Acute Skin Toxicity in Breast Cancer Patients Following Different Fractionation Regimens of Postoperative Radiotherapy

 

Milica Radić^1,2, Andrija Jović^1,3, Ana Cvetanović^1,2, Ivan Petković^1,2, Dane Krtinić^1,2,
Katarina Krasić⁴, Sandra Radenković⁵, Slavica Stojnev^1,6, Irena Conić^1,2

 

¹University of Niš, Faculty of Medicine, Niš, Serbia
²University Clinical Center Niš, Clinic of Oncology, Niš, Serbia
³University Clinical Center Niš, Clinic of Dermatovenerology, Niš, Serbia
⁴Clinical Center Kragujevac, Clinic of Oncology, Kragujevac, Serbia
⁵Institute of Oncology and Radiology of Serbia, Department of Radiation Oncology and Diagnostics, Belgrade, Serbia
⁶University Clinical Center Niš, Center for Pathology and Pathological Anatomy, Niš, Serbia

 

  SUMMARY

 

Introduction/Aim. Breast cancer (BC) represents a globally significant health issue, with incidence rates varying worldwide. Radiotherapy is crucial in treating BC, however, it can cause adverse effects, including skin reactions. The aim of this research was to evaluate the impact of two different radiotherapy fractionation regimens on the occurrence and severity of acute skin toxicity in BC patients.
Methods. The prospective study involved 44 patients who underwent postoperative radiotherapy. The patients were randomly divided into two groups: one group received hypofractionated regimen (40.05 Gy in 15 fractions over three weeks), while the other group received the standard fractionated regimen (50 Gy in 25 fractions over five weeks). The patients in this study were monitored weekly for acute skin toxicity throughout the duration of radiotherapy and following the completion of treatment.
Results. The patients receiving the standard fractionated regimen experienced a higher frequency and intensity of acute skin reactions, including erythema, dry desquamation, and moist desquamation.  Skin reactions of grade I and II were particularly prominent in the patients receiving 50 Gy. Although the patients receiving hypofractionated radiotherapy had less severe skin reactions, mild skin changes did occur, although they were generally less prominent.
Conclusion. The study points to the need for a careful selection of fractionation regimens in postoperative breast radiotherapy. Additionally, this study contributes to the understanding of the relationship between different radiotherapy modalities and the occurrence of acute skin toxicity, providing guidelines for optimizing treatment in BC patients.

 Keywords: breast cancer, breast-conserving surgery, radiotherapy, radiodermatitis

Corresponding author:
Milica Radić
e-mail: milica91nis@ymail.com