A Comprehensive Prospective Comparison of Acute Skin Toxicity after Hypofractionated and Normofractionated Radiation Therapy in Breast Cancer
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. Evaluati...
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2021
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oai:doaj.org-article:c259f566c0c54fcf92502251d57769c52021-11-25T17:04:28ZA Comprehensive Prospective Comparison of Acute Skin Toxicity after Hypofractionated and Normofractionated Radiation Therapy in Breast Cancer10.3390/cancers132258262072-6694https://doaj.org/article/c259f566c0c54fcf92502251d57769c52021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5826https://doaj.org/toc/2072-6694The 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); <i>p</i> = 0.03; Skindex-16: CF: 20.8 (IQR: 25.8); HF: 8.3 (27.1); <i>p</i> = 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.Kai J. BormJohanne Kleine VennekateJan VagedesMohammad O. A. IslamMarciana N. DumaMaximilian LoosStephanie E. CombsKilian SchillerSophie KlusenStefan PaepkeMarion B. KiechleDaniela PaepkeMDPI AGarticlebreast cancerradiotherapyhypofractionationorgan-sparingradiodermatitisNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5826, p 5826 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
breast cancer radiotherapy hypofractionation organ-sparing radiodermatitis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 |
| spellingShingle |
breast cancer radiotherapy hypofractionation organ-sparing radiodermatitis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Kai J. Borm Johanne Kleine Vennekate Jan Vagedes Mohammad O. A. Islam Marciana N. Duma Maximilian Loos Stephanie E. Combs Kilian Schiller Sophie Klusen Stefan Paepke Marion B. Kiechle Daniela Paepke A Comprehensive Prospective Comparison of Acute Skin Toxicity after Hypofractionated and Normofractionated Radiation Therapy in Breast Cancer |
| description |
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); <i>p</i> = 0.03; Skindex-16: CF: 20.8 (IQR: 25.8); HF: 8.3 (27.1); <i>p</i> = 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. |
| format |
article |
| author |
Kai J. Borm Johanne Kleine Vennekate Jan Vagedes Mohammad O. A. Islam Marciana N. Duma Maximilian Loos Stephanie E. Combs Kilian Schiller Sophie Klusen Stefan Paepke Marion B. Kiechle Daniela Paepke |
| author_facet |
Kai J. Borm Johanne Kleine Vennekate Jan Vagedes Mohammad O. A. Islam Marciana N. Duma Maximilian Loos Stephanie E. Combs Kilian Schiller Sophie Klusen Stefan Paepke Marion B. Kiechle Daniela Paepke |
| author_sort |
Kai J. Borm |
| title |
A Comprehensive Prospective Comparison of Acute Skin Toxicity after Hypofractionated and Normofractionated Radiation Therapy in Breast Cancer |
| title_short |
A Comprehensive Prospective Comparison of Acute Skin Toxicity after Hypofractionated and Normofractionated Radiation Therapy in Breast Cancer |
| title_full |
A Comprehensive Prospective Comparison of Acute Skin Toxicity after Hypofractionated and Normofractionated Radiation Therapy in Breast Cancer |
| title_fullStr |
A Comprehensive Prospective Comparison of Acute Skin Toxicity after Hypofractionated and Normofractionated Radiation Therapy in Breast Cancer |
| title_full_unstemmed |
A Comprehensive Prospective Comparison of Acute Skin Toxicity after Hypofractionated and Normofractionated Radiation Therapy in Breast Cancer |
| title_sort |
comprehensive prospective comparison of acute skin toxicity after hypofractionated and normofractionated radiation therapy in breast cancer |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/c259f566c0c54fcf92502251d57769c5 |
| work_keys_str_mv |
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