title: Adjuvant chemotherapy and acute toxicity in hypofractionated radiotherapy for early breast cancer.
abstract: OBJECTIVE
  To evaluate the effect of chemotherapy to the acute toxicity of a hypofractionated radiotherapy (HFRT) schedule for breast cancer.
  
  
  METHODS
  We retrospectively analyzed 116 breast cancer patients with T1, 2N0Mx. The patients received 3-D conformal radiotherapy with a total physical dose of 50.54 Gy or 53.2 Gy in 19 or 20 fractions according to stage, over 23-24 d. The last three to four fractions were delivered as a sequential tumor boost. All patients were monitored for acute skin toxicity according to the European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group criteria. The maximum monitored value was taken as the final grading score. Multivariate analysis was performed for the contribution of age, chemotherapy and 19 vs 20 fractions to the radiation acute skin toxicity.
  
  
  RESULTS
  The acute radiation induced skin toxicity was as following: grade I 27.6%, grade II 7.8% and grade III 2.6%. No significant correlation was noted between toxicity grading and chemotherapy (P = 0.154, χ(2) test). The mean values of acute toxicity score in terms of chemotherapy or not, were 0.64 and 0.46 respectively (P = 0.109, Mann Whitney test). No significant correlation was also noted between acute skin toxicity and radiotherapy fractions (P = 0.47, χ(2) test). According to univariate analysis, only chemotherapy contributed significantly to the development of acute skin toxicity but with a critical value of P = 0.05. However, in multivariate analysis, chemotherapy lost its statistical significance. None of the patients during the 2-years of follow-up presented any locoregional relapse.
  
  
  CONCLUSIONS
  There is no clear evidence that chemotherapy has an impact to acute skin toxicity after an HFRT schedule. A randomized trial is needed for definite conclusions.
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Vassilis
authors.initials: V
authors.lastname: Kouloulias
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Zygogianni
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Efrosini
authors.initials: E
authors.lastname: Kypraiou
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Georgakopoulos
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Zoi
authors.initials: Z
authors.lastname: Thrapsanioti
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Ivelina
authors.initials: I
authors.lastname: Beli
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Eftychia
authors.initials: E
authors.lastname: Mosa
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Amanta
authors.initials: A
authors.lastname: Psyrri
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Antypas
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Armbilia
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Tolia
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Platoni
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Papadimitriou
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Arkadopoulos
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Costas
authors.initials: C
authors.lastname: Gennatas
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Zografos
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Kyrgias
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Dilvoi
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Patatoucas
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kelekis
authors.affiliation: Vassilis Kouloulias, Efrosini Kypraiou, John Georgakopoulos, Zoi Thrapsanioti, Ivelina Beli, Eftychia Mosa, Maria Tolia, Kalliopi Platoni, Maria Dilvoi, George Patatoucas, Nikolaos Kelekis, 2 Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kouvaris
keywords: Acute toxicity; Breast cancer; Chemotherapy; Hypofractionated radiotherapy; Retrospective analysis