Correlation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study

Abstract ORCID: 0000–0001-6019–7309. In the treatment of breast cancer, intensity-modulated radiation therapy (IMRT) reportedly reduces the high-dose irradiation of at-risk organs and decreases the frequency of adverse events (AEs). Comparisons with conventional radiotherapy have shown that IMRT is...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	David Pasquier, Benoit Bataille, Florence Le Tinier, Raoudha Bennadji, Hélène Langin, Alexandre Escande, Emmanuelle Tresch, Franck Darloy, Damien Carlier, Frederik Crop, Eric Lartigau
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2e2dc4130ff547289a41c701fb24758e
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2e2dc4130ff547289a41c701fb24758e
record_format	dspace
spelling	oai:doaj.org-article:2e2dc4130ff547289a41c701fb24758e2021-12-02T14:26:48ZCorrelation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study10.1038/s41598-021-83159-32045-2322https://doaj.org/article/2e2dc4130ff547289a41c701fb24758e2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83159-3https://doaj.org/toc/2045-2322Abstract ORCID: 0000–0001-6019–7309. In the treatment of breast cancer, intensity-modulated radiation therapy (IMRT) reportedly reduces the high-dose irradiation of at-risk organs and decreases the frequency of adverse events (AEs). Comparisons with conventional radiotherapy have shown that IMRT is associated with lower frequencies of acute and late-onset AEs. Here, we extended a prospective, observational, single-center study of the safety of IMRT to a second investigating center. Patients scheduled for adjuvant IMRT after partial or total mastectomy were given a dose of 50 Gy (25 fractions of 2 Gy over 5 weeks), with a simultaneous integrated boost in patients having undergone conservative surgery. 300 patients were included in the study, and 288 were analyzed. The median follow-up period was 2.1 years. The 2-year disease-free survival rate [95% CI] was 93.4% [89.2–96.0%]. Most AEs were mild. The most common AEs were skin-related—mainly radiodermatitis [in 266 patients (92.4%)] and hyperpigmentation (in 178 (61.8%)). 35% and 6% of the patients presented with grade 2 acute skin and esophageal toxicity, respectively. Only 4 patients presented with a grade 3 event (radiodermatitis). Smoking (odds ratio) [95% CI] = 2.10 [1.14–3.87]; p = 0.017), no prior chemotherapy (0.52 [0.27–0.98]; p = 0.044), and D98% for subclavicular skin (1.030 [1.001–1.061]; p = 0.045) were associated with grade ≥ 2 acute AEs. In a univariate analysis, the mean dose, (p < 0.0001), D2% (p < 0.0001), D50% (p = 0.037), D95% (p = 0.0005), D98% (p = 0.0007), V30Gy (p < 0.0001), and V45Gy (p = 0.0001) were significantly associated with grade ≥ 1 acute esophageal AEs. In a multivariate analysis, D95% for the skin (p < 0.001), D98% for the subclavicular skin and low D95% for the internal mammary lymph nodes were associated with grade ≥ 1 medium-term AEs. The safety profile of adjuvant IMRT after partial or total mastectomy is influenced by dosimetric parameters. Trial registration: ClinicalTrials.gov NCT02281149.David PasquierBenoit BatailleFlorence Le TinierRaoudha BennadjiHélène LanginAlexandre EscandeEmmanuelle TreschFranck DarloyDamien CarlierFrederik CropEric LartigauNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q David Pasquier Benoit Bataille Florence Le Tinier Raoudha Bennadji Hélène Langin Alexandre Escande Emmanuelle Tresch Franck Darloy Damien Carlier Frederik Crop Eric Lartigau Correlation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study
description	Abstract ORCID: 0000–0001-6019–7309. In the treatment of breast cancer, intensity-modulated radiation therapy (IMRT) reportedly reduces the high-dose irradiation of at-risk organs and decreases the frequency of adverse events (AEs). Comparisons with conventional radiotherapy have shown that IMRT is associated with lower frequencies of acute and late-onset AEs. Here, we extended a prospective, observational, single-center study of the safety of IMRT to a second investigating center. Patients scheduled for adjuvant IMRT after partial or total mastectomy were given a dose of 50 Gy (25 fractions of 2 Gy over 5 weeks), with a simultaneous integrated boost in patients having undergone conservative surgery. 300 patients were included in the study, and 288 were analyzed. The median follow-up period was 2.1 years. The 2-year disease-free survival rate [95% CI] was 93.4% [89.2–96.0%]. Most AEs were mild. The most common AEs were skin-related—mainly radiodermatitis [in 266 patients (92.4%)] and hyperpigmentation (in 178 (61.8%)). 35% and 6% of the patients presented with grade 2 acute skin and esophageal toxicity, respectively. Only 4 patients presented with a grade 3 event (radiodermatitis). Smoking (odds ratio) [95% CI] = 2.10 [1.14–3.87]; p = 0.017), no prior chemotherapy (0.52 [0.27–0.98]; p = 0.044), and D98% for subclavicular skin (1.030 [1.001–1.061]; p = 0.045) were associated with grade ≥ 2 acute AEs. In a univariate analysis, the mean dose, (p < 0.0001), D2% (p < 0.0001), D50% (p = 0.037), D95% (p = 0.0005), D98% (p = 0.0007), V30Gy (p < 0.0001), and V45Gy (p = 0.0001) were significantly associated with grade ≥ 1 acute esophageal AEs. In a multivariate analysis, D95% for the skin (p < 0.001), D98% for the subclavicular skin and low D95% for the internal mammary lymph nodes were associated with grade ≥ 1 medium-term AEs. The safety profile of adjuvant IMRT after partial or total mastectomy is influenced by dosimetric parameters. Trial registration: ClinicalTrials.gov NCT02281149.
format	article
author	David Pasquier Benoit Bataille Florence Le Tinier Raoudha Bennadji Hélène Langin Alexandre Escande Emmanuelle Tresch Franck Darloy Damien Carlier Frederik Crop Eric Lartigau
author_facet	David Pasquier Benoit Bataille Florence Le Tinier Raoudha Bennadji Hélène Langin Alexandre Escande Emmanuelle Tresch Franck Darloy Damien Carlier Frederik Crop Eric Lartigau
author_sort	David Pasquier
title	Correlation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study
title_short	Correlation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study
title_full	Correlation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study
title_fullStr	Correlation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study
title_full_unstemmed	Correlation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study
title_sort	correlation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2e2dc4130ff547289a41c701fb24758e
work_keys_str_mv	AT davidpasquier correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy AT benoitbataille correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy AT florenceletinier correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy AT raoudhabennadji correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy AT helenelangin correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy AT alexandreescande correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy AT emmanuelletresch correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy AT franckdarloy correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy AT damiencarlier correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy AT frederikcrop correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy AT ericlartigau correlationbetweentoxicityanddosimetricparametersforadjuvantintensitymodulatedradiationtherapyofbreastcanceraprospectivestudy
_version_	1718391301040242688

Correlation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study

Ejemplares similares