Author: Rosa Maria Cibrián Ortiz de Anda, Altea C Esteve, Carlos M Galindo-González, Carmen C García, Amparo Gonzalez-Sanchis, Jose C Gordo-Partearroyo, Emilio Soria-Olivas, Javier Vijande 👨🔬
Affiliation: IFIC-UV, Valencia University, Hospital General Universitario 🌍
Purpose: To determine how skin microcirculation is affected by the two hypo-fractionated radiotherapy protocols in breast cancer patients using Laser Doppler Imaging, a non-invasive method for assessing blood flow. The study also aims to evaluate if a specialized bra mitigates skin side effects caused by RT.
Methods: Fifty patients participated. Eighteen patients received 40.05 Gy in 15 sessions (2.67 Gy per session), while 32 patients followed an ultra-hypofractionated protocol of 26 Gy in 5 sessions (5.2 Gy per session). Half of each group wore a specialized bra made of biodegradable viscose-chitosan and ionized polyamide with silver, designed to enhance skin defenses. Measurements were taken using a Laser Doppler Imager to quantify skin perfusion at three points: baseline, midway through treatment (after the third session for the 26 Gy group and after the fifth session for the 40.05 Gy group), and at the end of treatment. The relative difference in mean blood flow between the ipsilateral and contralateral breast was calculated as the microcirculation index. Skin toxicity was evaluated using the CTCAE scale.
Results: A significant increase in the microcirculation index was observed in both groups. At treatment completion, the 40.05 Gy group without the bra showed a higher microcirculation index, along with more radiation dermatitis, including grade 1 and grade 2 reactions. In contrast, the 40.05 Gy group with the bra had fewer reactions, nearly half grade 1 and none at grade 2. In the ultra-hypofractionated group, the increase in the microcirculation index was lower compared to the 40 Gy group. Only 4 patients without the bra showed grade 1 reactions (mild erythema). No skin changes were observed in patients who wore the bra in the ultra-hypofractionated group
Conclusion: The specialized bra effectively protects skin health during radiotherapy, showing benefits even in the ultra-hypofractionated group, with no adverse effects