 2018; 24 (05) 816-819
    CrossrefPubMedGoogle Scholar
  • 123 Lee JW, Tutela JP, Zoumalan RA. et al. Inhibition of Smad3 expression in radiation-induced fibrosis using a novel method for topical transcutaneous gene therapy. Arch Otolaryngol Head Neck Surg 2010; 136 (07) 714-719
    CrossrefPubMedGoogle Scholar
  • 124 Flechsig P, Dadrich M, Bickelhaupt S. et al. LY2109761 attenuates radiation-induced pulmonary murine fibrosis via reversal of TGF-β and BMP-associated proinflammatory and proangiogenic signals. Clin Cancer Res 2012; 18 (13) 3616-3627
    CrossrefPubMedGoogle Scholar
  • 125 Xavier S, Piek E, Fujii M. et al. Amelioration of radiation-induced fibrosis: inhibition of transforming growth factor-beta signaling by halofuginone. J Biol Chem 2004; 279 (15) 15167-15176
    CrossrefPubMedGoogle Scholar
  • 126 Martin M, Lefaix J, Delanian S. TGF-beta1 and radiation fibrosis: a master switch and a specific therapeutic target?. Int J Radiat Oncol Biol Phys 2000; 47 (02) 277-290
    CrossrefPubMedGoogle Scholar
  • 127 Wright JA, Richards T, Srai SK. The role of iron in the skin and cutaneous wound healing. Front Pharmacol 2014; 5: 156
    CrossrefPubMedGoogle Scholar
  • 128 Shen X, Wan C, Ramaswamy G. et al. Prolyl hydroxylase inhibitors increase neoangiogenesis and callus formation following femur fracture in mice. J Orthop Res 2009; 27 (10) 1298-1305
    CrossrefPubMedGoogle Scholar
  • 129 Donneys A, Deshpande SS, Tchanque-Fossuo CN. et al. Deferoxamine expedites consolidation during mandibular distraction osteogenesis. Bone 2013; 55 (02) 384-390
    CrossrefPubMedGoogle Scholar
  • 130 Farberg AS, Jing XL, Monson LA. et al. Deferoxamine reverses radiation induced hypovascularity during bone regeneration and repair in the murine mandible. Bone 2012; 50 (05) 1184-1187
    CrossrefPubMedGoogle Scholar
  • 131 Mericli AF, Das A, Best R, Rodeheaver P, Rodeheaver G, Lin KY. Deferoxamine mitigates radiation-induced tissue injury in a rat irradiated TRAM flap model. Plast Reconstr Surg 2015; 135 (01) 124e-134e
    CrossrefPubMedGoogle Scholar
  • 132 Shen AH, Borrelli MR, Adem S. et al. Prophylactic treatment with transdermal deferoxamine mitigates radiation-induced skin fibrosis. Sci Rep 2020; 10 (01) 12346
    CrossrefPubMedGoogle Scholar