Radiation Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, PN, Italy.
Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, PN, Italy.
Breast. 2022 Oct;65:49-54. doi: 10.1016/j.breast.2022.06.008. Epub 2022 Jul 2.
and purpose: Radiation recall dermatitis is an adverse event predominantly due to systemic therapy administration after a previous radiation therapy course. Few case reports describe radiation recall dermatitis in breast cancer patients treated with postoperative radiation therapy following COVID-19 vaccination. In this study we investigated the incidence and severity of radiation recall dermatitis after COVID-19 vaccination in irradiated breast cancer patients.
Patients that received at least one COVID-19 vaccination dose during the year after the end of postoperative breast radiation therapy were included in this observational monocentric study. Local symptoms occurring inside the radiation field after vaccination were patient-reported and scored according to the PRO-CTCAE questionnaire. Descriptive data of radiation recall dermatitis incidence and severity, and potential risk factors were evaluated.
A cohort of 361 patients with 756 administered COVID-19 vaccinations was analyzed. Breast symptoms were reported by 7.5% of patients, while radiation recall dermatitis was considered for 5.5%. The incidence of radiation recall dermatitis per single dose of vaccine was 2.6%, with a higher risk for the first dose compared to the second/third (4.4% vs 1%, p = 0.003), especially when administered within the first month after the end of irradiation (12.5% vs 2.2%, p = 0.0004). Local symptoms were generally self-limited and a few cases required anti-inflammatory drugs.
Radiation recall dermatitis is an uncommon but not rare phenomenon in breast cancer patients that received COVID-19 vaccination within one year after breast irradiation. However, symptoms severity were generally low/mild and reversible. These findings can be useful for patient counseling.
目的：辐射召回性皮炎主要是由于先前放射治疗后全身治疗引起的不良反应。少数病例报告描述了 COVID-19 疫苗接种后接受术后放射治疗的乳腺癌患者发生辐射召回性皮炎。在这项研究中，我们调查了 COVID-19 疫苗接种后接受放射治疗的乳腺癌患者辐射召回性皮炎的发生率和严重程度。
本观察性单中心研究纳入了在术后乳房放射治疗结束后至少接受过一次 COVID-19 疫苗接种的患者。接种疫苗后在放射野内发生的局部症状由患者报告并根据 PRO-CTCAE 问卷进行评分。评估了辐射召回性皮炎发生率和严重程度的描述性数据以及潜在的危险因素。
分析了 361 例患者（共 756 例）的队列。7.5%的患者报告有乳房症状，而 5.5%的患者被认为患有辐射召回性皮炎。每单剂疫苗的辐射召回性皮炎发生率为 2.6%，与第二/第三剂相比，第一剂的风险更高（4.4%比 1%，p=0.003），尤其是在放射治疗结束后第一个月内接种时（12.5%比 2.2%，p=0.0004）。局部症状通常是自限性的，少数病例需要使用抗炎药。
在放射治疗后一年内接受 COVID-19 疫苗接种的乳腺癌患者中，辐射召回性皮炎是一种不常见但并非罕见的现象。然而，症状严重程度通常较低/轻度且可逆转。这些发现可为患者咨询提供有用信息。
