Abstract
Evaluate and classify skin reactions through the Radiation Therapy Oncology Group (RTOG) criteria and characterize factors that can intervene in these reactions. Prospective study, with 86 women submitted to adjuvant breast radiotherapy with a total dose of 5040cGy, in a 6 MeV Linear Accelerator. Personal data were collected and breast size was measured (distance between field separation and breast height). The treated skin area was evaluated weekly. Breast height and treatment technique were significant factors in the univariate analysis for the incidence of degree 3 skin reactions. However, only breast height was a significant factor in the multivariate analysis for the severity of skin reactions. The chances of occurring degree 3 reactions increase 2.61 times for each increase in height unit (cm). These findings allow nurses to plan more adequate and individualized procedures for each patient and contribute to the optimization of treatment.
Highlights
Radiotherapy has been used as adjuvant therapy in patients with breast cancer submitted to conservative surgeries in initial stages
All topical products prescribed by the physicians were recorded, though, due to their variety, they were only considered as adjunct factors in the irradiation effect on the skin
Breasts were marked in the following regions: superior exterior quadrant (QSE), superior internal quadrant (QSI), inferior external quadrant (QIE), inferior internal quadrant (QII), central quadrant (QC) and inframammary region (IM)
Summary
Radiotherapy has been used as adjuvant therapy in patients with breast cancer submitted to conservative surgeries in initial stages. It aims to diminish loco-regional recurrence and favor survival[1,2]. In 1982, the Radiation Therapy Oncology Group (RTOG) developed the Radiation Morbidity Scoring Criteria to classify radiotherapy effects. It identifies degree 0 (no reaction), 1 (faint erythema, dry desquamation, epilation, diminished sweating), 2 (moderate, brisk erythema, exudative dermatitis in plaques and moderate edema), 3 (exudative dermatitis, besides cutaneous folds and intense edema) and 4 (ulceration, hemorrhage, necrosis). RTOG score has been widely employed for more than 25 years and is accepted and acknowledged by medical and nursing communities[5]
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