Prospective evaluation of radiation-induced skin toxicity in a race/ethnically diverse breast cancer population

Jean Wright, Cristiane Takita, Isildinha M. Reis, Wei Zhao, Eunkyung Lee, Omar L. Nelson, Jennifer J. Hu

Research output: Contribution to journalArticle

Abstract

We evaluated predictors of radiation-induced skin toxicity in a prospective study of a tri-racial/ethnic breast cancer population. We evaluated patient demographics, tumor characteristics, and treatment variables in the first 392 patients in a prospective study assessing radiation-induced skin toxicity. Logistic regression analyses were conducted to evaluate potential predictors of skin toxicity. The study consists of 59 non-Hispanic whites (NHW; 15%), 241 Hispanic Whites (HW; 62%), 79 black or African Americans (AA; 20%), and 13 others (3%). Overall, 48% developed grade 0-1 skin toxicity, 49.8% grade 2, and 2.2% grade 3 by the National Cancer Institute's Common Toxicity Criteria for Adverse Events (CTCAE) scale. Twenty-one percent developed moist desquamation. In multivariate analysis, higher body mass index (BMI; OR = 2.09; 95%CI = 1.15, 3.82), higher disease stage (OR = 1.82; 95%CI = 1.06, 3.11), ER-positive/PR-negative status (OR = 2.74; 95%CI = 1.26, 5.98), and conventionally fractionated regimens (OR = 3.25; 95%CI = 1.76, 6.01) were significantly associated with higher skin toxicity grade after adjustment for age, race, ethnicity, ER status, and breast volume. BMI specifically predicted for moist desquamation, but not degree of erythema. In this racially and ethnically diverse cohort of breast cancer patients receiving radiation to the intact breast, risk factors including BMI, disease stage, and conventionally fractionated radiation predicted for higher skin toxicity grade, whereas age, race, ethnicity, and breast volume did not. BMI specifically predicted for moist desquamation, suggesting that preventive measures to address this particular outcome should be investigated.

Original languageEnglish (US)
Pages (from-to)454-464
Number of pages11
JournalCancer Medicine
Volume5
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Radiation
Breast Neoplasms
Skin
Population
Breast
Prospective Studies
National Cancer Institute (U.S.)
Erythema
Hispanic Americans
African Americans
Body Mass Index
Multivariate Analysis
Logistic Models
Regression Analysis
Demography
Neoplasms
Therapeutics

Keywords

  • Breast cancer
  • Racial/ethnic disparity
  • Radiation dermatitis
  • Radiation therapy
  • Skin toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Prospective evaluation of radiation-induced skin toxicity in a race/ethnically diverse breast cancer population. / Wright, Jean; Takita, Cristiane; Reis, Isildinha M.; Zhao, Wei; Lee, Eunkyung; Nelson, Omar L.; Hu, Jennifer J.

In: Cancer Medicine, Vol. 5, No. 3, 01.03.2016, p. 454-464.

Research output: Contribution to journalArticle

Wright, Jean ; Takita, Cristiane ; Reis, Isildinha M. ; Zhao, Wei ; Lee, Eunkyung ; Nelson, Omar L. ; Hu, Jennifer J. / Prospective evaluation of radiation-induced skin toxicity in a race/ethnically diverse breast cancer population. In: Cancer Medicine. 2016 ; Vol. 5, No. 3. pp. 454-464.
@article{dec773981c074fd987607845cad44e4a,
title = "Prospective evaluation of radiation-induced skin toxicity in a race/ethnically diverse breast cancer population",
abstract = "We evaluated predictors of radiation-induced skin toxicity in a prospective study of a tri-racial/ethnic breast cancer population. We evaluated patient demographics, tumor characteristics, and treatment variables in the first 392 patients in a prospective study assessing radiation-induced skin toxicity. Logistic regression analyses were conducted to evaluate potential predictors of skin toxicity. The study consists of 59 non-Hispanic whites (NHW; 15{\%}), 241 Hispanic Whites (HW; 62{\%}), 79 black or African Americans (AA; 20{\%}), and 13 others (3{\%}). Overall, 48{\%} developed grade 0-1 skin toxicity, 49.8{\%} grade 2, and 2.2{\%} grade 3 by the National Cancer Institute's Common Toxicity Criteria for Adverse Events (CTCAE) scale. Twenty-one percent developed moist desquamation. In multivariate analysis, higher body mass index (BMI; OR = 2.09; 95{\%}CI = 1.15, 3.82), higher disease stage (OR = 1.82; 95{\%}CI = 1.06, 3.11), ER-positive/PR-negative status (OR = 2.74; 95{\%}CI = 1.26, 5.98), and conventionally fractionated regimens (OR = 3.25; 95{\%}CI = 1.76, 6.01) were significantly associated with higher skin toxicity grade after adjustment for age, race, ethnicity, ER status, and breast volume. BMI specifically predicted for moist desquamation, but not degree of erythema. In this racially and ethnically diverse cohort of breast cancer patients receiving radiation to the intact breast, risk factors including BMI, disease stage, and conventionally fractionated radiation predicted for higher skin toxicity grade, whereas age, race, ethnicity, and breast volume did not. BMI specifically predicted for moist desquamation, suggesting that preventive measures to address this particular outcome should be investigated.",
keywords = "Breast cancer, Racial/ethnic disparity, Radiation dermatitis, Radiation therapy, Skin toxicity",
author = "Jean Wright and Cristiane Takita and Reis, {Isildinha M.} and Wei Zhao and Eunkyung Lee and Nelson, {Omar L.} and Hu, {Jennifer J.}",
year = "2016",
month = "3",
day = "1",
doi = "10.1002/cam4.608",
language = "English (US)",
volume = "5",
pages = "454--464",
journal = "Cancer Medicine",
issn = "2045-7634",
publisher = "John Wiley and Sons Ltd",
number = "3",

}

TY - JOUR

T1 - Prospective evaluation of radiation-induced skin toxicity in a race/ethnically diverse breast cancer population

AU - Wright, Jean

AU - Takita, Cristiane

AU - Reis, Isildinha M.

AU - Zhao, Wei

AU - Lee, Eunkyung

AU - Nelson, Omar L.

AU - Hu, Jennifer J.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - We evaluated predictors of radiation-induced skin toxicity in a prospective study of a tri-racial/ethnic breast cancer population. We evaluated patient demographics, tumor characteristics, and treatment variables in the first 392 patients in a prospective study assessing radiation-induced skin toxicity. Logistic regression analyses were conducted to evaluate potential predictors of skin toxicity. The study consists of 59 non-Hispanic whites (NHW; 15%), 241 Hispanic Whites (HW; 62%), 79 black or African Americans (AA; 20%), and 13 others (3%). Overall, 48% developed grade 0-1 skin toxicity, 49.8% grade 2, and 2.2% grade 3 by the National Cancer Institute's Common Toxicity Criteria for Adverse Events (CTCAE) scale. Twenty-one percent developed moist desquamation. In multivariate analysis, higher body mass index (BMI; OR = 2.09; 95%CI = 1.15, 3.82), higher disease stage (OR = 1.82; 95%CI = 1.06, 3.11), ER-positive/PR-negative status (OR = 2.74; 95%CI = 1.26, 5.98), and conventionally fractionated regimens (OR = 3.25; 95%CI = 1.76, 6.01) were significantly associated with higher skin toxicity grade after adjustment for age, race, ethnicity, ER status, and breast volume. BMI specifically predicted for moist desquamation, but not degree of erythema. In this racially and ethnically diverse cohort of breast cancer patients receiving radiation to the intact breast, risk factors including BMI, disease stage, and conventionally fractionated radiation predicted for higher skin toxicity grade, whereas age, race, ethnicity, and breast volume did not. BMI specifically predicted for moist desquamation, suggesting that preventive measures to address this particular outcome should be investigated.

AB - We evaluated predictors of radiation-induced skin toxicity in a prospective study of a tri-racial/ethnic breast cancer population. We evaluated patient demographics, tumor characteristics, and treatment variables in the first 392 patients in a prospective study assessing radiation-induced skin toxicity. Logistic regression analyses were conducted to evaluate potential predictors of skin toxicity. The study consists of 59 non-Hispanic whites (NHW; 15%), 241 Hispanic Whites (HW; 62%), 79 black or African Americans (AA; 20%), and 13 others (3%). Overall, 48% developed grade 0-1 skin toxicity, 49.8% grade 2, and 2.2% grade 3 by the National Cancer Institute's Common Toxicity Criteria for Adverse Events (CTCAE) scale. Twenty-one percent developed moist desquamation. In multivariate analysis, higher body mass index (BMI; OR = 2.09; 95%CI = 1.15, 3.82), higher disease stage (OR = 1.82; 95%CI = 1.06, 3.11), ER-positive/PR-negative status (OR = 2.74; 95%CI = 1.26, 5.98), and conventionally fractionated regimens (OR = 3.25; 95%CI = 1.76, 6.01) were significantly associated with higher skin toxicity grade after adjustment for age, race, ethnicity, ER status, and breast volume. BMI specifically predicted for moist desquamation, but not degree of erythema. In this racially and ethnically diverse cohort of breast cancer patients receiving radiation to the intact breast, risk factors including BMI, disease stage, and conventionally fractionated radiation predicted for higher skin toxicity grade, whereas age, race, ethnicity, and breast volume did not. BMI specifically predicted for moist desquamation, suggesting that preventive measures to address this particular outcome should be investigated.

KW - Breast cancer

KW - Racial/ethnic disparity

KW - Radiation dermatitis

KW - Radiation therapy

KW - Skin toxicity

UR - http://www.scopus.com/inward/record.url?scp=85006207079&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006207079&partnerID=8YFLogxK

U2 - 10.1002/cam4.608

DO - 10.1002/cam4.608

M3 - Article

C2 - 26763411

AN - SCOPUS:85006207079

VL - 5

SP - 454

EP - 464

JO - Cancer Medicine

JF - Cancer Medicine

SN - 2045-7634

IS - 3

ER -