Incidence of radiodermatitis in breast cancer patients during hypofractionated radiotherapy.
Larissa Aparecida Corrêa Vieira, Amanda Gomes de Menêses, Priscila de Sousa Maggi Bontempo and 4 others
PMID 36469486WHAT IT FOUND
73.1% of breast cancer patients developed radiodermatitis during hypofractionated radiotherapy, with erythema most common, especially in the axilla.
Nurses can use this to monitor skin folds, breast volume, statin use, and symptoms as dose rises.
Key findings
01In 104 women, 76 (73.1%) developed radiodermatitis during hypofractionated radiotherapy, with erythema the most common reaction (72.1%) and first occurrence at a mean cumulative dose of 35.4 Gy and mean time of 13 days.
02Erythema most often affected the axillary region (66 patients, 63.5%; mean dose 36.5 Gy), dry desquamation the frontal region (7 patients, 6.7%; mean dose 43.2 Gy), and moist desquamation the inframammary fold (5 patients, 4.8%; mean dose 43.3 Gy).
03Statin use was associated with moist desquamation (OR = 1.1; 95% CI 1.01-1.13), voluminous breast with dry desquamation (OR = 1.2; 95% CI 1.07-1.33), and phototype III with lower odds of erythema (OR = 0.3; 95% CI 0.13-0.84).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single-site observational study with no comparison group, so it cannot show whether hypofractionated radiotherapy caused more or less radiodermatitis than conventional radiotherapy. Patients also received the service's skin-care manual and liposomal gel, and most had previous chemotherapy or surgery, with 61 participants (58.7%) receiving concomitant hormone therapy, so the contribution of any single component cannot be separated. Device maintenance interrupted treatment for 1 to 2 days in 49 patients, which may have contributed to underreporting of radiodermatitis occurrence and severity. The COVID-19 pandemic hindered follow-up, nursing consultations, photo-based skin assessment, and continuity of treatment. The study included 104 women at one outpatient clinic in Brasília, so it reports only that setting.
The easy way to misread this
Do not read this as evidence that hypofractionated radiotherapy causes less radiodermatitis than conventional radiotherapy or that the liposomal gel prevents radiodermatitis. There was no comparison group, and patients also received the service's skin-care manual and liposomal gel, with most having previous chemotherapy or surgery and 61 participants (58.7%) receiving concomitant hormone therapy, so the contribution of any single component cannot be separated.