Objective Evaluation of Risk Factors for Radiation Dermatitis in Whole-Breast Irradiation Using the Spectrophotometric L*a*b Color-Space

Alexander M C Böhner; David Koch; Frederic Carsten Schmeel; Fred Röhner; Felix Schoroth; Gustavo R Sarria; Alina-Valik Abramian; Brigitta Gertrud Baumert; Frank Anton Giordano; Leonard Christopher Schmeel

doi:10.3390/cancers12092444

Objective Evaluation of Risk Factors for Radiation Dermatitis in Whole-Breast Irradiation Using the Spectrophotometric Lab Color-Space

Cancers (Basel). 2020 Aug 28;12(9):2444. doi: 10.3390/cancers12092444.

Affiliations

¹ Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany.
² Institute for Experimental Immunology, University Hospital Bonn, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany.
³ Department of Neuroradiology, University Hospital Bonn, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany.
⁴ Department of Gynecology and Obstetrics, Division of Senology, University Hospital Bonn, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany.
⁵ Institute of Radiation Oncology, Graubuenden Cantonal Hospital, Loestr. 170, 7000 Chur, Switzerland.

Abstract

Background: Radiation-induced dermatitis (RID) is frequent in breast cancer patients undergoing radiotherapy (RT). Spectrophotometry (SP) is an objective and reliable tool for assessing RID severity. Despite intensive research efforts during the past decades, no sustainable prophylactic and treatment strategies have been found. Estimation of new and reevaluation of established risk factors leading to severe RID is therefore of major importance. Methods: 142 early breast cancer patients underwent whole-breast irradiation following breast-conserving surgery. RID was evaluated by physician-assessed Common Terminology Criteria of Adverse Events (CTCAE v4.03). Spectrophotometers provided additional semi quantification of RID using the L*a*b color-space. A total of 24 patient- and treatment-related parameters as well as subjective patient-assessed symptoms were analyzed. Results: Values for a*max strongly correlated with the assessment of RID severity by physicians. Breast volume, initial darker skin, boost administration, and treatment technique were identified as risk factors for severe RID. RID severity positively correlated with the patients' perception of pain, burning, and reduction of everyday activities. Conclusions: Physician-assessed RID gradings correlate with objective SP skin measurements. Treatment technique and high breast volumes were identified as objective and significant predictors of RID. Our data provide a solid benchmark for future studies on RID with objective SP.

Keywords: L*a*b* color-space; RISRAS; breast cancer; radiation dermatitis; radiodermatitis; radiotherapy; risk factor; spectrophotometry; whole-breast irradiation.