ESTRO 36 Abstract Book

S622

ESTRO 36 2017

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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

breast

cancer

patients

Figure 2. Variation of red blood cell concentration in

irradiated skin of breast cancer patients

Conclusion

The results showed that radiation-induced microvascular

changes in the skin can be objectively measured using

novel camera-based techniques before visual changes in

the skin are apparent. Also, the proposed methods may be

valuable in the comparison of skin reactions between

different radiation treatments.

EP-1155 Outcomes of breast cancer patients older

than 80 years treated with adjuvant radiotherapy

R. Barrientos

, M. Frelinghuysen

, M. Burotto

Instituto de Radiomedicina IRAM, Radiation Oncology,

Concepcion, Chile

Hospital Clinico Regional de Concepcion, Radiation

Oncology, Concepcion, Chile

Clinica Alemana de Santiago, Medical Oncology,

Santiago de Chile, Chile

Purpose or Objective

The main purpose was to estimate surviva l of patients

older than 80 years, diagnosed by Stage I-III breast cancer

that were treated by surgery and adjuvant radiotherapy

with curative intent. Breast cancer specific survival

different clinical and pathologic factors that influence

survival were estimated.

Material and Methods

We analyzed 85 breast cancer patients older than 80 years

old that received surgery and adjuvant radiotherapy with

curative intent. Overall survival was defined as the time

from the date histopathological diagnosis until the last

date of follow-up (official death certificate). Survival was

performed by Kaplan Meier method. A log rank test was

used to compare survival of different clinical and

pathological factors. Signficance level was determined by

(p-value <0.05).

Results

The median age at the time of diagnosis was 82.7 (range

77 to 88). The median follow up was 42 months. Overall

survival was 70% at 5 years. Breast cancer specific survival

(BCSS) was 94% a 5 years. Four patients (4.2%) died of

cardiovascular disease. Fifty five patients (65%) received

partial mastectomy, while 30 patients (35%) received total

mastectomy (MT). Fifty four patients (63%) received whole

breast or chest wall irradiation, while 31 patients (37%)

received locorregional irradiation. Five patients presented

cutaneous toxicity grade ≥

3.In

the univariate analysis

Clinical preoperative nodes, clinical tumor, locorregional

irradiation and pathologic tumor stage were significant for

overall survival . No other examined factor was

significant.