CR-Predicting skin toxicity.

When determining which patients with breast cancer should receive post-op radiation, every decision comes down to one thing: risk/benefit ratio. And while hundreds of thousands of women have been enrolled in trials to help us decide who will benefit most, we're left not really knowing much at all about which women are at most risk of side effects. A prospective study at Wake Forest assessed 1K women undergoing adjuvant radiation to whole breast or chest wall +/- regional nodes. They all had with pre- and post-radiation blood samples and questionnaires assessing skin toxicity. About 60% of patients were white, 30% were black and a full half were obese. In other words, it was a pretty representative population. So what were the big predictors of at least grade 4 skin toxicity? Obesity with an OR of 2.2 and, the headliner, level of C-reactive protein (CRP) drawn immediately following last radiation treatment (specifically if ≥ 4.11) with an OR of 1.6. And if you had an abundance of both pounds and CRP, that OR rose to 3.7. TBL: Elevated CRP following breast radiation is a new biomarker for skin toxicity. Too bad to comes only after the damage is done. | Hu, J Clin Oncol 2018