What Is the Actual Rate of Acute Skin Toxicity in Women Undergoing Adjuvant Radiation Therapy for Early Breast Cancer? Preliminary Results of a Single Institution Phase II Study.
Notice bibliographique
Résumé
Abstract The accurate rate of acute skin toxicity experienced by women undergoing adjuvant radiation therapy as part of Breast-Conservative Therapy (BCT) for early breast cancer is lacking in the literature. The limited available publications place the rate of grade II or higher at around 40-50%, while the rate of grade III moist desquamation is reported to be around 15-20%. In this prospective phase II study we evaluated the actual rate of acute skin toxicity in these patients and correlated that with patient characteristics.Material and method: Patients with breast separation of less than 25 cm were treated with Canadian hypofractionation regimen (42.4 Gy in 16 fractions) while patients with 25 cm or more were treated with the usual adjuvant breast fractionation (50 Gy in 25 fractions). As part of the institution's standard of care all patients were advised to apply hydrating cream from day one of the radiation therapy (RT) (Glaxal Base and Aveeno were most commonly used). The National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0 (CTCAE) was used for grading of the acute skin toxicity. To avoid subjective interpretation of the CTCAE, Each patient was graded by two radiation oncologist at week 0 week 2, week 3, last day of treatment and 2 weeks after treatment completion. Univariant and multivariant analysis were performed to evaluate the contribution of patient characteristics to the toxicity.Results: At the time of this analysis 85 patients with a median age of 57 (range 33-80) have completed their adjuvant RT. Of these 72% received the hypofractionated regimen and 69% had an extra boost of 10 Gy in 4 fractions to the tumor bed either because of younger age (less than 60) or close margins. 37 patients (44%) received chemotherapy prior to RT and 30 patients (35%) were active smokers. The volume of the breast varied significantly among the patients, median volume of 729 cc (range 246-2271).Acute skin toxicity was 18% at 2 weeks with only 2 patients (3%) having grade II, 54% at 3 weeks with only 5 patients (6%) having grade II and 82% at the last day of the treatment with 18 patients (21%) having grade II or higher. Only 2 patients had grade III and no grade IV skin toxicity was observed. The rate of residual skin reaction at 2 weeks post RT was 41% with only 7% grade II and no grade III. Multivariant analysis associated hypofractionation with decreased acute skin reaction at the last day of the treatment, 100% vs. 71% (p=0.0204), and active smoking with delayed skin healing at 2 weeks post RT 25% vs. 52% (p=0.0373). There was no correlation between the volume of the breast and skin toxicity at any of the evaluation timelines.Conclusion: The actual rate of acute skin toxicity in women undergoing adjuvant radiation therapy for BCT is considerably overstated in medical literature. Hypofractionation is associated with decreased acute skin reaction and active smoking is correlated with delayed healing. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4109.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».