Adjuvant chemotherapy and acute toxicity in hypofractionated radiotherapy for early breast cancer  

作　　者：Vassilis Kouloulias Anna Zygogianni Efrosini Kypraiou John Georgakopoulos Zoi Thrapsanioti Ivelina Beli Eftychia Mosa Amanta Psyrri Christos Antypas Christina Armbilia Maria Tolia Kalliopi Platoni Christos Papadimitriou Nikolaos Arkadopoulos Costas Gennatas George Zografos George Kyrgias Maria Dilvoi George Patatoucas Nikolaos Kelekis John Kouvaris 

机构地区：[1]2nd Department of Radiology, Radiotherapy Unit, Attikon University Hospital, 12462 Athens, Greece [2]1st Department of Radiology, Radiotherapy Unit, Aretaieion University Hospital, 12462 Athens, Greece [3]Radiotherapy Department,Larisa University Hospital, 12462 Athens, Greece [4]Medical Oncology Unit, Attikon University Hospital, 12462 Athens, Greece [5]Department of Clinical Therapeutics,Alexandra Hospital, 12462 Athens, Greece [6]4th Surgical Clinic, Attikon University Hospital, 12462 Athens, Greece [7]1st Propaedeutic Surgical Clinic, Medical School, Ippokration Hospital, 12462 Athens, Greece

出　　处：《World Journal of Clinical Cases》2014年第11期705-710,共6页世界临床病例杂志

摘　　要：AIM: To evaluate the effect of chemotherapy to the acute toxicity of a hypofractionated radiotherapy(HFRT) schedule for breast cancer. METHODS: We retrospectively analyzed 116 breast cancer patients with T1, 2N0 Mx. The patients received3-D conformal radiotherapy with a total physical dose of 50.54 Gy or 53.2 Gy in 19 or 20 fractions according to stage, over 23-24 d. The last three to four fractions were delivered as a sequential tumor boost. All patients were monitored for acute skin toxicity according to the European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group criteria. The maximum monitored value was taken as the final grading score. Multivariate analysis was performed for the contribution of age, chemotherapy and 19 vs 20 fractions to the radiation acute skin toxicity.RESULTS: The acute radiation induced skin toxicity was as following: grade Ⅰ 27.6%, grade Ⅱ 7.8% and grade Ⅲ 2.6%. No significant correlation was noted between toxicity grading and chemotherapy(P = 0.154, χ2 test). The mean values of acute toxicity score in terms of chemotherapy or not, were 0.64 and 0.46 respectively(P = 0.109, Mann Whitney test). No significant correlation was also noted between acute skin toxicity and radiotherapy fractions(P = 0.47, χ2test). According to univariate analysis, only chemotherapy contributed significantly to the development of acute skin toxicity but with a critical value of P = 0.05. However, in multivariate analysis, chemotherapy lost its statistical significance. None of the patients during the 2-years of follow-up presented any locoregional relapse.CONCLUSION: There is no clear evidence that chemotherapy has an impact to acute skin toxicity after an HFRT schedule. A randomized trial is needed for definite conclusions.AIM: To evaluate the effect of chemotherapy to the acute toxicity of a hypofractionated radiotherapy(HFRT) schedule for breast cancer. METHODS: We retrospectively analyzed 116 breast cancer patients with T1, 2N0 Mx. The patients received3-D conformal radiotherapy with a total physical dose of 50.54 Gy or 53.2 Gy in 19 or 20 fractions according to stage, over 23-24 d. The last three to four fractions were delivered as a sequential tumor boost. All patients were monitored for acute skin toxicity according to the European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group criteria. The maximum monitored value was taken as the final grading score. Multivariate analysis was performed for the contribution of age, chemotherapy and 19 vs 20 fractions to the radiation acute skin toxicity.RESULTS: The acute radiation induced skin toxicity was as following: grade Ⅰ 27.6%, grade Ⅱ 7.8% and grade Ⅲ 2.6%. No significant correlation was noted between toxicity grading and chemotherapy(P = 0.154, χ2 test). The mean values of acute toxicity score in terms of chemotherapy or not, were 0.64 and 0.46 respectively(P = 0.109, Mann Whitney test). No significant correlation was also noted between acute skin toxicity and radiotherapy fractions(P = 0.47, χ2test). According to univariate analysis, only chemotherapy contributed significantly to the development of acute skin toxicity but with a critical value of P = 0.05. However, in multivariate analysis, chemotherapy lost its statistical significance. None of the patients during the 2-years of follow-up presented any locoregional relapse.CONCLUSION: There is no clear evidence that chemotherapy has an impact to acute skin toxicity after an HFRT schedule. A randomized trial is needed for definite conclusions.

关 键 词：HYPOFRACTIONATED RADIOTHERAPY BREAST cancer Acute TOXICITY CHEMOTHERAPY RETROSPECTIVE analysis 

分 类 号：R737.9[医药卫生—肿瘤]