Systematic review and meta-analysis of impact of radiotherapy technique on chronic skin toxicities in breast cancer survivors

A systematic review and meta-analysis identified seven studies (2418 patients) comparing intensity-modulated and conventional radiotherapy for the endpoint chronic skin toxicity in breast cancer survivors. Most studies used conventional fractionation (45-50 Gy in 25 fractions. IMRT was associated with a lower incidence of chronic grade ≥ 2 hyperpigmentation (RR 0.39; 95% CI 0.17-0.89; I²=0%). No significant differences were found for grade ≥ 2 breast fibrosis, telangiectasia, edema, and atrophy/retraction. Cosmetic outcomes from IMRT were favorable in the short term, with no long-term differences. Three studies reported no significant HRQoL differences between IMRT and conventional RT.