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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Autores principales: 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
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Publicado: MDPI AG 2021
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spelling 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
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