Journal of cancer research and therapeutics · 2026
Assessment of acute skin reactions in hypofractionated chest wall irradiation on a telecobalt machine for breast cancer.
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Manjunath G N, Raj M Krishna, Kulal Santhosha
Аннотация
BACKGROUND: Adjuvant chest wall radiation therapy for postmastectomy breast cancer patients is highly effective in reducing the risk of locoregional recurrence. Hypofractionated regimen is increasingly being adopted in adjuvant radiotherapy. One of the reasons for its slow adoption is the concern that a hypofractionated regimen can lead to higher side effects, such as radiation-induced dermatitis. Even while modern techniques like intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT) have made great strides in protecting healthy tissues, the use of two-dimensional treatments with a telecobalt machine is still prevalent in many parts of developing countries like India. Hence, we conducted a retrospective study of the incidence and severity of radiation-induced dermatitis in breast cancer patients undergoing hypofractionated chest wall radiation therapy on a telecobalt machine.
OBJECTIVES: 1. To evaluate acute skin reaction in patients treated with chest wall hypofractionated adjuvant radiation in carcinoma of the breast on a telecobalt machine. 2. To evaluate the incidence of severity of odynophagia. 3. To evaluate the weight change during treatment.
MATERIALS AND METHODS: In this retrospective study, we analyzed the data from postmodified radical mastectomy (PMRM) breast cancer patients treated with adjuvant chest wall radiotherapy using a hypofractionated regimen on a telecobalt machine at our hospital from 2017 to 2023 after institutional ethical committee approval. One hundred and fifty-six patients were treated with a hypofractionated regimen during this time period. The hypofractionated radiation schedule used was 40 Gy in 15 fractions with 2.66 Gy per fraction over 3 weeks, with 5 fractions per week on a telecobalt machine. Patient demographics, disease characteristics, treatment details, comorbidities, and skin reactions during treatment were retrieved from patient records and analyzed.
RESULTS: In our study, 148 (89.74%) patients had no skin reaction, and 16 patients had grade I radiation induced dermatitis during first week. During second week 88 (56.41%) patients had no skin reaction and 70 (56.41%) patients had grade I radiation induced dermatitis During third week, 137 (87.82%) patients had grade 1 and 9 (5.76%) patients developed grade 2 radiation induced dermatitis. None of the patient had grade III or IV radiation dermatitis during the treatment. During week 1 no patients had odynophagia and during week 2, grade 1 and 2 odynophagia was observed in 3 and 2 patients, respectively. Grade I odynophagia was observed in 16 patients and grade 2 odynophagia was documented in 9 patients during 3rd week of treatment and none of the patients had significant weight loss during treatment.
CONCLUSION: Our study demonstrates that hypofractionated adjuvant chest wall radiation therapy using a telecobalt machine is associated with a low incidence of severe acute skin reactions and odynophagia. The regimen appears to be well-tolerated, with minimal impact on weight and nutritional status.
OBJECTIVES: 1. To evaluate acute skin reaction in patients treated with chest wall hypofractionated adjuvant radiation in carcinoma of the breast on a telecobalt machine. 2. To evaluate the incidence of severity of odynophagia. 3. To evaluate the weight change during treatment.
MATERIALS AND METHODS: In this retrospective study, we analyzed the data from postmodified radical mastectomy (PMRM) breast cancer patients treated with adjuvant chest wall radiotherapy using a hypofractionated regimen on a telecobalt machine at our hospital from 2017 to 2023 after institutional ethical committee approval. One hundred and fifty-six patients were treated with a hypofractionated regimen during this time period. The hypofractionated radiation schedule used was 40 Gy in 15 fractions with 2.66 Gy per fraction over 3 weeks, with 5 fractions per week on a telecobalt machine. Patient demographics, disease characteristics, treatment details, comorbidities, and skin reactions during treatment were retrieved from patient records and analyzed.
RESULTS: In our study, 148 (89.74%) patients had no skin reaction, and 16 patients had grade I radiation induced dermatitis during first week. During second week 88 (56.41%) patients had no skin reaction and 70 (56.41%) patients had grade I radiation induced dermatitis During third week, 137 (87.82%) patients had grade 1 and 9 (5.76%) patients developed grade 2 radiation induced dermatitis. None of the patient had grade III or IV radiation dermatitis during the treatment. During week 1 no patients had odynophagia and during week 2, grade 1 and 2 odynophagia was observed in 3 and 2 patients, respectively. Grade I odynophagia was observed in 16 patients and grade 2 odynophagia was documented in 9 patients during 3rd week of treatment and none of the patients had significant weight loss during treatment.
CONCLUSION: Our study demonstrates that hypofractionated adjuvant chest wall radiation therapy using a telecobalt machine is associated with a low incidence of severe acute skin reactions and odynophagia. The regimen appears to be well-tolerated, with minimal impact on weight and nutritional status.