Clinical and therapeutic factors associated with the occurrence and severity of radiodermatitis in women with breast cancer undergoing adjuvant radiotherapy.

Abstract

Introduction: Radiotherapy is an integral part of cancer treatment for women diagnosed with breast cancer. Several side effects are observed during this treatment, most notably cutaneous toxicity, which manifests in a large proportion of patients and is called radiodermatitis. The severity of radiation-induced skin lesions is determined by a combination of factors related to both the treatment and the individual characteristics of the patient. Among the aspects associated with the patient, nutritional status stands out, with malnutrition being a factor that compromises tissue regeneration and obesity, which can alter tissue perfusion and oxygenation. In addition, technical variables such as the body area subjected to irradiation, the total radiation dose administered, and the type of equipment used also exert a significant influence on the extent and intensity of skin damage. Together, these factors modulate the biological response of the skin to radiotherapy stress and determine the risk of developing acute or chronic complications. Objective: To investigate the association between clinical and therapeutic characteristics and the severity of radiodermatitis in breast cancer patients undergoing adjuvant radiotherapy. Methods: This is an analytical observational study with a cross-sectional design, conducted using a sample from a randomized clinical trial whose main purpose was to investigate the effects of photobiomodulation in the prevention of radiodermatitis in breast cancer patients undergoing adjuvant radiotherapy. In this substudy, clinical and therapeutic variables of the participants included in the original trial were analyzed in order to identify possible factors associated with a higher chance of developing radiodermatitis, as well os its severity. This approach allowed a retrospective and exploratory evaluation of individual characteristics and aspects related to treatment, seeking to understand which elements may influence the adverse cutaneous response induced by radiation. Results: The total sample, composed of 20 patients, was analyzed with the objective of evaluating the association and influence of clinical and therapeutic variables on the occurrence and severity of radiodermatitis. However, the statistical analysis showed low significance, possibly due to the small sample size. Regarding BMI, descriptive data indicated a higher prevalence of radiodermatitis among overweight women (p = 0.0964). In relation to previous chemotherapy treatment, a higher occurrence of radiodermatitis was observed among those undergoing neoadjuvant chemotherapy (p = 0.356). Furthermore, the analysis of the type of surgical approach demonstrated that conservative procedures were associated with a higher frequency of radiodermatitis (p = 1). Conclusion: The data collected suggest that some factors may influence both the occurrence and severity of radiodermatitis. However, the small sample size of this study limits the robustness of the statistical analyses. Thus, it is necessary to conduct research with greater sampling power in order to improve the accuracy of the analyses and optimize the screening of these individuals.