643 / 1096
S627
ESTRO 36
_______________________________________________________________________________________________
control, including patients treated with BCS and MRM,
between November 2012 and March 2016.
Material and Methods
We included 560 patients: 394 were treated with MRM and
166
with
BCS.
According to the radiotherapy schedule received, they
were divided in 3 groups: 40Gy/15Fx, 42Gy/16Fx, and
50Gy/25Fx.
Results
At the end of the treatment, acute skin morbidity grade 1
was found in 57, 72 and 32% of the cases; grade 2 in 42,
27 and 64% for treatments with 40, 42 and 50 Gy,
respectively, and grade 3 in 3% for a dose of 50 Gy in
patients treated with
MRM.
Regarding BCS, skin morbidity grade 1 was found in 48, 66
and 23% of the cases, while grade 2 in 51, 33 and 73% for
treatments with 40, 42 and 50 Gy, respectively, and grade
3 in 3% of patients treated with 50 Gy (Figure 1).
After the first month, morbidity was reported in 489
patients (341 MRM and 148 BCS); mainly xerosis and
hyperpigmentation; subacute morbidity (at third month)
was reported in 346 patients (247 of MRM group and 99 of
BCS
group),
mainly
xerosis
(Table
1).
In follow-up studies, radiation pneumonitis was found in
seven patients treated with MRM (2.8% of the total),
regardless of the schedule received; they were still
asymptomatic
in
the
last
follow-up.
So far, we have an average 6-month follow-up after ending
RT treatment with 226 patients (136 of them were treated
with MRM, and 90 with BCS), with a maximum 3-year
follow-up.
In total, nine locoregional recurrences (LR) are reported,
either on the chest wall, breast or the lymph node regions,
while we found 14 systemic recurrences which are
reported in one or more sites. Most LR were observed
among patients treated with MRM, which may be
associated with the patients undergoing radical
treatments that generally have a more advanced clinical
stage.
Conclusion
With these results we can conclude that it is safe to use
hypofractionated treatments for patients with breast
cancer treated either with MRM , with acute and subacute
morbidity similar to that found in patients treated with
conventional schedules, at least with a similar local
control
between
the
different
schedules.
It is required, however, to complete the long-term
monitoring.
EP-1154 Changes in skin microcirculation during
radiation therapy for breast cancer
E. Tesselaar
1
, A.M. Flejmer
2
, S. Farnebo
3
, A. Dasu
4
1
Linköping University, Department of Radiation Physics
and Department of Medical and Health Sciences,
Linköping, Sweden
2
Linköping University, Department of Oncology and
Department of Clinical and Experimental Medicine,
Linköping, Sweden
3
Linköping University, Department of Hand and Plastic
Surgery and Burns and Department of Clinical and
Experimental Medicine, Linköping, Sweden
4
Skandionkliniken, ----, Uppsala, Sweden
Purpose or Objective
The majority of breast cancer patients who receive
radiation treatment are affected by acute radiation-
induced skin changes that are usually assessed by
subjective methods, like Radiation Therapy Oncology
Group (RTOG) scoring. These methods complicate the
comparison between treatments or patient groups and
therefore objective and robust methods are needed to
assess acute skin reactions. This study investigates the
feasibility of new camera-based methods for monitoring
skin microcirculation to objectively assess and quantify
acute skin reactions during radiation treatment.
Material and Methods
Fifteen patients undergoing adjuvant radiation therapy for
breast cancer were included in the study. The patients
received 42.56 Gy in 16 fractions using three dimensional
conformal radiotherapy with tangential photon
irradiation. Radiation-induced changes in microvascular
perfusion and red blood cell (RBC) concentration in the
skin of the patients were quantified with laser Doppler
flowmetry, laser speckle contrast imaging and polarized
light spectroscopy imaging. Measurements were made
before treatment, once a week during treatment and
directly after the last fraction. Changes in measured
values were analysed with two-way analyses of variance
with Dunnett’s correction for multiple comparisons.
Results
Perfusion (Figure 1) and RBC concentration (Figure 2) were
increased in the treated breast after 1-5 fractions, with
largest effects in the areola and the medial area. No
changes in perfusion and RBC concentration were seen in
the untreated breast. In contrast, RTOG scores were
increased above 0.5 only after two weeks of treatment.
Correlations have also been found between perfusion
(r=0.52) and RBC concentration (r=0.59) measurements
performed during current week and the RTOG score in the
following week. Furthermore, a good correlation has been
found between perfusion, as measured with LSCI, and
relative RBC concentration (r=0.64). Clinically, the results
indicate that optical techniques could be used for early
assessment of skin changes, with RBC concentration the
better predictor.
Figure 1. Variation of capillary perfusion in irradiated skin
of
breast
cancer
patients