Evidence map›Paper›PMID 40323361›Full record

SynthesisBreast cancer research and treatment2025

Chronic skin toxicities in breast cancer survivors: a systematic review and meta-analysis of radiotherapy techniques.

Shing Fung Lee, Henry C Y Wong, Jolien Robijns, Stephen Lowell B Ciocon, Paula Elaine Diniz Dos Reis, Sarina Sadeghi, Muna Al-Khaifi, Mami Ogita, Adrian W Chan, Agata Rembielak and 20 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Shing Fung LeeDepartment of Radiation Oncology, National University Cancer Institute, National University Hospital, 1E Kent Ridge Road, Singapore, 119228, Singapore. leesf@nuhs.edu.sg.ORCID http://orcid.org/0000-0003-4696-9434
Henry C Y WongDepartment of Oncology, Princess Margaret Hospital, Hospital Authority, Lai Chi Kok, Hong Kong.
Jolien RobijnsFaculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Hasselt, Belgium.
Stephen Lowell B CioconRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Paula Elaine Diniz Dos ReisInterdisciplinary Laboratory of Oncology Research, School of Health Sciences, University of Brasilia, Brasília, Brazil.
Sarina SadeghiDepartment of Medical Oncology and Hematology, Sunnybrook Health Science Centre, Odette Cancer Centre, University of Toronto, Toronto, Canada.
Muna Al-KhaifiDepartment of Medical Oncology and Hematology, Sunnybrook Health Science Centre, Odette Cancer Centre, University of Toronto, Toronto, Canada.
Mami OgitaDepartment of Radiology, The University of Tokyo Hospital, Tokyo, Japan.
Adrian W ChanDepartment of Radiation Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.
Agata RembielakDivision of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Daniel LiveseyChristie Education, The Christie NHS Foundation Trust, Manchester, UK.
Matthew ChongScarborough General Hospital, Toronto, Canada.
Zhihui Amy LiuDepartment of Biostatistics, Princess Margaret Cancer Centre, Dalla Lana School of Public Health, University Health Network, University of Toronto, Toronto, Canada.
Mark TrombettaDepartment of Radiation Oncology, Allegheny General Hospital, Drexel University College of Medicine, Pittsburgh, PA, USA.
Wee Yao KohDepartment of Radiation Oncology, National University Cancer Institute, National University Hospital, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Yiat Horng LeongDepartment of Radiation Oncology, National University Cancer Institute, National University Hospital, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Gustavo N MartaDepartment of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, Brazil.
Pierluigi BonomoRadiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy.
Viola SalvestriniRadiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy.
Vassilios VassiliouBank of Cyprus Oncology Centre, Nicosia, Cyprus.
Pradnya ChopadeRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Partha PatelFaculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Cindy WongUnion Oncology Centre, Tsim Sha Tsui, Hong Kong.
Julie Ryan WolfDepartment of Dermatology, University of Rochester Medical Center, Rochester, NY, USA.
Corina van den HurkCatharina Ziekenhuis, Eindhoven, The Netherlands.
Raymond J ChanCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Michael JeffordDepartment of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Edward ChowDepartment of Radiation Oncology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Jennifer Yin Yee KwanRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
on behalf of the Multinational Association of Supportive Care in Cancer (MASCC) Oncodermatology and, Survivorship Study Groups

Funding

Australian National Health and Medical Research Council APP1194051
6 · The paper itself

Abstract

purposeThis study assessed the impact of radiotherapy (RT) techniques on chronic skin reactions and health-related quality of life (HRQoL) in breast cancer patients, comparing conventional RT with modern techniques such as intensity-modulated RT (IMRT).

methodsA comprehensive search was conducted in Embase, MEDLINE, and Cochrane CENTRAL from inception to April 26, 2024. Conventional RT, which uses 2D or 3D imaging to shape radiation beams without dynamic intensity modulation, was compared with alternate RT techniques for adjuvant breast cancer treatment. Primary outcomes included chronic grade ≥ 2 skin toxicities (hyperpigmentation, breast fibrosis, telangiectasia, edema, and atrophy/retraction) and HRQoL, assessed mainly with EORTC QLQ-C30 and QLQ-BR23 modules. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effects model.

resultsFrom 1305 screened studies, nine articles representing seven studies (2418 patients), including three randomized controlled trials, met inclusion criteria. Most studies used conventional fractionation (45-50 Gray in 25 fractions). IMRT was associated with a lower incidence of chronic grade ≥ 2 hyperpigmentation (RR: 0.39, 95%CI: 0.17-0.89, I

conclusionIMRT may reduce certain chronic skin toxicities compared to conventional RT. However, consistent long-term differences in cosmetic outcomes or HRQoL were not observed. These findings are limited by the small number of studies and variability in reporting standards.

Indexed as

Breast NeoplasmsCancer SurvivorsRadiation InjuriesRadiotherapy, Intensity-ModulatedSkinFemaleHumansQuality of LifeBreast neoplasmsConformalIntensity-modulatedQuality of lifeRadiotherapySkin diseases

Identifiers

PMID40323361

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.