Incidence of radiodermatitis in breast cancer patients during hypofractionated radiotherapy

Abstract

Objective: To analyze the incidence, dose of occurrence, grade, severity, and associated risk factors for the development of radiodermatitis, by area of the irradiated breast, in women with breast cancer, during hypofractionated radiotherapy. Method: Observational, prospective, and longitudinal study, according to the guidelines of the Strengthening the Reporting of Observational studies in Epidemiology, carried out between May 2019 and May 2021. Results: A total of 104 women participated in the study, and 73.1% (95%CI: 64–82) developed signs of radiodermatitis during treatment. The majority (63.5%, 95%CI: 54–73) developed erythema in the axillary region with about 36.5 Grays. Women with large breasts and statin users are more likely to develop radiodermatitis. However, women with Phototype III skin color classification (light brown skin) are less likely to develop radiodermatitis, with skin color being a protective factor. Conclusion: The incidence of radiodermatitis in women with breast cancer during hypofractionated radiotherapy is significant. Therefore, the development of protocols for the management of this radiotoxicity is suggested, considering the cumulative dose and associated risk factors.

Adverse effects in the management of breast cancer – recent studies

“…According to Camidge et al, radiation recall dermatitis should be reported when the systemic therapy is administered at least 7 days after the end of radiotherapy, while radiosensitization is associated with radiosensitizers administered before or during radiation [31,32]. RD manifests as erythema, pigmentary changes, ulceration, itching, soreness, or peeling skin [33]. Moreover, RD can lead to dose reduction or interruption therapy, but also esthetic, psychological problems and affect negatively the daily functioning and quality of life [29,30].…”

“…Vieira et al assessed risk factors of RD in females undergoing hypofractionated radiotherapy -the study revealed patients with large breasts and statin users were more prone to RD [33]. In contrast, skin color was considered a risk-reducing factor.…”

“…In contrast, skin color was considered a risk-reducing factor. It was noted that erythema -the most common symptom of RD during hypofractionated radiotherapy was mostly in the axillary region, while dry desquamation in the frontal region and moist desquamation in the inframammary fold region [33].…”

“…Recently, Yu et al noted that Topical Chinese herbal medicine -TCHM has properties useful in the prevention and management of RD [30]. As described, proper skin care, use of mobile applications during BC therapy is helpful in the prevention of skin adverse effects of therapy [33].…”