Impact of hypofractionation and tangential beam IMRT on the acute skin reaction in adjuvant breast cancer radiotherapy

Table 3 Treatment characteristics stratified by fractionation regimen

	Total		Fractionation regimen				p value
	Total		CF		HF
	n	%	n	%	n	%
Fractionation regimen
	266	100.0	145	100.0	121	100.0
Planning Target Volume (PTV)
Whole breast	130	48.9	69	47.6	61	50.4	0.65
Chest wall	136	51.1	76	52.4	60	49.6	0.65
Locoregional lymph nodes treated as part of plan
Yes	133	50.0	77	53.1	56	46.3	0.27
No	133	50.0	68	46.9	65	53.7	0.27
Boost to the PTV
Yes	129	48.5	83	57.2	46	38.0	<0.01
No	137	51.5	62	42.8	75	62.0	<0.01
Radiation technique
3DCRT	115	43.2	73	50.3	42	34.7	0.01
TB-IMRT	151	56.8	72	49.7	79	65.3	0.01
Prolongation of the prescribed overall treatment time (days)
0	220	82.7	103	71.0	117	96.7	<0.001
1	20	7.5	18	12.4	2	1.7
2	13	4.9	12	8.3	1	0.8
3	6	2.3	5	3.4	1	0.8
4	5	1.9	5	3.4	0	0
5	2	08	2	1.4	0	0
Chemotherapy
Neo-adjuvant	198	74.4	115	79.3	83	68.6	0.10
Adjuvant	56	21.1	26	17.9	30	24.8
No chemotherapy	12	4.5	4	2.8	8	6.6
Hormone therapy
Yes	198	74.7	111	76.6	87	72.5	0.45
No	67	25.3	34	23.4	33	27.5	0.45
Maximal radiation dermatitis grade (CTC v4.0)^a
0	20	7.5	7	4.8	13	10.7	<0.001
1	216	81.2	110	75.9	106	87.6
2	30	11.3	28	19.3	2	1.7
Time to dermatitis radiation grade 1 (days)^a
Mean	17		21		13		<0.0001
Standard deviation	7		7		3		<0.0001
Time to dermatitis radiation grade 2 (days)^a
Mean	34		35		21		<0.0001
Standard deviation	5		4		1		<0.0001

Abbreviation: ^a = Skin reactions observed during the radiotherapy of the whole breast or chest wall (before the possible application of a boost to the PTV; for CF at the planned dose of 50.4 Gy or 50.0 Gy, for HF at the planned dose of 40.05 Gy)

ISSN: 1748-717X