by Vinante Lorenzo, Caroli Angela, Revelant Alberto, Bertini
Federica, Giroldi Anna, Marson Marta, Franchin Giovanni, Muraro Elena, Brisotto
Giulia, Steffan Agostino, Baboci Lorena
The Breast: Published: July 01, 2022
Background
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.
Methods
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.
Results
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.
Conclusions
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.
