1. A Prospective Randomized Controlled Trial to Compare the Use of Conventional Dark-Ink Tattoo and Ultraviolet-Ink Tattoo for Patients Undergoing Breast Radiation Therapy
- Author
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Bryan Shihan Ho, Grace Kusumawidjaja, Avelyn Yun Fang Sim, Wee Loon Ng, Eu Tiong Chua, Li Hoon Lim, Rehena Sultana, Ru Xin Wong, Faye Lynette Wei Tching Lim, Fuh Yong Wong, Eric Pei Ping Pang, and Richard M.C. Yeo
- Subjects
Body image perception ,Tattooing ,business.industry ,Radiotherapy Planning, Computer-Assisted ,medicine.medical_treatment ,Significant difference ,Radiotherapy Dosage ,Middle Aged ,Breast radiation ,medicine.disease ,law.invention ,Radiation therapy ,Minimal effect ,Breast cancer ,Oncology ,Randomized controlled trial ,law ,medicine ,Humans ,Initial treatment ,Ink ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,business ,Nuclear medicine - Abstract
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.
- Published
- 2021