Purpose

Permanent tattoo marks used in radiation therapy remain for the duration of treatment and essentially for the rest of the patient's life. This study compared the initial positioning setup errors and body image perception between patients with ultraviolet (UV) and conventional dark ink tattoos.

Methods and Materials

Thirty-four patients from February 2018 to March 2019, who underwent radiation therapy (RT) to the breast or chest wall for ductal carcinoma in situ or breast cancer were prospectively recruited and randomized (1:1) to receive either conventional dark ink or UV ink tattoos. Each patient received the assigned tattoos during computed tomography (CT) simulation and initial treatment setup shifts were compared. A 9-item body-image survey was administered to all patients at 3 time points: CT simulation, last week of RT, and 6 weeks post-RT. Feedback from CT and treatment staff in terms of setup time and challenges were collated.

Results

The median age of the patient cohort was 46 years old. No statistically significant difference was observed between the mean setup errors for the conventional dark ink group (0.11 cm inferior, 0.01 cm left, 0.11 cm posterior) and UV ink group (0.01 cm superior, 0.01 cm right, 0.06 cm posterior; P = NS). Similar responses were observed in the body-image survey between the 2 groups across all time points (P = NS). The majority of the patients (dark ink 82.3% vs UV ink 88.2%) did not feel less sexually attractive as a result of the tattoo at 6 weeks post-RT. At 6 weeks post-RT, patients in both groups were satisfied with the appearance of the tattoo and did not feel cautious about their choice of clothes (82.4% vs 88.2%; P = NS). In addition, 88.6% of staff (n = 35) felt minimum effect of UV ink on the overall setup time, and 94.3% found no difficulty localizing the UV ink tattoos during patient positioning.

Conclusions

No difference in setup accuracy was found using UV ink tattoos, and it could be implemented clinically with minimal effect on the existing workflow. Patients expressed high satisfaction and self-confidence with the use of UV ink tattoos.

中文翻译：

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一项前瞻性随机对照试验，比较传统深色墨水纹身和紫外线墨水纹身对接受乳房放射治疗的患者的使用

目的

放射治疗中使用的永久性纹身标记会在治疗期间保留，并且基本上会在患者的余生中保留。本研究比较了紫外线 (UV) 和传统深色墨水纹身患者之间的初始定位设置误差和身体图像感知。

方法和材料

前瞻性招募了 2018 年 2 月至 2019 年 3 月期间接受乳房或胸壁放射治疗 (RT) 的 34 名原位导管癌或乳腺癌患者，并随机 (1:1) 接受常规深色墨水或紫外线治疗墨水纹身。每位患者在计算机断层扫描 (CT) 模拟期间接受了指定的纹身，并比较了初始治疗设置的变化。在 3 个时间点对所有患者进行了 9 项身体图像调查：CT 模拟、放疗的最后一周和放疗后的 6 周。整理了 CT 和治疗人员在设置时间和挑战方面的反馈。

结果

患者队列的中位年龄为 46 岁。传统深色墨水组（下 0.11 厘米，左 0.01 厘米，后 0.11 厘米）和 UV 墨水组（上 0.01 厘米，右 0.01 厘米，后 0.06 厘米；P  = NS ）。在所有时间点的两组之间的身体图像调查中观察到类似的反应（P  = NS）。大多数患者（深色墨水 82.3% 与紫外线墨水 88.2%）在 RT 后 6 周并没有因为纹身而感到性吸引力降低。放疗后 6 周时，两组患者对纹身的外观都感到满意，对衣服的选择并不谨慎（82.4% vs 88.2%；P = NS）。此外，88.6% 的员工 (n = 35) 认为 UV 墨水对整体设置时间的影响最小，94.3% 发现在患者定位期间定位 UV 墨水纹身没有困难。

结论

使用 UV 墨水纹身在设置精度上没有发现差异，它可以在临床上实施，对现有工作流程的影响最小。患者对使用UV墨水纹身表示高度满意和自信。