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Abstract
Purpose: In this study, we examined the impact of reconstruction using tissue expander insertion (TEI) on the risk of radiation dermatitis in patients undergoing postmastectomy radiotherapy (PMRT).

Methods: Between August 2015 and March 2019, patients with breast cancer who had received systemic chemotherapy and PMRT were prospectively included. Skin parameters, including melanin, erythema, hydration, sebum, and elasticity, were measured using a multi-probe instrument at 6 time points: before the initiation of radiotherapy (pre-RT), at weeks 1, 3, and 5 during radiotherapy (weeks 1-5), and 1 and 3-month after radiotherapy (post-RT-1m and post-RT-3m). Patient-reported outcomes (PROs) were assessed at each time point. Changes in biophysical parameters and PRO were compared between patients with and without TEI (TEI+ vs. TEI-).

Results: Thirty-eight patients, including 18 with TEI+ and 20 with TEI-, were analyzed. The pattern of time-course changes in biophysical parameters and PRO did not differ between TEI+ and TEI- patients. The melanin index was highest at post-RT-1m, while the erythema index was highest at week 5. At post-RT-3m, TEI+ patients presented higher melanin values than TEI- patients, with no statistical significance (coefficient, 47.9 vs. 14.2%; p = 0.07). In all patients, water content decreased throughout the measurement period. At post-RT-3m, TEI+ patients demonstrated a further decrease in water content, while the TEI- group nearly recovered the water content to pre-RT status (coefficient, -17.1, -2.5; p = 0.11). The sebum and elasticity levels were not altered by TEI.

Conclusion: In patients undergoing PMRT, TEI did not significantly affect the changing patterns of skin biophysical parameters and PRO during radiotherapy.

Affiliations

Haeyoung Kim #  1 , Danbee Kang #  2   3 , Won Park  4 , Juhee Cho  2   3 , Hyeokgon Park  5 , Eunjoo Kim  5 , Doo Ho Choi  1 , Won Kyung Cho  1 , Byung Joon Jeon  6 , Kyeong Tae Lee  6
1 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2 Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea.
3 Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
4 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonro.park@samsung.com.
5 Skin Research Institute, Amorepacific Corporation R&D Center, Youngin, Korea.
6 Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
# Contributed equally.