Longitudinal practical measurement of skin color and moisture during and after breast-conserving therapy: influence of neoadjuvant systemic therapy.
OBJECTIVE
The aim of this study was to assess radiation dermatitis, especially exploring the influence of neoadjuvant systemic therapy (NST).


METHODS
We examined maximum toxicity using the Common Toxicity Criteria version 3 score (CTC v3) following radiotherapy between 40 patients treated with NST and 59 patients without NST. In addition, objective skin color (L*, a*, b* values) and moisture analyses were applied in 13 NST and 25 control patients, and the ratio of the values for the irradiated side to the nonirradiated side was calculated.


RESULTS
For the CTC v3 assessment, 27 grade 1 (68%) and 13 grade 2 (32%) reactions occurred in the NST group and 44 grade 1 (75%) and 15 grade 2 (25%) reactions in the control group. All ratios except the b* ratio showed significant alterations when radiotherapy was added. The ratio of the a* value peaked at the completion of radiotherapy, whereas the L* ratio bottomed out 1 month later. Furthermore, moisture change remained even 1 year after treatment. Boost irradiation doses caused enhanced alterations in the L* and a* ratios. Furthermore, the L* and a* ratios had good agreement with the CTC v3 assessment. NST did not enhance alterations.


CONCLUSIONS
Objective analysis is useful for detailed assessment of radiation dermatitis. NST did not worsen skin reactions.
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. hideya10@hotmail.com
Hideya
H
Yamazaki
Ken
K
Yoshida
Tadayuki
T
Kotsuma
Keiko
K
Kuriyama
Norikazu
N
Masuda
Takuya
T
Nishimura
Kana
K
Kobayashi
Takuji
T
Tsubokura
Tsunehiko
T
Nishimura
D000704:Analysis of Variance; D001834:Body Water / Q000378:metabolism*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects*; D012307:Risk Factors; D012867:Skin / Q000528:radiation effects*; D012880:Skin Pigmentation / Q000528:radiation effects*; D018709:Statistics, Nonparametric