对乳腺癌患者治疗中皮肤毒性风险因素的评估：CANTO皮肤研究
CANTO skin: Evaluation of skin toxicity risk factors in patients treated for breast cancer.
发表日期：2023 Aug 12
作者：
Sofiane Allali, Matthieu Carton, Sibille Everhard, Sofia Rivera, Youssef Ghannam, Karine Peignaux, Phillippe Guilbert, Brigitte De La Lande, Claire Chara-Brunaud, Julien Blanchecotte, David Pasquier, Séverine Racadot, Céline Bourgier, Paul Cottu, Fabrice André, Youlia Kirova
来源：
INTERNATIONAL JOURNAL OF CANCER
摘要：
皮肤反应是肿瘤学管理中常见的毒性反应，尤其是在放疗期间。评估和理解影响其发生的因素是早期乳腺癌（BC）患者管理中的重要问题。我们评估了8561名BC患者的全程管理情况。我们关注特定的皮肤毒性反应：红斑、纤维化、毛细血管扩张和皮肤颜色改变。这些毒性反应在基线定义的0-3-6个月（M0）、12个月（M12）、36个月（M36）和60个月（M60）时进行评估。有关毒性反应的患病率随时间变化，所以在M0时，30.4%的患者出现红斑，而17.7%的患者出现纤维化。在M60时，红斑的患病率为2%，而纤维化保持在约19%的稳定水平。经过调整，发现在M0时，皮肤红斑的发生与肥胖、腋窝淋巴结清除手术的存在、手术类型和肿瘤表型RH+/HER2+之间存在显著关联。对于纤维化问题，在M12发现与患者年龄、肥胖、Charlson评分和手术类型之间存在显著关联。关于皮肤颜色的改变，在M12发现与患者年龄、肥胖、吸烟和饮酒之间存在联系。预防这种毒性反应对生活质量至关重要。我们的研究结果使我们能够了解患者发生皮肤毒性反应的风险，这取决于她的内在特征、肿瘤特征或治疗特征，并采取适当的预防和监测措施。© 2023 UICC.
Skin reaction is a common toxicity during oncology management, especially followed during the radiotherapy. Its assessment and understanding of the factors influencing its occurrence, is a major issue in the management of patients treated for an early breast cancer (BC). We evaluated 8561 patients during their overall management for a BC. We focus on specific skin toxicities: erythema, fibrosis, telangiectasia and changes of skin colour. These toxicities were assessed at the baseline defined as 0-3-6 (M0), 12 (M12), 36 (M36) and 60 (M60) months. The prevalence of toxicities of interest varied over time, so at M0, 30.4% of patients had erythema while 17.7% of patients had fibrosis. At M60, the prevalence of erythema was 2%, while fibrosis remained stable at about 19%. After adjustments, at M0, there was a significant association between the onset of cutaneous erythema and obesity, the presence of axillary dissection, the type of surgery and the tumour phenotype RH+/HER2+. Concerning fibrosis, a significant association was found, at M12, with the age of the patient, obesity, Charlson score and type of surgery. Concerning the modification of skin colour at M12, we find a link between the age of the patient, obesity, tobacco consumption and alcohol consumption. The prevention of this toxicity is a major issue for the quality of life. Our results allow us to understand the risk of developing skin toxicity in a patient, depending on her intrinsic, tumour or therapeutic characteristics and to implement adapted means of prevention and monitoring.© 2023 UICC.