Compared with intensity‐modulated radiotherapy, image‐guided radiotherapy reduces severity of acute radiation‐induced skin toxicity during radiotherapy in patients with breast cancer

Radiotherapy (RT) is an effective treatment for breast cancer. The side effects of breast irradiation, including skin toxicity in the irradiation field, cause considerable discomfort. This study compared the severity of skin toxicity caused by image‐guided RT (IGRT) and intensity‐modulated RT (IMRT) combined with an electronic portal imaging device (EPID) in breast cancer. This study retrospectively analyzed 458 patients with breast cancer who had received RT. The patients were divided into two groups: 302 and 156 patients in the IMRT and IGRT groups. In the IGRT group, 8 and 148 patients had received helical tomotherapy irradiation and IMRT with cone‐beam computed tomography. Simple and multiple logistic regression analyses were used to estimate the relationship between RT technique and the severity of radiation skin toxicity. In our study, 284, 97, and 6 patients exhibited grades I, II, and III radiation dermatitis (RD). Moreover, 75 patients in the IMRT group (24.80%) and 22 patients in the IGRT group (14.10%) exhibited grade II RD. All patients with grade III RD were in the IMRT group (2.00%). No patient exhibited grade IV RD. The patients in the IGRT group exhibited less severity of RD than in the IMRT group. The severity of acute RD due to IGRT is significantly lower than that due to IMRT with EPID.

[1]  J. Tsai,et al.  Compared planning dosimetry of TOMO, VMAT and IMRT in rectal cancer with different simulated positions , 2017, Oncotarget.

[2]  Chih-Jen Huang,et al.  RTOG, CTCAE and WHO criteria for acute radiation dermatitis correlate with cutaneous blood flow measurements. , 2015, Breast.

[3]  Wei-Hsiu Liu,et al.  Comparing Treatment Plan in All Locations of Esophageal Cancer , 2015, Medicine.

[4]  A. Kuten,et al.  Patterns of practice of regional nodal irradiation in breast cancer: results of the European Organization for Research and Treatment of Cancer (EORTC) NOdal Radiotherapy (NORA) survey. , 2015, Annals of oncology : official journal of the European Society for Medical Oncology.

[5]  Guk Jin Lee,et al.  Setup Error and Effectiveness of Weekly Image-Guided Radiation Therapy of TomoDirect for Early Breast Cancer , 2015, Cancer research and treatment : official journal of Korean Cancer Association.

[6]  A. Whitehead,et al.  Mometasone furoate cream reduces acute radiation dermatitis in patients receiving breast radiation therapy: results of a randomized trial. , 2014, International journal of radiation oncology, biology, physics.

[7]  S. Tofani,et al.  Intensity-modulated adjuvant whole breast radiation delivered with static angle tomotherapy (TomoDirect): a prospective case series , 2013, Journal of Cancer Research and Clinical Oncology.

[8]  D. Roses,et al.  Prospective assessment of optimal individual position (prone versus supine) for breast radiotherapy: volumetric and dosimetric correlations in 100 patients. , 2012, International journal of radiation oncology, biology, physics.

[9]  P. Vos,et al.  Feasibility of Tomotherapy to spare the cochlea from excessive radiation in head and neck cancer. , 2011, Oral oncology.

[10]  Jan-Jakob Sonke,et al.  Breast patient setup error assessment: comparison of electronic portal image devices and cone-beam computed tomography matching results. , 2010, International journal of radiation oncology, biology, physics.

[11]  Randall K Ten Haken,et al.  Guest editor's introduction to QUANTEC: a users guide. , 2010, International journal of radiation oncology, biology, physics.

[12]  F. Lovat,et al.  Targeted Intraoperative Radiotherapy Impairs the Stimulation of Breast Cancer Cell Proliferation and Invasion Caused by Surgical Wounding , 2008, Clinical Cancer Research.

[13]  Laurence Collette,et al.  Impact of a Higher Radiation Dose on Local Control and Survival in Breast-Conserving Therapy of Early Breast Cancer: 10-Year Results of the Randomized Boost Versus No Boost EORTC 22881-10882 Trial , 2007 .

[14]  D. Kopans.  The effect of changes in tumor size on breast carcinoma survival in the U.S. , 2006, Cancer.

[15]  A. Hanlon,et al.  Intensity Modulated Radiation Therapy (IMRT) Decreases Acute Skin Toxicity for Women Receiving Radiation for Breast Cancer , 2006, American journal of clinical oncology.

[16]  C. Begg,et al.  The effect of changes in tumor size on breast carcinoma survival in the U.S.: 1975–1999 , 2005, Cancer.

[17]  T. Buchholz.  Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial , 2005 .

[18]  John J Spinelli,et al.  Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. , 2005, Journal of the National Cancer Institute.

[19]  F. Vicini,et al.  Optimizing breast cancer treatment efficacy with intensity-modulated radiotherapy. , 2002, International journal of radiation oncology, biology, physics.

[20]  B. E. F. Isher,et al.  Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. , 2002 .

[21]  G. Sherouse.  In regard to Intensity-Modulated Radiotherapy Collaborative Working Group, IJROBP 2001; 51:880-914. , 2002, International journal of radiation oncology, biology, physics.

[22]  Hans Svensson,et al.  Dose response and latency for radiation-induced fibrosis, edema, and neuropathy in breast cancer patients. , 2002, International journal of radiation oncology, biology, physics.

[23]  B. Fowble,et al.  Patterns of dose variability in radiation prescription of breast cancer. , 1997, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[24]  George W. Sherocse.  In regard to: Intensity-modulated radiotherapy collaborative working group , 2002 .