Dose-surface analysis for prediction of severe acute radio-induced skin toxicity in breast cancer patients

Abstract

Using body DSH as representative of skin dose, the LKB n parameter was consistent with a surface effect for the skin. A good prediction performance was obtained using a data-driven multivariate model including S30 and a pre-existing skin disease (psoriasis) as a clinical factor.

Prophylactically applied Hydrofilm polyurethane film dressings reduce radiation dermatitis in adjuvant radiation therapy of breast cancer patients

“…The female breast is especially susceptible to skin damage during radiotherapy because of the mechanical/physical irritation from proximity to clothing, frequent movement of the arms, and perspiration. While protection from friction and maceration is standard of care in slow healing wounds, this has not been widely appreciated in radiation-induced skin injury [29][30][31]. The application of a protective layer on the skin surface may reduce such friction by deflecting shear forces to a larger skin surface, thereby reducing damage to the subjacent basal-stem layer, which, because of its rapidly dividing skin stem-cells, is predestined for radiotherapy-induced injury.…”

Development of a normal tissue complication probability model for late unfavourable aesthetic outcome after breast-conserving therapy

“…In contrary to the above cited studies, in the present cohort the dose-volume metrics for the whole breast were taken into account, thus including the skin. Pastore et al have estimated LKB parameters for severe acute radioinduced skin toxicity from dose-surface histograms and concluded a high n-value of 0.4, consistent with a surface effect for skin [35].…”

Potential skin morbidity reduction with intensity-modulated proton therapy for breast cancer with nodal involvement

“…Each patient had three different proton plans with the same objectives and constraints in the cost-functions (Table 1) except for the skin3mm and boundary breast-PTV structures which were not included in the cost function for the first plan (IMPT 1 ). In the second plan (IMPT 2 ), the skin3mm structure (corresponding to the average derma thickness) was added in the optimization as an objective at a maximum dose of 30 Gy [16], and the boundary breast-PTV structure was used to keep the dose in the PTV at least equal to the photon plan, in particular in the area of the PTV closest to the skin. Finally, in the third plan (IMPT3), the dose to the skin3mm structure was forced to be equal to the IMXT plan by means of objectives on D10%, D20%, D30%, … , D90% (Table 1).…”

“…Relevant DVH metrics for PTV and OARs were analyzed: the percentage volume receiving dose (V x ); near maximum dose (D 2% ); near minimum dose (D 98% ); mean dose (D mean ), and median dose (D med ). In addition, the DSH of the body were computed as representative of skin irradiation [16,24] and DSH metrics extracted.…”

“…Skin toxicity is a common side-effect following BC irradiation, and, although generally of grade 1 or 2, it can often adversely affects patients' quality of life. Recently, Normal Tissue Complication Probability (NTCP) models for severe acute radiation-induced skin morbidity have been developed for BC patients treated with photons or protons [12,15,16]. These models are based on dose-volume histograms (DVHs) from pseudo-skin structure (a layer of 5 mm from the body contour) [12,15] or are based on skin dose evaluation by dose-surface histograms (DSH) from the body (i.e., the skin) [16].…”