Breast intensity-modulated radiation therapy reduces time spent with acute dermatitis for women of all breast sizes during radiation.
OBJECTIVE
To study the time spent with radiation-induced dermatitis during a course of radiation therapy for breast cancer in women treated with conventional or intensity-modulated radiation therapy (IMRT).


METHODS
The study population consisted of 804 consecutive women with early-stage breast cancer treated with breast-conserving surgery and radiation from 2001 to 2006. All patients were treated with whole-breast radiation followed by a boost to the tumor bed. Whole-breast radiation consisted of conventional wedged photon tangents (n = 405) earlier in the study period and mostly of photon IMRT (n = 399) in later years. All patients had acute dermatitis graded each week of treatment.


RESULTS
The breakdown of the cases of maximum acute dermatitis by grade was as follows: 3%, Grade 0; 34%, Grade 1; 61%, Grade 2; and 2%, Grade 3. The breakdown of cases of maximum toxicity by technique was as follows: 48%, Grade 0/1, and 52%, Grade 2/3, for IMRT; and 25%, Grade 0/1, and 75%, Grade 2/3, for conventional radiation therapy (p < 0.0001). The IMRT patients spent 82% of weeks during treatment with Grade 0/1 dermatitis and 18% with Grade 2/3 dermatitis, compared with 29% and 71% of patients, respectively, treated with conventional radiation (p < 0.0001). Furthermore, the time spent with Grade 2/3 toxicity was decreased in IMRT patients with small (p = 0.0015), medium (p < 0.0001), and large (p < 0.0001) breasts.


CONCLUSIONS
Breast IMRT is associated with a significant decrease both in the time spent during treatment with Grade 2/3 dermatitis and in the maximum severity of dermatitis compared with that associated with conventional radiation, regardless of breast size.
Freedman
Gary M
GM
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA. Gary.Freedman@FCCC.edu
Li
Tianyu
T
Nicolaou
Nicos
N
Chen
Yan
Y
Ma
Charlie C-M
CC
Anderson
Penny R
PR
D000208:Acute Disease; D000970:Antineoplastic Agents / Q000009:adverse effects; D001940:Breast / Q000033:anatomy & histology*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D009929:Organ Size; D017785:Photons / Q000627:therapeutic use; D011855:Radiodermatitis / Q000473:pathology*; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors
D000970:Antineoplastic Agents