A Comprehensive Prospective Comparison of Acute Skin Toxicity after Hypofractionated and Normofractionated Radiation Therapy in Breast Cancer

Cancers

Jan Vagedes¹  Mohammad O. A. Islam¹  Marion B. Kiechle²  Stefan Paepke²  Daniela Paepke²  Kilian Schiller³  Marciana N. Duma³  Johanne Kleine Vennekate³  Maximilian Loos³  Kai J. Borm³  Stephanie E. Combs³  Sophie Klusen³ 

[1] ARCIM Institute (Academic Research in Complementary and Integrative Medicine), 70794 Filderstadt, Germany;Department of Gynecology and Obstetrics, Technical University of Munich (TUM), Ismaninger Strasse 22, 81675 Munich, Germany;Department of Radiation Oncology, Klinikum Rechts der Isar, Medical School, Technical University Munich, 81675 Munich, Germany;

关键词: breast cancer;    radiotherapy;    hypofractionation;    organ-sparing;    radiodermatitis;   

DOI  :  10.3390/cancers13225826

来源: DOAJ

【 摘 要 】

The current study aims to determine whether hypofractionated radiotherapy (HF) leads to lower rates of acute radiodermatitis compared to conventional normofractionated radiotherapy (CF). A total of 166 patients with invasive breast cancer or DCIS were included in a prospective cohort study. Evaluation of acute radiodermatitis was obtained before radiotherapy, at the end of the treatment (T1), and 6 weeks after the treatment (T2) using CTCAE (v5.0) scores, the Skindex-16 questionnaire, and ultrasound measurement of the skin. CTCAE and Skindex-16 scores in the CF-group were significantly higher compared to the HF group indicating more pronounced side effects at the end of the treatment (CTCAE: CF-RT 1.0 (IQR: 0.0) vs. HF-RT 0.0 (0.25); p = 0.03; Skindex-16: CF: 20.8 (IQR: 25.8); HF: 8.3 (27.1); p = 0.04). At 6 weeks after the treatment, no significant differences between the two fractionation schemes were observed. Ultrasound based assessment showed that the skin thickness in the treated breast was higher compared to the healthy breast at all time-points. However, no significant difference between HF and CF was seen either at T1 or T2. The current study complements and confirms pre-existing evidence that HF leads to a lower degree of acute radiodermatitis and better patient reported outcome compared to CF at the end of treatment. This should be considered whenever fractionation of adjuvant breast cancer treatment is being discussed.

【 授权许可】

Unknown