Increased Risk of Varicella-Zoster Virus Infection in Breast Cancer Patients Treated with Adjuvant Radiation Therapy - A Population Based Cohort Study

e12048 Background: Fatigue and insomnia are frequent conditions experienced by breast cancer patients during adjuvant radiation therapy (RT). Our group reported that fatigue correlates with reduced CD34+ circulating hematopoetic stem cell (HSC) levels. Our current study examined the role of inflammatory cytokines in mediating fatigue and insomnia following adjuvant RT. Methods: Phlebotomies were conducted on 148 breast cancer patients undergoing adjuvant RT at five time points: prior to RT (D1), after two (D2) and five (D5) days of treatment, during the final week of RT (Df), and one month post-RT completion (M1). CD34+, CD45+, circulating blood cell (CBC), and 17 inflammatory cytokine levels were assessed. Patients also completed questionnaires at each time point, including the multidimensional fatigue inventory (MIF-21), insomnia severity index (ISI), and hospital anxiety and depression scale (HADS). Results: CD34+, CD45+ and CBC levels decreased during treatment with adjuvant RT, with the lowest levels observed at Df (p<0.001). General fatigue significantly worsened throughout treatment from D1 to Df, returning to baseline at M1, (p<0.001; adjusted for insomnia, depression and anxiety). General fatigue worsened as CD34+ counts, hemoglobin and CBCs increased (p<0.001). Insomnia increased with reduced CD34+, CD45+ and CBCs (p<0.05). TGF-β1, MCP-1, MMP-2, IL-1ra and IFN-α2a cytokine expression varied throughout RT (p<0.01), most significantly at Df. Elevated MCP-1, TNF-RII and TNF-a levels correlated with worsening general fatigue, increased insomnia, and reduced activity and motivation (p<0.001). MMP-2 increased as IL-1ra, CD34+, CD45+ and CBC counts decreased (p<0.001). Further, the 52 patients who received prior adjuvant chemotherapy had elevated levels of fatigue, insomnia and anxiety, which correlated with high HSCs levels. Conclusions: Our findings demonstrate that fatigue and insomnia are associated with reduced HSCs and increased MCP-1, TNF-RII and TNF-a pro-inflammatory cytokines. This examination of the effect of RT on fatigue and insomnia is one of the most comprehensive longitudinal clinical evaluations of its kind.

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SKIN AND SUBCUTANEOUS ADIPOSE TISSUE DAMAGE AFTER RADIATION THERAPY IN BREAST CANCER PATIENTS

Проблеми радіаційної медицини та радіобіології = Problems of Radiation Medicine and Radiobiology ◽

10.33145/2304-8336-2021-26-18-35 ◽

2021 ◽

Vol 26 ◽

pp. 18-35

Author(s):

D. Bazyka ◽

◽

O. Litvinenko ◽

S. Bugaytsov ◽

G. Shakhrai ◽

...

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Adjuvant Radiotherapy ◽

Soft Tissues ◽

Morphological Changes ◽

Subcutaneous Tissue ◽

Adjuvant Radiation ◽

Pathological Changes ◽

Breast Cancer Patients ◽

Adjuvant Radiation Therapy

The analysis of long-term researches of the pathological changes arising in soft tissues at patients with a breast cancer as a result of radical surgical treatment and adjuvant radiotherapy is carried out in work. The article shows that the standard approach to postoperative radiation therapy, which is based only on the prevalence of the primary tumor process is not always justified. Very often it leads to excessive radiation load on the patient's body and the development of local acute and chronic radiation reactions of the skin, subcutaneous tissue and other soft tissues. In this regard, the question of differentiated purpose of radiotherapy acquires special value first of all at patients with small primary prevalence of tumor process. The paper presents the results of studies to study changes in the anterior chest wall in patients with breast cancer. In relation to the conduct of adjuvant radiotherapy more often need to use the concept of personalized radiation therapy. Radical operation, post-radiation early and late pathological changes in soft tissues, disturbance of microcirculation of lymph and blood, disturbance of innervation of vessels of an upper extremity, peripheral nerves in system of a cervical and plexus plexus, leads to intensive degenerative and dystrophic changes in soft tissues of the upper. and causes morphological changes in them and further progression of reflex neurovascular and neurodystrophic disorders. Based on the data of adverse effects of radiotherapy on the skin and surrounding tissues, as well as to reduce excessive radiation exposure to the patient's body, a differentiated approach to the appointment of adjuvant radiation therapy. The Scientific Council meeting of NAMS approved the NRCRM Annual Report. Key words: breast cancer, radiation therapy, adjuvant radiation therapy, complications of radiation therapy, radiation reactions, radiation injuries.

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