Abstract
Background: Up to 95% of irradiated patients suffer from ionizing radiation (IR) induced early skin reaction, acute radiation dermatitis (ARD). Some experts think that additional skin hydration can reduce acute skin reactions. Individual radiosensitivity (IRS) determined from lymphocytes may help to predict acute radiation toxicity. The purpose of this study is to evaluate the clinical manifestation of ARD in different skincare groups during whole breast radiotherapy depending on IRS and other risk factors. Methods: A total of 108 early-stage breast cancer patients were randomized into best supportive care (BSC) and additional skincare (ASC) groups. IRS was evaluated using a G2 assay modified with caffeine-induced G2 checkpoint arrest. All patients received a 50 Gy dose to the breast planning target volume (PTV). Clinical assessment of ARD symptoms according to the CTCAE grading scale was performed once a week. Results: IRS was successfully determined for 91 out of 108 patients. A total of 10 patients (11%) had normal IRS, 47 patients (52%) were categorized as radiosensitive, and 34 (37%) as highly radiosensitive. There was no significant difference in the manifestation of ARD between patient groups by skincare or IRS. According to logistic regression, patients with bigger breasts were prone to more severe ARD (p = 0.002). Conclusions: The additional skincare did not improve skin condition during RT. A total of 89% of patients had increased radiosensitivity. IRS determined before RT did not show the predictive value for the manifestation of ARD. Logistic regression revealed that breast volume was the most significant risk factor for the manifestation of ARD.
Highlights
Breast cancer is the most common type of oncological disease among women, with more than 2 million new cases worldwide annually, and the most common cause of death among women with more than 600,000 deaths per year [1].Whole breast radiotherapy (WBRT) after breast-conserving surgery (BCS) is the standard treatment for breast cancer patients due to its beneficial effect on survival, low risk of local recurrence, and acceptable cosmetic results [2,3].Almost all irradiated patients suffer from ionizing radiation (IR)-induced early skin reaction, acute radiation dermatitis (ARD)
We present results from a prospective, randomized, open-label singlecenter biomedical study focusing on the influence of Individual radiosensitivity (IRS) and other risk factors on ARD manifestation in breast cancer patients with different skincare during RT
There were no significant differences among IRS groups according to age, disease stage, hormone therapy, breast volume, skincare, and RT dose (Table 1)
Summary
Breast cancer is the most common type of oncological disease among women, with more than 2 million new cases worldwide annually, and the most common cause of death among women with more than 600,000 deaths per year [1].Whole breast radiotherapy (WBRT) after breast-conserving surgery (BCS) is the standard treatment for breast cancer patients due to its beneficial effect on survival, low risk of local recurrence, and acceptable cosmetic results [2,3].Almost all irradiated patients suffer from ionizing radiation (IR)-induced early skin reaction, acute radiation dermatitis (ARD). The clinical manifestation of ARD varies from mild erythema to moist desquamation and depends on various risk factors. Technical risk factors such as total IR dose, fractionation, etc., can be modified, while patient-related factors cannot. The purpose of this study is to evaluate the clinical manifestation of ARD in different skincare groups during whole breast radiotherapy depending on IRS and other risk factors. Methods: A total of 108 early-stage breast cancer patients were randomized into best supportive care (BSC) and additional skincare (ASC) groups. There was no significant difference in the manifestation of ARD between patient groups by skincare or IRS.
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