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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
Content type Text
Language English
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.
ISSN 03603016
Educational Use Research
Learning Resource Type Article
Publisher Date 2015-01-01
Publisher Place United States
Journal International Journal of Radiation Oncology, Biology and Physics
Volume Number 91
Issue Number 1


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