3253 - Current Evidence for the Use of Reflectance Confocal Microscopy in Assessing Radiation Dermatitis

12:45pm - 02:00pm PT

Hall F

Screen: 4

POSTER

Presenter(s)

Hamail Iqbal, BS - Cooper Medical School of Rowan University, Camden, NJ

H. Iqbal, and A. E. Dragun; Department of Radiation Oncology, Cooper Medical School of Rowan University, MD Anderson Cancer Center at Cooper University Healthcare, Camden, NJ

Purpose/Objective(s):

Radiation dermatitis (RD) is seen in patients undergoing radiotherapy and can impact quality of life and treatment adherence. Current clinical grading scales for RD rely heavily on subjective assessments, which may not fully capture subclinical changes or early signs of RD, particularly in patients with diverse skin tones. Reflectance confocal microscopy (RCM) provides in-vivo histological visualization of the skin, allowing objective assessment of its features. This review synthesizes current evidence on the use of RCM in evaluating RD, highlighting its role in diagnosis, monitoring, and guiding treatment.

Materials/Methods:

A systematic review of the literature search was performed with the keywords “reflectance confocal microscopy” AND “radiation dermatitis” on PubMed, SCOPUS, and Google Scholar. The inclusion criteria encompassed articles assessing the use of RCM for RD. The exclusion criteria encompassed studies with a focus on RCM for an indication other than RD. Data of study design, sample size, imaging protocols, and findings related to the use of RCM in RD assessment were extracted from included studies. The risk of bias for each study was evaluated using the ROBINS-I Tool, which assesses the quality of non-randomized studies across multiple domains, including selection and measurement bias, and confounding factors.

Results:

PubMed yielded 5 results, SCOPUS yielded 13 results, and Google Scholar yielded 472 results. After review of the titles and abstracts, 3 articles were included. All 3 studies were prospective, open-label, and included patients undergoing radiotherapy for breast cancer. The sample sizes were 6, 1, and 103. RCM was significantly associated with the clinical grade of RD determined by CTCAE scales. RCM revealed signs of RD before becoming clinically evident. Risk of bias was moderate for two studies (N=6, N=103), and high for one study (N=1). The study quality was affected by limited sample sizes, assessment of breast RD only, and unclear blinding between clinical scores and RCM images.

Conclusion:

RCM demonstrates significant potential as a noninvasive imaging tool for assessing RD, offering a method to evaluate the skin histologically without the need for invasive biopsy. However, the current body of evidence is limited by small sample sizes and variability in study protocols, underscoring the need for larger, multicenter studies with standardized methodologies to validate these preliminary findings. Additionally, future research should explore the clinical relevance of early detection of RD using RCM, particularly its potential to guide interventions and reduce the burden of chronic skin complications associated with radiation therapy. By addressing these gaps, RCM could become an invaluable asset in the management and prevention of RD, advancing the standard of care for patients undergoing radiation treatment.