Radiation Dermatitis and Pneumonitis in Patients Irradiated for Breast Cancer

In Vivo. 2023 Nov-Dec;37(6):2654-2661. doi: 10.21873/invivo.13374.

Abstract

Background/aim: Adjuvant radiotherapy (RT) for breast cancer can be associated with acute dermatitis (ARD) and pneumonitis (RP). Prevalence and risk factors were characterized.

Patients and methods: This study included 489 breast cancer patients receiving adjuvant RT with conventional fractionation (CF) ± sequential or simultaneous integrated boost, or hypo-fractionation ± sequential boost. RT-regimen and 15 characteristics were investigated for grade ≥2 ARD and RP.

Results: Prevalence of grade ≥2 ARD and RP was 25.3% and 2.5%, respectively. On univariate analyses, ARD was significantly associated with CF and radiation boost (p<0.0001), age ≤60 years (p=0.008), Ki-67 ≥15% (p=0.012), and systemic treatment (p=0.002). On multivariate analysis, RT-regimen (p<0.0001) and age (p=0.009) were associated with ARD. Chronic inflammatory disease was significantly associated with RP on univariate (p=0.007) and multivariate (p=0.016) analyses.

Conclusion: Risk factors for grade ≥2 ARD and RP were determined that may help identify patients who require closer monitoring during and after RT.

Keywords: Breast cancer; acute dermatitis; adjuvant radiotherapy; pneumonitis; prevalence; risk factors.

MeSH terms

  • Breast Neoplasms* / complications
  • Breast Neoplasms* / radiotherapy
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Lung Neoplasms* / complications
  • Middle Aged
  • Pneumonia*
  • Radiation Pneumonitis* / diagnosis
  • Radiation Pneumonitis* / epidemiology
  • Radiation Pneumonitis* / etiology
  • Radiodermatitis* / diagnosis
  • Radiodermatitis* / epidemiology
  • Radiodermatitis* / etiology