Predicting acute radiation dermatitis in breast cancer: a prospective cohort study

Xie, Yuxiu; Hu, Ting; Chen, Renwang; Chang, Haiyan; Wang, Qiong; Cheng, Jing

doi:10.1186/s12885-023-10821-6

Cited by 10 publications

(5 citation statements)

References 51 publications

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“…ARD is the most common toxicity occurring during the course of RT or shortly afterwards (5). In previous studies, the prevalence of grade ≥2 ARD ranged between 3% and 76% (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). Considering this wide range, additional studies are needed.…”

Section: Discussionmentioning

confidence: 99%

Radiation Dermatitis and Pneumonitis in Patients Irradiated for Breast Cancer

EGGERT,

YU,

RADES

2023

In Vivo

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Background/Aim: Adjuvant radiotherapy (RT) for breast cancer can be associated with acute dermatitis (ARD) and pneumonitis (RP). Prevalence and risk factors were characterized. Patients and Methods: This study included 489 breast cancer patients receiving adjuvant RT with conventional fractionation (CF) ± sequential or simultaneous integrated boost, or hypo-fractionation ± sequential boost. RTregimen and 15 characteristics were investigated for grade ≥2 ARD and RP. Results: Prevalence of grade ≥2 ARD and RP was 25.3% and 2.5%, respectively. On univariate analyses, ARD was significantly associated with CF and radiation boost (p<0.0001), age ≤60 years (p=0.008), and systemic treatment (p=0.002). On multivariate analysis, and age (p=0.009) were associated with ARD. Chronic inflammatory disease was significantly associated with RP on univariate (p=0.007) and multivariate (p=0.016) analyses. Conclusion: Risk factors for grade ≥2 ARD and RP were determined that may help identify patients who require closer monitoring during and after RT.Breast cancer is the most common cancer type in females in Western countries (1, 2). Many of these women with nonmetastatic disease receive breast conserving surgery or mastectomy followed by local or loco-regional irradiation (3,4). Adjuvant radiotherapy (RT) may be associated with adverse events including acute radiation dermatitis (ARD) and radiation pneumonitis (RP) (5,6). ARD was reported to have a negative impact on the patients' quality of life, and RP can even be fatal (7, 8). In the literature, the prevalence of clinically relevant grade ≥2 ARD ranges between 3% and 76%, with higher rates in patients treated with conventional fractionation (CF) than in patients receiving hypofractionation (HF) (9-26). ARD usually develops during the second to third week of radiotherapy, becomes more severe during the further RT-course and possibly the first post-RT week, and disappears a few weeks after completion of RT (5). In contrast, RP is considered a subacute effect of RT, which often develops only several weeks or months following RT (6). The prevalence of RP after RT of breast cancer ranges between 0.8% and 19. 6% (6, 10, 27-33). Considering the comparably wide ranges regarding the prevalence of ARD and RP, it becomes obvious that additional studies are required to more precisely define the prevalence of these two RT-related side effects in breast cancer patients. Our present study evaluated the prevalence in a cohort of breast cancer patients irradiated between 2016 and 2019. Moreover, it aimed to determine risk factors for ARD and RP, in order to contribute to early identification of patients at risk who would benefit from closer monitoring of adverse events during and after the RT-course. Patients and MethodsThe present retrospective study investigated grade ≥2 ARD and grade ≥2 RP in 489 female breast cancer patients treated with adjuvant radiotherapy between 2016 and 2019. The original study protocol and an amendment were approved by the ethics committee of the University of Lü...

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Section: Discussionmentioning

confidence: 99%

Radiation Dermatitis and Pneumonitis in Patients Irradiated for Breast Cancer

EGGERT,

YU,

RADES

2023

In Vivo

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“…Normo-fractionated radiotherapy was associated with a higher risk of acute dermatitis in several studies and review articles (4, 5, 13, 15-17, 21-23, 31-33). So were the administration of a radiation boost (4,5,19,32,34) and the history of smoking prior to or during the course of radiotherapy (4,12,16,29,35,36). Diabetes mellitus was associated with an increased risk of acute dermatitis in one prospective cohort study and a meta-analysis (4,29).…”

Section: Discussionmentioning

confidence: 99%

“…So were the administration of a radiation boost (4,5,19,32,34) and the history of smoking prior to or during the course of radiotherapy (4,12,16,29,35,36). Diabetes mellitus was associated with an increased risk of acute dermatitis in one prospective cohort study and a meta-analysis (4,29). In addition, a prospective trial showed a trend for an association between diabetes mellitus and radiation dermatitis (37), and another study found an association between diabetes mellitus and late radiationrelated skin toxicity (19).…”

Section: Discussionmentioning

confidence: 99%

Clinically Significant Dermatitis During Adjuvant Radiotherapy for Invasive Breast Cancer

RADES,

KRISTIANSEN,

TIMKE

et al. 2024

Anticancer Res

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Background/Aim: Patients with breast cancer receiving adjuvant radiotherapy may experience grade ≥2 dermatitis. In the Interreg-project HeAT, a mobile application (app) reminding patients to perform skin care will be prospectively tested with the goal of decreasing clinically significant radiation dermatitis. This study aimed to identify the prevalence of grade ≥2 dermatitis and risk factors, required for designing the prospective trial. Patients and Methods: In a retrospective study of 327 patients with breast cancer irradiated during 2022-2023, the prevalence of grade ≥2 dermatitis and 23 potential risk factors were investigated. Results: The prevalence of grade ≥2 dermatitis was 31.2%. On multivariate analysis, it was significantly associated with chronic inflammatory disease (p=0.001), significant cardiovascular disease (p<0.001), smoking history >10 pack years (p<0.001), advanced T-stage (p=0.017), normo-fractionation (p<0.001), and radiation boost (p<0.001). Conclusion: The prevalence of grade ≥2 dermatitis and independent risk factors during adjuvant radiotherapy for invasive breast cancer were identified that contribute to improved patient care and the design of a prospective trial.

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“…Radiotherapy is widely used in the clinical treatment of cancer, more than 50% of cancer patients need radiotherapy [ 3] ,it is called three traditional cancer therapies together with surgery and chemotherapy. However, when radiation kills tumor cells, it also causes an acute reaction in the irradiated area of normal skin [ 4] .95% of cancer patients receive radiotherapy will appear acute radioactive dermatitis (Acute Radiation Dermatitis, ARD) [ 5] .…”

Section: Introductionmentioning

confidence: 99%

Disease experience of patients with acute radiodermatitis: a qualitative study

Wang,

Shi,

Guo

et al. 2024

Preprint

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Objectives To understand the true feelings and disease experience of radiodermatitis patients and to provide reference for formulating accurate intervention and support strategies for this group. Methods A semi-structured interview was conducted by using an objective sampling with patients who received radiotherapy in the tertiary hospital in Shanxi province from October 2023 to January 2024. With the help of Nvivo software, Colaizzi's seven-step analysis and triangulation were used to analyze the Interview data and extract themes. Results The disease experience of patients with acute radiation dermatitis can be summarized into 4 themes:(1) Decreased quality of daily life: sleep quality decreased, living habits forced to change;(2) Negative psychological experience: anxiety, decreased self-efficacy;(3) Disease coping style: active response, negative avoidance;(4) Resource requirements: desire for phased access to disease information, desire for more cost-effective preventive medicines. Conclusions The disease experience of patients with acute radiation dermatitis has specific and diverse attributes. Nurses should pay attention to the status of patients and self-perceived burden, guide patients to establish correct disease cognition and improve self-efficacy so as to promote positive coping. Strengthen the support of family, hospital and society to meet the needs of patients effectively. Through scientific and effective intervention to improve the quality of life and reduce the incidence of adverse outcomes of patients.

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Predicting acute radiation dermatitis in breast cancer: a prospective cohort study

Cited by 10 publications

References 51 publications

Radiation Dermatitis and Pneumonitis in Patients Irradiated for Breast Cancer

Radiation Dermatitis and Pneumonitis in Patients Irradiated for Breast Cancer

Clinically Significant Dermatitis During Adjuvant Radiotherapy for Invasive Breast Cancer

Disease experience of patients with acute radiodermatitis: a qualitative study

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