Balneotherapy as a promising method for the correction of dermatologic adverse events of cancer therapy

Abstract

Cancer treatment with chemotherapy, targeted and immunotherapy is associated with a wide spectrum of dermatologic adverse events. Xerosis (dryness) of the skin is the most prevalent skin side effect in oncologic patients, which occurs both during treatment with "classic" chemotherapy drugs and modern cancer drugs, such as targeted therapy and immunotherapy.

Despite the high prevalence of this side effect, current approaches to the correction of skin xerosis in cancer patients are very limited. At the same time, in the absence of adequate supportive treatment of xerosis, the formation of persistent fissures, eczematization and secondary infection is observed, which may lead to antitumor therapy regimen modification. Thus, optimization of prophylactic and treatment strategies for xerosis in patients treated with anticancer drugs remain an important interdisciplinary problem. Balneotherapy is a promising method for the correction of skin xerosis due to a complex positive effect on the level of skin hydration, a decrease in the intensity of inflammatory processes, a beneficial effect on the state of the skin barrier function, as well as an increase in antimicrobial protection. Available data on the use of balneotherapy in the supportive treatment of skin xerosis as a dermatological adverse event of anticancer therapy confirms the high efficacy and safety, as well as good tolerability of this method in cancer patients.

Keywords

balneotherapy / hydrotherapy / dermatologic adverse events / cancer therapy / rehabilitation / supportive treatment

References

[1] Lacouture ME, Sibaud V, Gerber PA, et al. Prevention and management of dermatological toxicities related to anticancer agents: ESMO Clinical Practice Guidelines. Ann Oncol. 2021;32(2):157–170. doi: 10.1016/j.annonc.2020.11.005

[2] Lacouture M.E., Sibaud V., Gerber P.A., et al. Prevention and management of dermatological toxicities related to anticancer agents: ESMO Clinical Practice Guidelines // Ann Oncol. 2021. Vol. 32, N 2. P. 157–170. doi: 10.1016/j.annonc.2020.11.005

[3] Koroleva IA, Bolotina LV, Gladkov OA, et al. Practical recommendations on the management of dermatologic adverse events in patients, treated with targeted anticancer drugs. Malignant Tumors: Practical Recommendations RUSSCO. 2020;10(3s2):88–101. (In Russ). doi: 10.18027 / 2224-5057-2020-10-3s2-42

[4] Королева И. А., Болотина Л. В., Гладков О. А., и др. Практические рекомендации по лекарственному лечению дерматологических реакций у пациентов, получающих противоопухолевую лекарственную терапию // Злокачественные опухоли: практические рекомендации RUSSCO. 2020. Т. 10, № 3s2. С. 88–101. doi: 10.18027 / 2224-5057-2020-10-3s2-42

[5] Segaert S, Van Cutsem E. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol. 2005;16(9):1425–1433. doi: 10.1093/annonc/mdi279

[6] Segaert S., Van Cutsem E. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors // Ann Oncol. 2005. Vol. 16, N 9. P. 1425–1433. doi: 10.1093/annonc/mdi279

[7] Osio A, Mateus C, Soria JC, et al. Cutaneous side-effects in patients on long-term treatment with epidermal growth factor receptor inhibitors. Br J Dermatol. 2009;161(3):515–521. doi: 10.1111/j.1365-2133.2009.09214.x

[8] Osio A., Mateus C., Soria J.C., et al. Cutaneous side-effects in patients on long-term treatment with epidermal growth factor receptor inhibitors // Br J Dermatol. 2009. Vol. 161, N 3. P. 515–521. doi: 10.1111/j.1365-2133.2009.09214.x

[9] Galimont-Collen AF, Vos LE, Lavrijsen AP, et al. Classification and management of skin, hair, nail and mucosal side-effects of epidermal growth factor receptor (EGFR) inhibitors. Eur J Cancer. 2007;43(5):845–851. doi: 10.1016/j.ejca.2006.11.016

[10] Galimont-Collen A.F., Vos L.E., Lavrijsen A.P., et al. Classification and management of skin, hair, nail and mucosal side-effects of epidermal growth factor receptor (EGFR) inhibitors // Eur J Cancer. 2007. Vol. 43, N 5. P. 845–851. doi: 10.1016/j.ejca.2006.11.016

[11] Common terminology criteria for adverse events (CTCAE) version 4.0. Published: May 28, 2009 (v.4.03: June 14, 2010) [Internet]. US Department of Health and Human Services; National Institute of Health; National Cancer Institute [cited 2022 Jul 13]. Available from: https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf.

[12] Common terminology criteria for adverse events (CTCAE) version 4.0. Published: May 28, 2009 (v.4.03: June 14, 2010) [Internet]. US Department of Health and Human Services; National Institute of Health; National Cancer Institute [дата обращения: 13.07.2022]. Доступ по ссылке: https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf.

[13] Michenko AV, Kruglova LS, Shatokhina EA, et al. Dermatological toxicity of EGFR inhibitors: pathogenetic rationale and an algorithm for acne-like rash correction. Oncohematology. 2021;16(4):50–58. (In Russ). doi: 10.17650/1818-8346-2021-16-4-50-58

[14] Миченко А.В., Круглова Л.С., Шатохина Е.А., и др. Дерматологическая токсичность ингибиторов EGFR: патогенетическое обоснование и алгоритм коррекции акнеподобной сыпи // Онкогематология. 2021. Т. 16, № 4. С. 50–58. doi: 10.17650/1818-8346-2021-16-4-50-58

[15] Roé E, García Muret MP, Marcuello E, et al. Description and management of cutaneous side effects during cetuximab or erlotinib treatments: a prospective study of 30 patients. J Am Acad Dermatol. 2006;55(3):429–437. doi: 10.1016/j.jaad.2006.04.062

[16] Roé E., García Muret M.P., Marcuello E. et al. Description and management of cutaneous side effects during cetuximab or erlotinib treatments: a prospective study of 30 patients // J Am Acad Dermatol. 2006. Vol. 55, N 3. P. 429–437. doi: 10.1016/j.jaad.2006.04.062

[17] Ponomarenko GN. General physiotherapy. 5th ed. Moscow: GEOTAR-Media; 2014. 368 p. (In Russ).

[18] Пономаренко Г.Н. Общая физиотерапия. 5-е изд. Москва: ГЭОТАР-Медиа, 2014. 368 с.

[19] Vorontsova LV. SPA. Guidelines for cosmetologists. Мoscow; 2008. 252 p. (In Russ).

[20] Воронцова Л.В. SPA. Руководство для косметологов. Москва, 2008. 252 с.

[21] Matsumoto S. Evaluation of the Role of Balneotherapy in Rehabilitation Medicine. J Nippon Med Sch. 2018;85(4):196–203. doi: 10.1272/jnms.JNMS.2018_85-30

[22] Matsumoto S. Evaluation of the Role of Balneotherapy in Rehabilitation Medicine // J Nippon Med Sch. 2018. Vol. 85, N 4. P. 196–203. doi: 10.1272/jnms.JNMS.2018_85-30

[23] Merial-Kieny C, Castex-Rizzi N, Selas B, et al. Avène Thermal Spring Water: an active component with specific properties. J Eur Acad Dermatol Venereol. 2011;25(Suppl. 1):2–5. doi: 10.1111/j.1468-3083.2010.03892.x

[24] Merial-Kieny C., Castex-Rizzi N., Selas B., et al. Avène Thermal Spring Water: an active component with specific properties // J Eur Acad Dermatol Venereol. 2011. Vol. 25, suppl. 1. P. 2–5. doi: 10.1111/j.1468-3083.2010.03892.x

[25] Chebassier N, El Houssein O, Viegas I, Dréno B. Stimulatory effect of boron and manganese salts on keratinocyte migration. Acta Derm Venereol. 2004;84(3):191–194. doi: 10.1080/00015550410025273

[26] Chebassier N., El Houssein O., Viegas I., Dréno B. Stimulatory effect of boron and manganese salts on keratinocyte migration // Acta Derm Venereol. 2004. Vol. 84, N 3. P. 191–194. doi: 10.1080/00015550410025273

[27] Chebassier N, El Houssein O, Viegas I, Dréno B. In vitro induction of matrix metalloproteinase-2 and matrix metalloproteinase-9 expression in keratinocytes by boron and manganese. Exp Dermatol. 2004;13(8):484–490. doi: 10.1111/j.0906-6705.2004.00197.x

[28] Chebassier N., El Houssein O., Viegas I., Dréno B. In vitro induction of matrix metalloproteinase-2 and matrix metalloproteinase-9 expression in keratinocytes by boron and manganese // Exp Dermatol. 2004. Vol. 13, N 8. P. 484–490. doi: 10.1111/j.0906-6705.2004.00197.x

[29] Faga A, Nicoletti G, Gregotti C, et al. Effects of thermal water on skin regeneration. Int J Mol Med. 2012;29(5):732–740. doi: 10.3892/ijmm.2012.917

[30] Faga A., Nicoletti G., Gregotti C., et al. Effects of thermal water on skin regeneration // Int J Mol Med. 2012. Vol. 29, N 5. P. 732–740. doi: 10.3892/ijmm.2012.917

[31] Zöller N, Valesky E, Hofmann M, et al. Impact of Different Spa Waters on Inflammation Parameters in Human Keratinocyte HaCaT Cells. Ann Dermatol. 2015;27(6):709–714. doi: 10.5021/ad.2015.27.6.709

[32] Zöller N., Valesky E., Hofmann M., et al. Impact of Different Spa Waters on Inflammation Parameters in Human Keratinocyte HaCaT Cells // Ann Dermatol. 2015. Vol. 27, N 6. P. 709–714. doi: 10.5021/ad.2015.27.6.709

[33] Dechelette C, Belaubre F, Julie S, Charveron M. Avène thermal spring water enhances normal human keratinocyte differentiation. In: World Congress of Dermatology; Buenos Aires; 2007.

[34] Dechelette C., Belaubre F., Julie S., Charveron M. Avène thermal spring water enhances normal human keratinocyte differentiation. In: World Congress of Dermatology; Buenos Aires, 2007.

[35] Lehen’kyi V, Vandenberghe M, Belaubre F, et al. Acceleration of keratinocyte differentiation by transient receptor potential vanilloid (TRPV6) channel activation. J Eur Acad Dermatol Venereol. 2011;25(Suppl. 1):12–18.

[36] Lehen’kyi V., Vandenberghe M., Belaubre F., et al. Acceleration of keratinocyte differentiation by transient receptor potential vanilloid (TRPV6) channel activation // J Eur Acad Dermatol Venereol. 2011. Vol. 25, suppl. 1. P. 12–18.

[37] Galliano MF, Bäsler K, Caruana A, et al. Protective effect of Aquaphilusdolomiae extract-G1, ADE-G1, on tight junction barrier function in a Staphylococcus aureus-infected atopic dermatitis model. J Eur Acad Dermatol Venereol. 2020;34(Suppl. 5):30–36. doi: 10.1111/jdv.16516

[38] Galliano M.F., Bäsler K., Caruana A., et al. Protective effect of Aquaphilusdolomiae extract-G1, ADE-G1, on tight junction barrier function in a Staphylococcus aureus-infected atopic dermatitis model // J Eur Acad Dermatol Venereol. 2020. Vol. 34, suppl. 5. P. 30–36. doi: 10.1111/jdv.16516

[39] Eliasse Y, Redoules D, Espinosa E. Impact of Avène Thermal Spring Water on immune cells. J Eur Acad Dermatol Venereol. 2020;34(Suppl. 5):21–26. doi: 10.1111/jdv.16335

[40] Eliasse Y., Redoules D., Espinosa E. Impact of Avène Thermal Spring Water on immune cells // J Eur Acad Dermatol Venereol. 2020. Vol. 34, suppl. 5. P. 21–26. doi: 10.1111/jdv.16335

[41] Mahé YF, Martin R, Aubert L, et al. Induction of the skin endogenous protective mitochondrial MnSOD by Vitreoscilla filiformis extract. Int J Cosmet Sci. 2006;28(4):277–287. doi: 10.1111/j.14672494.2006.00333.x

[42] Mahé Y.F., Martin R., Aubert L., et al. Induction of the skin endogenous protective mitochondrial MnSOD by Vitreoscilla filiformis extract // Int J Cosmet Sci. 2006. Vol. 28, N 4. P. 277–287. doi: 10.1111/j.1467-2494.2006.00333.x

[43] Mahe YF, Perez MJ, Tacheau C, et al. A new Vitreoscilla filiformis extract grown on spa water enriched medium activates endogenous cutaneous antioxidant and antimicrobial defenses through a potential Toll-like receptor 2/protein kinase C, zeta transduction pathway. Clin Cosmet Investig Dermatol. 2013;6:191–196. doi: 10.2147/CCID.S47324

[44] Mahe Y.F., Perez M.J., Tacheau C., et al. A new Vitreoscilla filiformis extract grown on spa water enriched medium activates endogenous cutaneous antioxidant and antimicrobial defenses through a potential Toll-like receptor 2/protein kinase C, zeta transduction pathway // Clin Cosmet Investig Dermatol. 2013. Vol. 6. P. 191–196. doi: 10.2147/CCID.S47324

[45] Kruglova LS, Shatokhina EA, Kotenko KV, Korchazhkina NB. The use of the physical therapy methods for the rehabilitation of the patients presenting with cancer pathology. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016;15(2):97–101. (In Russ). doi: 10.18821/1681-3456-2016-15-2-97-101

[46] Круглова Л.С., Шатохина Е.А., Котенко К.В., Корчажкина Н.Б. Использование физиотерапевтических методов в реабилитации больных с онкологической патологией // Физиотерапия, бальнеология и реабилитация. 2016. Т. 15, № 2. С. 97–101. doi: 10.18821/1681-3456-2016-15-2-97-101

[47] Persiyanova-Dubrova AL, Badalov NG, Kavunenko DV. The specific methodological features of scientific research in the field of balneotherapy. Problems of Balneology, Physiotherapy, and Exercise Therapy. 2019;96(1):63–68. (In Russ). doi: 10.17116/kurort20199601163

[48] Персиянова-Дуброва А.Л., Бадалов Н.Г., Кавуненко Д.В. Методологичеcкие особенности проведения научных исследований в области бальнеотерапии // Вопросы курортологии, физиотерапии и лечебной физической культуры. 2019. Т. 96, № 1. С. 63–68. doi: 10.17116/kurort20199601163

[49] Dalenc F, Ribet V, Rossi AB, et al. Efficacy of a global supportive skin care programme with hydrotherapy after non-metastatic breast cancer treatment: A randomised, controlled study. Eur J Cancer Care (Engl). 2018;27(1). doi: 10.1111/ecc.12735

[50] Dalenc F., Ribet V., Rossi A.B., et al. Efficacy of a global supportive skin care programme with hydrotherapy after non-metastatic breast cancer treatment: A randomised, controlled study // Eur J Cancer Care (Engl). 2018. Vol. 27, N 1. doi: 10.1111/ecc.12735

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