Radiation-induced Skin Toxicity in Breast Cancer Patients: A Systematic Review of Randomized Trials

Yee, Caitlin; Wang, Katie; Asthana, Rashi; Drost, Leah; Lam, Henry; Lee, Justin; Vesprini, Danny; Leung, Eric; DeAngelis, Carlo; Chow, Edward

doi:10.1016/j.clbc.2018.06.015

Cited by 90 publications

(90 citation statements)

References 100 publications

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“…There is a paucity of data describing persistent PN in ESBC patients Xiao et al [ 50 ] 2018 Effects of adjuvant endocrine therapy on the QOL of post-menopausal women with non-metastatic ER+ Systematic review 3 13 Yes No Most studies found no differences between tamoxifen and aromatase inhibitor groups in terms of global QOL. The QOL of post-menopausal women is unlikely to be adversely affected by long-term use of adjuvant endocrine therapy Yee et al [ 51 ] 2018 Radiation-induced skin toxicity in breast cancer patients Systematic review NA 96 Yes No Methods including simultaneous integrated boost, accelerated partial breast irradiation, and prone positioning may cause less radiation dermatitis than conventional treatments Cheng et al [ 52 ] 2018 QOL of elderly patients with solid tumors undergoing adjuvant cancer therapy Systematic review 5 4 Yes Yes Adjuvant chemotherapy and radiotherapy may not have detrimental effects on QOL in most elderly patients with solid tumors Muller et al [ 53 ] 2018 Impact of manual lymphatic drainage on the HRQOL Systematic review 6 8 Yes Yes No studies reported reductions in HRQOL, or severe adverse events after MLD Jeffs et al [ 54 ] 2018 Effectiveness of decongestive treatments on excess arm volume and patient-centered outcomes in women with early breast cancer-related arm lymphedema Systematic review 3 7 …”

Section: Resultsmentioning

confidence: 99%

Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018

Mokhatri-Hesari

Montazeri

2020

Health Qual Life Outcomes

265

169

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Background Breast cancer still is a topic. This overview of the literature aimed to update the current knowledge on quality of life in breast cancer patients. Methods A review of literature in MEDLINE, Cochrane Database of Systematic Reviews and Google Scholar were carried out to identify review papers on health-related quality of life in breast cancer during the 2008 to 2018. All publications were screened using the PRISMA guideline. The methodological quality of reviews was assessed using the AMSTAR. The findings were summarized and tabulated accordingly. Results Within over a decade, a total of 974 review papers were identified which according to the study selection criteria finally we have evaluated 82 reviews. Of these about 85% had a reasonable methodological quality. The findings were mainly summarized on several headings including instruments used to measure quality of life, treatment, supportive care, psychological distress, and symptoms. Questionnaires had a good performance to quantify quality of life in breast cancer patients. Most reviews were focused on the impact of treatment including endocrine therapy as well as integrating complementary and alternative medicine into the current practice. According to the reviews, yoga was the most recommended exercise to improve quality of life in breast cancer patients. Conclusion Overall, the findings from this overview indicated that quality of life in breast cancer patients enhanced during the last decade. Several simple but effective interventions such as physical activity and psychosocial interventions proved to be effective in improving quality of life in this population. However, management of symptoms such as pain, and lymphedema, issues related to worry, sexual function especially for young patients, and the future outlooks all are among topics that deserve further consideration. Also, this overview indicated that methodological issues in measuring quality of life in breast cancer patients improved greatly, but still there is a long way to go to understand what really matter to patients.

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Section: Resultsmentioning

confidence: 99%

Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018

Mokhatri-Hesari

Montazeri

2020

Health Qual Life Outcomes

265

169

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“…There are still no well-established prophylactic treatments available to prevent RT-induced skin toxicity. 26 We previously reported that prophylactic skincare significantly attenuated the risk of radiation dermatitis. 12 Greater than 90% of patients in the study received prophylactic skin treatment.…”

Section: Discussionmentioning

confidence: 98%

<p>A Retrospective Analysis of Dose Distribution and Toxicity in Patients with Left Breast Cancer Treated with Adjuvant Intensity-Modulated Radiotherapy: Comparison with Three-Dimensional Conformal Radiotherapy</p>

Chen

Hsieh

Chang

et al. 2020

CMAR

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Background: A better understanding of the organs-at-risk (OAR) dose metrics and the related toxicity induced by radiotherapy (RT) for left breast cancer (BC) will improve the quality of life. This study addressed the issue for left-BC patients treated with intensity-modulated radiotherapy (IMRT) compared to three-dimensional conformal radiotherapy (3D-CRT). Patients and Methods: Between 2012 and 2018, 308 left-BC patients underwent adjuvant RT at our hospital. Before June 2015, 134 patients were treated with 3D-CRT. Thereafter, 174 patients underwent IMRT. The patient's characteristics in the IMRT group did not significantly different compared to those in the 3D-CRT group. Results: Among the total study population, the incidence of ≥grade 2 radiation dermatitis (RID) was 17.3%. Higher volumes receiving 105% (≥5.7%) and 107% (≥1%) of prescribed dose and 3D-CRT technique were associated with a higher risk of RID. Regarding lung toxicity, the mean lung dose (≥10.2Gy) and V20 (≥20%) of ipsilateral lung were significantly associated with the incidence of RT-induced pulmonary changes. By dosimetry analysis, IMRT achieved better dose conformity and delivered lower mean doses to heart and ipsilateral lung compared to 3D-CRT. Furthermore, propensity sore and multivariate analysis showed that IMRT technique helped to reduce RT-induced dermatitis and lung toxicity. Conclusion: Our data suggest that the volume of OAR exposed to higher doses is a predictor of RT-induced toxicity. Adjuvant RT with IMRT technique offered better dose conformity and spared high-dose levels to OARs to reduce radiation-related morbidity for BC patients.

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“…The acute radiation skin toxicity observed in the trial was comparable to that expected with standard RT alone, including in patients with cancer infiltrating overlying skin. 25 There were no cases of tumor lysis syndrome. Figure 2B (i) and Table E2 detail the tumor response based on US measurements at successive time points posttreatment.…”

Section: Primary Endpointmentioning

confidence: 97%

Intratumoral Hydrogen Peroxide With Radiation Therapy in Locally Advanced Breast Cancer: Results From a Phase 1 Clinical Trial

Nimalasena

Gothard

Anbalagan

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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Purpose: Hydrogen peroxide (H 2 O 2) plays a vital role in normal cellular processes but at supraphysiological concentrations causes oxidative stress and cytotoxicity, a property that is potentially exploitable for the treatment of cancer in combination with radiation therapy (RT). We report the first phase 1 trial testing the safety and tolerability of intratumoral H 2 O 2 þ external beam RT as a novel combination in patients with breast cancer and exploratory plasma marker analyses investigating possible mechanisms of action. Methods and Materials: Twelve patients with breast tumors !3 cm (surgically or medically inoperable) received intratumoral H 2 O 2 with either 36 Gy in 6 twice-weekly fractions (n Z 6) or 49.5 Gy in 18 daily fractions (n Z 6) to the whole breast AE

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Radiation-induced Skin Toxicity in Breast Cancer Patients: A Systematic Review of Randomized Trials

Cited by 90 publications

References 100 publications

Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018

Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018

<p>A Retrospective Analysis of Dose Distribution and Toxicity in Patients with Left Breast Cancer Treated with Adjuvant Intensity-Modulated Radiotherapy: Comparison with Three-Dimensional Conformal Radiotherapy</p>

Intratumoral Hydrogen Peroxide With Radiation Therapy in Locally Advanced Breast Cancer: Results From a Phase 1 Clinical Trial

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