Acute radiotherapy toxicity in breast cancer patients

Abstract

20592 Background: Radiotherapy is associated with several side effects, which adversely affect the quality of life. The aim of the study was to estimate the level of fatigue and radiation induced skin reaction after adjuvant postoperative radiotherapy of breast cancer patients after breast-conserving surgery. Methods: 50 patients (age 33–72 years, mean 56 years) with early breast cancer after breast- conserving surgery were treated with adjuvant radiotherapy between February 2006 and February 2007. RTOG Acute Radiation Morbidity Scoring Criteria (0–4) were used for the estimation of acute skin reaction. For quantitative evaluation of the erythema a reflectance spectrophotometr (Derma Spectrometr, Corex) with digital read-out was used. The subjective feeling of fatigue intensity was measured according to 10-score visual analog scale (VAS). Examinations were done before and weekly during radiotherapy, as well as 1 and 3 months after it. Results: Fatigue intensity increased gradually during radiotherapy (mean fatigue-VAS before and in the last week of treatment was 1.44 and 3.38 respectively; p=0.004). 1 month after the end of radiotherapy, fatigue intensity was still higher than before treatment (1.92; p=0.04), but 3 months after radiotherapy, fatigue relapsed to the pretreatment level. On the last day of radiotherapy patients estimated acute skin reaction according to RTOG scale on mean 1.52 (median 2), nurses on mean 1.16 (median 1). The objective measurments of erythema by the reflectance spectrophotometr were compatible with nurses‘ RTOG scale results. There was a correlation between fatigue level and intensity of skin reaction. Mean fatigue VAS was 2.75 and 4.76 for patients who estimated skin reaction on 0–1 and 2–4, respectively. Conclusions: Fatigue increased over the course of adjuvant radiotherapy in breast cancer patients. There was a positive correlation between fatigue level and intensity of skin reaction. Patients estimate radiation-induced skin side effects on higher level than nurses. RTOG scale was equivalent to the reflectance spectrophotometr. No significant financial relationships to disclose.