PMID- 33574446
OWN - NLM
STAT- MEDLINE
DCOM- 20211116
LR  - 20211116
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 11
IP  - 1
DP  - 2021 Feb 11
TI  - Correlation between toxicity and dosimetric parameters for adjuvant intensity 
      modulated radiation therapy of breast cancer: a prospective study.
PG  - 3626
LID - 10.1038/s41598-021-83159-3 [doi]
LID - 3626
AB  - ORCID: 0000-0001-6019-7309. 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.
FAU - Pasquier, David
AU  - Pasquier D
AUID- ORCID: 0000-0001-6019-7309
AD  - Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 rue Frederic 
      Combemale, 59000, Lille, France. d-pasquier@o-lambret.fr.
AD  - CRIStAL UMR CNRS 9189, Lille University, Avenue Carl Gauss, 59650, 
      Villeneuve-d'Ascq, France. d-pasquier@o-lambret.fr.
FAU - Bataille, Benoit
AU  - Bataille B
AD  - Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 rue Frederic 
      Combemale, 59000, Lille, France.
FAU - Le Tinier, Florence
AU  - Le Tinier F
AD  - Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 rue Frederic 
      Combemale, 59000, Lille, France.
FAU - Bennadji, Raoudha
AU  - Bennadji R
AD  - Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 rue Frederic 
      Combemale, 59000, Lille, France.
FAU - Langin, Helene
AU  - Langin H
AD  - Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 rue Frederic 
      Combemale, 59000, Lille, France.
FAU - Escande, Alexandre
AU  - Escande A
AD  - Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 rue Frederic 
      Combemale, 59000, Lille, France.
AD  - CRIStAL UMR CNRS 9189, Lille University, Avenue Carl Gauss, 59650, 
      Villeneuve-d'Ascq, France.
FAU - Tresch, Emmanuelle
AU  - Tresch E
AD  - Methodology and Biostatistics Unit, Centre Oscar Lambret, 3 rue Frederic 
      Combemale, 59000, Lille, France.
FAU - Darloy, Franck
AU  - Darloy F
AD  - Service de Radiotherapie, Clinique du Pont Saint-Vaast, Centre Leonard de Vinci, 
      2 rue du Pont Saint-Vaast, 59500, Douai, France.
FAU - Carlier, Damien
AU  - Carlier D
AD  - Service de Radiotherapie, Clinique du Pont Saint-Vaast, Centre Leonard de Vinci, 
      2 rue du Pont Saint-Vaast, 59500, Douai, France.
FAU - Crop, Frederik
AU  - Crop F
AD  - Medical Physics Department, Centre Oscar Lambret, 3 rue Frederic Combemale, 
      59000, Lille, France.
FAU - Lartigau, Eric
AU  - Lartigau E
AD  - Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 rue Frederic 
      Combemale, 59000, Lille, France.
AD  - CRIStAL UMR CNRS 9189, Lille University, Avenue Carl Gauss, 59650, 
      Villeneuve-d'Ascq, France.
LA  - eng
SI  - ClinicalTrials.gov/NCT02281149
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20210211
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
SB  - IM
MH  - Adult
MH  - Aged
MH  - Breast Neoplasms/*radiotherapy
MH  - Dose-Response Relationship, Radiation
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Middle Aged
MH  - Organs at Risk
MH  - Prospective Studies
MH  - *Radiotherapy Dosage
MH  - *Radiotherapy, Adjuvant/adverse effects
MH  - *Radiotherapy, Intensity-Modulated/adverse effects
PMC - PMC7878810
COIS- The authors declare no competing interests.
EDAT- 2021/02/13 06:00
MHDA- 2021/11/17 06:00
PMCR- 2021/02/11
CRDT- 2021/02/12 06:00
PHST- 2020/08/19 00:00 [received]
PHST- 2021/01/21 00:00 [accepted]
PHST- 2021/02/12 06:00 [entrez]
PHST- 2021/02/13 06:00 [pubmed]
PHST- 2021/11/17 06:00 [medline]
PHST- 2021/02/11 00:00 [pmc-release]
AID - 10.1038/s41598-021-83159-3 [pii]
AID - 83159 [pii]
AID - 10.1038/s41598-021-83159-3 [doi]
PST - epublish
SO  - Sci Rep. 2021 Feb 11;11(1):3626. doi: 10.1038/s41598-021-83159-3.