Comparison of radiation dermatitis between hypofractionated and conventionally fractionated postoperative radiotherapy: objective, longitudinal assessment of skin color

• Published in: Scientific reports 2018-08, Vol.8 (1), p.12306-8, Article 12306
• Main Authors: Yamazaki, Hideya, Takenaka, Tadashi, Aibe, Norihiro, Suzuki, Gen, Yoshida, Ken, Nakamura, Satoaki, Masui, Koji, Kimoto, Takuya, Sasaki, Naomi, Nishimura, Tsuyoshi, Nakashima, Akihiro, Goto, Mariko, Yamada, Kei
• Format: Article
• Language: English
• Subjects: 59; 692/1807/1812; 692/4028/67/1347; Adult; Aged; Breast Neoplasms - surgery; Color; Dermatitis; Dose Fractionation, Radiation; Female; Humanities and Social Sciences; Humans; Middle Aged; multidisciplinary; Radiation Injuries - diagnosis; Radiation therapy; Radiodermatitis - diagnosis; Radiotherapy, Adjuvant - adverse effects; Science; Science (multidisciplinary); Skin; Skin pigmentation; Skin Pigmentation - physiology; Statistical analysis; Surgery; Terminology
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-018-30710-4

This study aimed to quantitatively compare radiation dermatitis due to hypofractionated (Hypo) and conventionally fractionated (Conv) external-beam radiotherapy in patients who underwent postoperative radiotherapy after breast-conserving surgery. Skin color changes, in terms of L* (brightness, white-black), a* (red-green), and b* (yellow-blue) values, due to external-beam radiotherapy were examined at alternate fractions using an objective method. Twenty-six patients were included in the Hypo group (42.56 Gy/16 fractions) and 46 in the Conv group (50 Gy/25 fractions). Radiotherapy decreased the L* value (darker) and increased the a* value (redder) gradually. These color alterations progressed linearly according to elapsed fractions and were similar between Hypo and Conv per fraction. The Hypo group showed significantly milder alterations in L* and a* values than the Conv group. The maximal dosage was significantly correlated to alterations in L* and a* values. Common Terminology Criteria for Adverse Events v4 assessment did not show a statistically significant difference between the Hypo (Grade 0:1:2 = 2:24:1) and Conv (1:39:6, p = 0.25) groups. The results of our objective analysis revealed that patients undergoing Hypo show milder color alteration than those undergoing Conv and that the maximal dosage is a useful predicator of color alteration.