Freedman, G.M., Li, T., Nicolaou, N., Chen, Y., Ma, C.C.-M., & Anderson, P.R. (2009). Breast intensity-modulated radiation therapy reduces time spent with acute dermatitis for women of all breast sizes during radiation. International Journal of Radiation Oncology, Biology, Physics, 74, 689–694.
To determine differences in toxicity and time spent with radiation-induced dermatitis during a course of conventional radiation therapy (RT) or intensity modulated RT (IMRT)
At the time of treatment, a physician and nurse prospectively evaluated the skin and recorded the maximum skin toxicity each week. Chi-square and Wilcoxon analysis was used to find differences between groups from retrospective data. Multivariate analysis determined significant predictors of grade 2 or higher radiation dermatitis
The study included cases treated at Fox Chase Cancer Center in Philadelphia, PA.
The study used a retrospective analysis design, using cases from 2001–2006.
In all breast size groupings, a significantly lower percentage of patients in the IMRT group developed grade 2 or higher radiation dermatitis (p ≤ 0.0004). Per group, volumes that developed a maximum toxicity of grade 2 or higher were 52% for IMRT and 75% for CRT. The time spent per week of radiation with grade 2 or 3 dermatitis was lower in the IMRT group. In the IMRT group, 18% of weeks were at grade 2 or 3, and in the conventional group, 71% of weeks were at grade 2 or 3. Weeks 2–6 for those receiving IMRT had significantly less toxicity (p < 0.00001). Predictors of grade 2 or greater dermatitis found to be significant (p < 0.021) were technique (e.g., use of IMRT), large bra size, treatment week, and chemotherapy or tamoxifen administered prior to or during radiation.
IMRT is associated with less skin toxicity than conventional RT.