BACKGROUND: Severe acute radiation-induced skin toxicity (RIST) after breast irradiation is a side effect impacting the quality of life in breast cancer (BC) patients. The aim of the present study was to develop normal tissue complication probability (NTCP) models of severe acute RIST in BC patients. PATIENTS AND METHODS: We evaluated 140 consecutive BC patients undergoing conventional three-dimensional conformal radiotherapy (3D-CRT) after breast conserving surgery in a prospective study assessing acute RIST. The acute RIST was classified according to the RTOG scoring system. Dose-surface histograms (DSHs) of the body structure in the breast region were extracted as representative of skin irradiation. Patient, disease, and treatment-related characteristics were analyzed along with DSHs. NTCP modeling by Lyman-Kutcher-Burman (LKB) and by multivariate logistic regression using bootstrap resampling techniques was performed. Models were evaluated by Spearman's Rs coefficient and ROC area. RESULTS: By the end of radiotherapy, 139 (99%) patients developed any degree of acute RIST. G3 RIST was found in 11 of 140 (8%) patients. Mild-moderate (G1-G2) RIST was still present at 40 days after treatment in six (4%) patients. Using DSHs for LKB modeling of acute RIST severity (RTOG G3 vs. G0-2), parameter estimates were TD50=39 Gy, n=0.38 and m=0.14 [Rs = 0.25, area under the curve (AUC) = 0.77, p = 0.003]. On multivariate analysis, the most predictive model of acute RIST severity was a two-variable model including the skin receiving ≥30 Gy (S30) and psoriasis [Rs = 0.32, AUC = 0.84, p < 0.001]. CONCLUSIONS: Using body DSH as representative of skin dose, the LKB n parameter was consistent with a surface effect for the skin. A good prediction performance was obtained using a data-driven multivariate model including S30 and a pre-existing skin disease (psoriasis) as a clinical factor.
BACKGROUND: Severe acute radiation-induced skin toxicity (RIST) after breast irradiation is a side effect impacting the quality of life in breast cancer (BC) patients. The aim of the present study was to develop normal tissue complication probability (NTCP) models of severe acute RIST in BC patients. PATIENTS AND METHODS: We evaluated 140 consecutive BC patients undergoing conventional three-dimensional conformal radiotherapy (3D-CRT) after breast conserving surgery in a prospective study assessing acute RIST. The acute RIST was classified according to the RTOG scoring system. Dose-surface histograms (DSHs) of the body structure in the breast region were extracted as representative of skin irradiation. Patient, disease, and treatment-related characteristics were analyzed along with DSHs. NTCP modeling by Lyman-Kutcher-Burman (LKB) and by multivariate logistic regression using bootstrap resampling techniques was performed. Models were evaluated by Spearman's Rs coefficient and ROC area. RESULTS: By the end of radiotherapy, 139 (99%) patients developed any degree of acute RIST. G3 RIST was found in 11 of 140 (8%) patients. Mild-moderate (G1-G2) RIST was still present at 40 days after treatment in six (4%) patients. Using DSHs for LKB modeling of acute RIST severity (RTOG G3 vs. G0-2), parameter estimates were TD50=39 Gy, n=0.38 and m=0.14 [Rs = 0.25, area under the curve (AUC) = 0.77, p = 0.003]. On multivariate analysis, the most predictive model of acute RIST severity was a two-variable model including the skin receiving ≥30 Gy (S30) and psoriasis [Rs = 0.32, AUC = 0.84, p < 0.001]. CONCLUSIONS: Using body DSH as representative of skin dose, the LKB n parameter was consistent with a surface effect for the skin. A good prediction performance was obtained using a data-driven multivariate model including S30 and a pre-existing skin disease (psoriasis) as a clinical factor.
Authors: Kai J Borm; Maximilian Loos; Markus Oechsner; Michael C Mayinger; Daniela Paepke; Marion B Kiechle; Stephanie E Combs; Marciana N Duma Journal: Radiat Oncol Date: 2018-11-07 Impact factor: 3.481
Authors: Leonard Christopher Schmeel; David Koch; Frederic Carsten Schmeel; Bettina Bücheler; Christina Leitzen; Birgit Mahlmann; Dorothea Kunze; Martina Heimann; Dilini Brüser; Alina-Valik Abramian; Felix Schoroth; Thomas Müdder; Fred Röhner; Stephan Garbe; Brigitta Gertrud Baumert; Hans Heinz Schild; Timo Martin Wilhelm-Buchstab Journal: Polymers (Basel) Date: 2019-12-16 Impact factor: 4.329
Authors: Tim Rattay; Petra Seibold; Miguel E Aguado-Barrera; Manuel Altabas; David Azria; Gillian C Barnett; Renée Bultijnck; Jenny Chang-Claude; Ananya Choudhury; Charlotte E Coles; Alison M Dunning; Rebecca M Elliott; Marie-Pierre Farcy Jacquet; Sara Gutiérrez-Enríquez; Kerstie Johnson; Anusha Müller; Giselle Post; Tiziana Rancati; Victoria Reyes; Barry S Rosenstein; Dirk De Ruysscher; Maria C de Santis; Elena Sperk; Hilary Stobart; R Paul Symonds; Begoña Taboada-Valladares; Ana Vega; Liv Veldeman; Adam J Webb; Catharine M West; Riccardo Valdagni; Christopher J Talbot Journal: Front Oncol Date: 2020-10-30 Impact factor: 6.244