Dermatological sequel of adjuvant breast cancer radiotherapy in Iraqi women

Abstract

Author(s): Alaa Mobder Mohammed Alrubai, Hadeel Majid Ali Al-Jassani, Shaymaa Mohammed Radhi Alsaymaree and Ahmed Salih Alshewered*

Adjuvant breast cancer radiotherapy raises the risk of skin toxicities. We aimed to identify and determined patients and treatment characteristics that may increase this risk to help individualize and health worker in radiation field to prevention and management of radiation-induced these toxicities. We enrolled 157 women with breast cancer who received adjuvant radiation treatment based upon age, employments, educational level, marital status, parity, menopause status, weight, height, BMI, grade, types of surgery, chemotherapy, radiation fractionation, total dose, site of radiation, energy of accelerator used, skin color types, duration of skin toxicities manifestation, side effect of radiation, smoking, diabetes, hypertension, and coronary heart diseases. Univariate logistic regression was used to compare each factor across the skin toxicities groups. Significant risk factors were analyzed in a multivariate analysis. Most of women enrolled in this study belong to the age above 45 years. The common BMI recorded was within normal limit as 37.2%, followed by overweight 32.7%. Mastectomy plus ALND was the common surgical procedure. The chest wall plus axillary area was the common site of RT. The 4050cG/15F was the common RT dose utilized. The most duration of the sequel of skin toxicities was at 2 weeks of RT. The dermatological manifestations recorded in 72.6% of women exposed to RT. All skin manifestations of toxicities mostly recorded. In univariate analysis, weight was being the fold-increase in odds for every 10-Kg increase in weight (OR 0.676, p=0.008). Also, abnormal BMI, was more likely to increased risk of dermatitis (OR 0.609, p=0.0015). For those underwent MRM were more suffering from skin toxicities (OR 4.488, p=0.019). Regarding sites of RT, chest wall when exposed to RT was more liable to develop dermatitis (OR 0.322, p=0.01). In hypofractionated courses, toxicities was less likely to occur (OR 0.211, p=0.0015). In, multivariate analysis the higher risk of toxicities remained with increasing BMI (OR 1.09, p<0.000), and when the standard breast dose utilized (OR 0.05, p<0.000). The incidence of adjuvant RT-induced skin toxicities is common. Lower BMI, and weight, BCS, RT sites and hypofractionated courses were beneficial to decrease skin toxicities.

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