Title :

Correlation between toxicity and dosimetric parameters for adjuvant intensity modulated radiation therapy of breast cancer: a prospective study

Author(s) :

Pasquier, David [Auteur]
Centre de Recherche en Informatique, Signal et Automatique de Lille - UMR 9189 [CRIStAL]
Bataille, Benoit [Auteur]
Le Tinier, Florence [Auteur]
Bennadji, Raoudha [Auteur]
Langin, Hélène [Auteur]
Escande, Alexandre [Auteur]
Tresch, Emmanuelle [Auteur]
Darloy, Franck [Auteur]
Carlier, Damien [Auteur]
Crop, Frederik [Auteur]
Lartigau, Eric [Auteur]

Journal title :

Scientific Reports

Publisher :

Nature Publishing Group

Publication date :

2021-12

ISSN :

2045-2322

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

In the treatment of breast cancer, intensity-modulated radiation therapy (IMRT) reportedly reduces the high-dose irradiation of at-risk organs and decreases the frequency of adverse events (AEs). Comparisons with conventional ...
Show more >In the treatment of breast cancer, intensity-modulated radiation therapy (IMRT) reportedly reduces the high-dose irradiation of at-risk organs and decreases the frequency of adverse events (AEs). Comparisons with conventional radiotherapy have shown that IMRT is associated with lower frequencies of acute and late-onset AEs.Here, we extended a prospective, observational, single-center study of the safety of IMRT to a second investigating center. Patients scheduled for adjuvant IMRT after partial or total mastectomy were given a dose of 50 Gy (25 fractions of 2 Gy over 5 weeks), with a simultaneous integrated boost in patients having undergone conservative surgery. 300 patients were included in the study, and 288 were analyzed. The median follow-up period was 2.1 years. The 2-year disease-free survival rate [95% CI] was 93.4% [89.2–96.0%].Most AEs were mild. The most common AEs were skin-related—mainly radiodermatitis [in 266 patients (92.4%)] and hyperpigmentation (in 178 (61.8%)). 35% and 6% of the patients presented with grade 2 acute skin and esophageal toxicity, respectively. Only 4 patients presented with a grade 3 event (radiodermatitis).Smoking (odds ratio) [95% CI] = 2.10 [1.14–3.87]; p = 0.017), no prior chemotherapy (0.52 [0.27–0.98]; p = 0.044), and D98% for subclavicular skin (1.030 [1.001–1.061]; p = 0.045) were associated with grade ≥ 2 acute AEs.In a univariate analysis, the mean dose, (p < 0.0001), D2% (p < 0.0001), D50% (p = 0.037), D95% (p = 0.0005), D98% (p = 0.0007), V30Gy (p < 0.0001), and V45Gy (p = 0.0001) were significantly associated with grade ≥ 1 acute esophageal AEs.In a multivariate analysis, D95% for the skin (p < 0.001), D98% for the subclavicular skin, and low D95% for the internal mammary lymph nodes were associated with grade ≥ 1 medium-term AEs.The safety profile of adjuvant IMRT after partial or total mastectomy is influenced by dosimetric parameters.Trial registration:ClinicalTrials.gov NCT02281149.Show less >

Language :

Anglais

Popular science :

Non

Collections :

• Centre de Recherche en Informatique, Signal et Automatique de Lille (CRIStAL) - UMR 9189

Source :

Harvested from HAL