Radiation Induced Dermatitis In Patients Receiving Neoadjuvant Chemoradiation. A Phase II Prospective Feasibility Study

Abstract

Background: Locally advanced breast cancer patients represent nearly half of newly diagnosed breast cancer patients in developing countries and despite the different systemic treatment options in neoadjuvant settings they still represent a challenging situation. Applying radiation therapy concurrently with systemic therapy may improve pathological response in such patients and therefore facilitate surgery and improve survival outcomes.

Materials and Methods: Eighty female breast cancer patients were enrolled, all received neoadjuvant systemic therapy in the form of Adriamycin and cyclophosphamides followed by Taxanes concurrently with Radiation Therapy. Surgery was performed 6-8 weeks post Radiation- therapy. Radiation Therapy Details: All patients received whole breast as well as regional lymphatics irradiation 4005 cGy in 15 fractions. Boost was given to patients younger than 50 years old or pathological Grade 3. Treatment plans were done using Monaco planning system and patients were treated using Elekta Versa HD machine.

Results:  ninety percent of the patients had stage III disease.

Luminal disease represented 49% of the patients, while Her2 represented 45% of the patients. Grade (G) 1: dermatitis represented the majority of events, G2 and G3

represented 15% only with no G 4 toxicity.

Postoperative complications were observed in 16% of the patients.

Conclusion: Applying concurrent chemoradiation in preoperative settings is safe and feasible with acceptable complications rate.