title: Prospective evaluation of radiation-induced skin toxicity in a race/ethnically diverse breast cancer population.
abstract: We evaluated predictors of radiation-induced skin toxicity in a prospective study of a tri-racial/ethnic breast cancer population. We evaluated patient demographics, tumor characteristics, and treatment variables in the first 392 patients in a prospective study assessing radiation-induced skin toxicity. Logistic regression analyses were conducted to evaluate potential predictors of skin toxicity. The study consists of 59 non-Hispanic whites (NHW; 15%), 241 Hispanic Whites (HW; 62%), 79 black or African Americans (AA; 20%), and 13 others (3%). Overall, 48% developed grade 0-1 skin toxicity, 49.8% grade 2, and 2.2% grade 3 by the National Cancer Institute's Common Toxicity Criteria for Adverse Events (CTCAE) scale. Twenty-one percent developed moist desquamation. In multivariate analysis, higher body mass index (BMI; OR = 2.09; 95%CI = 1.15, 3.82), higher disease stage (OR = 1.82; 95%CI = 1.06, 3.11), ER-positive/PR-negative status (OR = 2.74; 95%CI = 1.26, 5.98), and conventionally fractionated regimens (OR = 3.25; 95%CI = 1.76, 6.01) were significantly associated with higher skin toxicity grade after adjustment for age, race, ethnicity, ER status, and breast volume. B MI specifically predicted for moist desquamation, but not degree of erythema. In this racially and ethnically diverse cohort of breast cancer patients receiving radiation to the intact breast, risk factors including BMI, disease stage, and conventionally fractionated radiation predicted for higher skin toxicity grade, whereas age, race, ethnicity, and breast volume did not. BMI specifically predicted for moist desquamation, suggesting that preventive measures to address this particular outcome should be investigated.
authors.affiliation: Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Wright
authors.affiliation: Department of Radiation Oncology, University of Miami School of Medicine, Miami, Florida.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Takita
authors.affiliation: Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida.|Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida.
authors.forename: Isildinha M
authors.initials: IM
authors.lastname: Reis
authors.affiliation: Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida.
authors.forename: Eunkyung
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida.|Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida.
authors.forename: Omar L
authors.initials: OL
authors.lastname: Nelson
authors.affiliation: Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida.|Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Hu
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000208:ethnology / Q000532:radiotherapy*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011446:Prospective Studies; D011855:Radiodermatitis / Q000453:epidemiology / Q000208:ethnology* / Q000473:pathology; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data
keywords: Breast cancer; racial/ethnic disparity; radiation dermatitis; radiation therapy; skin toxicity