• Leah Drost, Nim Li, Danny Vesprini, Arneet Sangha, Justin Lee, Eric Leung, Eileen Rakovitch, Caitlin Yee, Edward Chow, and Mark Ruschin.
• Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
• Clin. Breast Cancer. 2018 Oct 1; 18 (5): e789-e795.

BackgroundDespite clear benefits of radiotherapy (RT) for breast cancer, there are numerous side effects. Radiation dermatitis has a significant impact on quality of life and can result in treatment interruptions or cessation. The purpose of this study was to prospectively follow breast radiation dermatitis and determine trends including peak toxicity.Patients And MethodsUpon initiation of RT treatment, to assess skin reaction, each patient was seen weekly by the healthcare team, or contacted via telephone to assess patient-reported symptoms. Weekly progression of radiation dermatitis was assessed using the Common Terminology Criteria for Adverse Events (CTCAE), version 4.03. Patients were stratified for analysis of radiation dermatitis based on RT technique and dosage.ResultsA total of 148 patients with 2 or more skin assessments were analyzed. The majority of patients received 2-field tangential RT (64.2%) with a dose of 5000 cGy in 25 fractions. Overall, patients experienced the most Grade 2 CTCAE toxicity (61.9%) 2 weeks after completion of RT; Grade 3 toxicity also peaked at this time (8.3%). Regardless of stratification by RT technique or by dosage of RT, Grade 2 and 3 toxicities consistently peaked at 1 or 2 weeks after RT.ConclusionsBreast radiation dermatitis appears to peak approximately 2 weeks after RT. Treatment factors such as technique or dosing regimen do not appear to have a substantial effect on radiation dermatitis, but our study was limited by small sample size. This study provides additional evidence that radiation dermatitis should continue to be followed closely, especially in the 2 weeks following RT.Copyright © 2018 Elsevier Inc. All rights reserved.

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