Abstract
Objectives
To evaluate the impact of patient and treatment factors on the incidence and timing of moist desquamation (MD) during adjuvant whole-breast radiotherapy (RT).
Methods
Sixty-nine consecutive patients treated with lumpectomy and tangential-field whole-breast RT to 46-50 Gy in 2 Gy fractions were reviewed. Separate contours were generated for the skin and irradiated breast. Patient factors and dosimetric data for breast and skin contours were assessed using univariate and multivariate logistic regressions to determine the significant predictors of moist desquamation during RT. Kaplan–Meier analyses and log-rank tests assessed the influence of these factors on time-to-development of MD.
Results
Twenty-three patients (33.3 %) developed MD at a median of 46 Gy. MD occurred earlier for patients with a BMI >30, >45 cm3 of skin receiving 45 Gy or >15 cm3 receiving 50 Gy, and >1,300 cm3 breast receiving 50 Gy. In multivariate logistic regressions, only BMI remained as a statistically significant predictor of MD, as BMI was correlated with higher volumes of breast and skin receiving at least 50 Gy.
Conclusions
In tangential field breast RT, dose–volume relationships influence the development and timing of MD. Fine differences in dose delivered to skin and subcutaneous structures appear to significantly alter the time course of MD development.
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Conflict of interest
Charles Rutter, Li Qin, Susan Higgins, Meena Moran, and Suzanne Evans report that they have no conflicts of interest to disclose. This article does not contain any studies with human or animal subjects performed by any of the authors.
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Rutter, C.E., Qin, L., Higgins, S.A. et al. Dosimetric and clinical predictors of the development of moist desquamation in breast cancer irradiation. J Radiat Oncol 3, 147–152 (2014). https://doi.org/10.1007/s13566-013-0129-0
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DOI: https://doi.org/10.1007/s13566-013-0129-0