HF for WBI yields lower frequency, severity of radiation dermatitis

  • Schmeel LC & al.
  • Radiother Oncol
  • 12 Mar 2020

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Hypofractionated (HF) vs conventional fractionated (CF) radiotherapy for whole-breast irradation (WBI) in early breast cancer was associated with less frequent and less severe acute radiation-induced skin toxicity (i.e., radiation dermatitis) in this German randomized controlled trial (RCT).

Why this matters

  • Results add to evidence of benefits of HF, including shorter duration (2-4 weeks instead of 5-6 weeks), greater convenience, decreased resource use.

Study design

  • Patients (N=140) were randomly assigned to HF (40.05 Gy in 15 fractions) vs CF (50 Gy in 25 fractions) as adjuvant therapy for WBI.
  • Severity and frequency of radiation dermatitis was assessed by 3 methods, including objective photospectrometric skin readings.
  • Funding: None disclosed.

Key results

  • HF vs CF WBI was linked to less severe physician-assessed radiation dermatitis:
    • Mean, 1.05 vs 1.43 (P=.024).
  • HF WBI was associated with more grade 0 radiation dermatitis (no dermatitis):
    • 21.43% vs 4.28%.
  • HF also was associated with less grade ≥2 radiation dermatitis:
    • 27.14% vs 42.86%.
  • By objective photospectrometric measurements (n=4200), HF vs CF was linked to decreased erythema severity (P=.008) and less hyperpigmentation (P=.002).
  • Patients assigned to HF WBI also reported less pain (P=.006), less hyperpigmentation (P<.001 and fewer limitations on day-to-day activities>

Limitations

  • Patients were aware of treatment.