{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:25:38Z","timestamp":1787030738305,"version":"build-2736575974"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immediate breast reconstruction is increasingly performed in women with breast cancer, yet many such patients also require post-mastectomy radiotherapy (PMRT), during which acute radiation dermatitis (RD) is common and may compromise reconstruction outcomes and quality of life. Risk factors for RD have been characterized mainly in non-reconstructed or breast-conserving populations, and data specific to immediately-reconstructed patients are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 61 women with immediate reconstruction (implant\/expander or autologous tissue) who completed adjuvant radiotherapy. All patients received intensity-modulated radiotherapy (IMRT) delivered in 25 fractions with a routine 0.5-cm chest-wall bolus; the prescribed chest-wall\/breast target dose was \u226550 Gy (EQD2 50 Gy) in 57 of 61 patients (93%) and slightly lower (&amp;lt;50 Gy) in the remaining 4. Acute RD was graded with the Radiation Therapy Oncology Group (RTOG) scale and dichotomized at grade \u22652. Univariable comparisons used the Mann -Whitney U and Fisher exact tests. Because of the small sample, imbalanced outcome and quasi-separation, Firth penalized-likelihood logistic regression with profile penalized-likelihood 95% confidence intervals (CIs) was used as the primary method. A parsimonious model (age plus supraclavicular irradiation) was pre-specified from clinical priors and univariable P&amp;lt;0.10, and evaluated by likelihood-ratio test, area under the receiver-operating-characteristic curve (AUC) and 1000-fold bootstrap optimism correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Grade \u22652 RD occurred in 72.1% of patients (44\/61). In the multivariable model, older age (odds ratio [OR] 2.30 per 10 years, 95% CI 1.11 -5.87; P=0.023) and supraclavicular irradiation (OR 6.40, 95% CI 1.37 -37.37; P=0.018) were associated with grade \u22652 RD; the event rate was 76.9% (40\/52) with versus 44.4% (4\/9) without supraclavicular irradiation. The model likelihood-ratio \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      was 16.30 (P=0.0003); the apparent AUC was 0.719 and the optimism-corrected AUC 0.705. Findings were consistent in an exploratory sensitivity analysis additionally adjusting for tumour laterality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion, grade \u22652 acute RD was common after adjuvant radiotherapy in immediately-reconstructed patients, and older age and supraclavicular (regional nodal) irradiation were associated with the outcome. These hypothesis-generating findings support intensified skin-protective strategies for high-risk patients and warrant validation in larger, multicenter cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1903847","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:29Z","timestamp":1787027309000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with grade \u22652 acute radiation dermatitis after adjuvant radiotherapy in breast cancer patients with immediate breast reconstruction: a single-center study using penalized regression"],"prefix":"10.3389","volume":"16","author":[{"given":"Yadong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Oncology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuejuan","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cunkai","family":"Wang","sequence":"additional","affiliation":[{"name":"Geriatric Gastroenterology Department, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibo","family":"Li","sequence":"additional","affiliation":[{"name":"Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaying","family":"Wu","sequence":"additional","affiliation":[{"name":"Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixuan","family":"He","sequence":"additional","affiliation":[{"name":"Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peihong","family":"Lian","sequence":"additional","affiliation":[{"name":"Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianbo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hebei General 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