|Author||Pignol, Jean-Philippe ♦ Vu, Thi Trinh Thuc ♦ Mitera, Gunita ♦ Bosnic, Sandy ♦ Verkooijen, Helena M. ♦ Truong, Pauline|
|Source||United States Department of Energy Office of Scientific and Technical Information|
|Subject Keyword||RADIOLOGY AND NUCLEAR MEDICINE ♦ EVALUATION ♦ HAZARDS ♦ MULTIVARIATE ANALYSIS ♦ NEOPLASMS ♦ PAIN ♦ PATIENTS ♦ RADIOTHERAPY ♦ SIDE EFFECTS ♦ SKIN ♦ TOBACCO SMOKES ♦ TOXICITY ♦ WOMEN|
|Abstract||Purpose: To prospectively capture acute toxicities and pain associated with postmastectomy radiation therapy (PMRT), to analyze patient and treatment risk factors for severe side effects. Methods and Materials: Women referred for PMRT were prospectively enrolled and assessed weekly during and after radiation therapy. The endpoint included severe National Cancer Institute Common Terminology Criteria for Adverse Effects grade 3 moist desquamation, other skin symptoms, and pain. Results: Of 257 patients, 73 (28.4%) experienced extensive moist desquamation, 84 (32.7%) Common Terminology Criteria for Adverse Effects skin toxicity grade 3, and 57 (22.2%) a pain impacting on daily life activities. Among symptoms only grade 3 moist desquamation was significantly associated with severe pain (P<.001). On multivariate analysis, smoking, high-energy photons, and skin bolus were significantly associated with severe moist desquamation. Skin toxicity doubled for smokers, with 40% severe pain, 48% grade 3 moist desquamation, and 64% grade 3 skin toxicity. Without skin bolus 4.2% had severe pain, none moist desquamation, and 2.1% grade 3 skin toxicity. When skin bolus was used on alternate days, the frequency increased to 15% for pain, 22% for moist desquamation, and 26% for grade 3 skin toxicity. When bolus was used daily, 32% had pain, 41% moist desquamation, and 47% grade 3 skin toxicity. Symptoms peaked 1 to 2 weeks after the end of PMRT. Conclusions: The present cohort study suggests excessive radiation toxicity after PMRT. Among factors associated with an increase of toxicity are smoking habits and the use of skin bolus.|
|Learning Resource Type||Article|
|Publisher Place||United States|
|Journal||International Journal of Radiation Oncology, Biology and Physics|
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