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Japanese Journal of Clinical Oncology Advance Access published online on April 16, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyn030
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© The Author (2008). Published by Oxford University Press. All rights reserved

Acute Radiation Dermatitis and Pneumonitis in Japanese Breast Cancer Patients with Whole Breast Hypofractionated Radiotherapy Compared to Conventional Radiotherapy

Tomo Osako1,2, Masahiko Oguchi1,2, Madoka Kumada1,2, Keiko Nemoto1,2, Takuji Iwase2 and Takashi Yamashita1,2

1 Department of Radiation Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
2 Department of Breast Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

For reprints and all correspondence: Tomo Osako, Department of Pathology, The Cancer Institute of Japanese Foundation for Cancer Research, 3-10-6, Ariake, Koto-ku, Tokyo 135-8550, Japan. E-mail: tomo.osako{at}jfcr.or.jp

Received January 21, 2008; accepted March 21, 2008

Objective: To evaluate acute morbidity, radiation dermatitis and pneumonitis, of Japanese patients treated with whole breast hypofractionated radiotherapy (RT) after breast-conserving surgery (BCS), compared to conventional RT.

Methods: Japanese patients who received whole breast RT after BCS between October 2003 and September 2006 were retrospectively reviewed. Patients who had selected the conventional or hypofractionated schedule received whole breast irradiation of 50 Gy in 25 fractions plus boost or 40 Gy in 16 fractions plus boost. Radiation dermatitis and symptomatic pneumonitis were graded according to the Common Terminology Criteria for Adverse Events version 3.0.

Results: Of 443 consecutive patients, 377 (85%) received the conventional schedule and 66 (15%) received the hypofractionated schedule. Of patients treated with the conventional schedule, Grade 0, 1, 2 and 3 radiation dermatitis were observed in 16 (4%), 278 (74%), 77 (20%) and 6 (2%), respectively. Of patients treated with the hypofractionated schedule, Grade 0, 1, 2 and 3 dermatitis were observed in 11 (17%), 49 (74%), 5 (8%) and 1 (1%), respectively. Grade 2–3 dermatitis by the hypofractionated schedule (9%) was observed less frequently than that by the conventional schedule (22%) (chi-square test; P = 0.016). Moreover, of patients treated with the conventional schedule, 4 (1%) had Grade 2 radiation pneumonitis. No patient treated with the hypofractionated schedule had symptomatic pneumonitis.

Conclusions: Radiation dermatitis and pneumonitis in Japanese patients treated with the hypofractionated schedule is acceptable. Especially, radiation dermatitis by the hypofractionated schedule is milder than that by the conventional schedule.

Key Words: breast cancer • breast-conserving surgery • whole breast hypofractionated radiotherapy • radiation dermatitis • radiation pneumonitis


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