Comparison Of Acute Skin Toxicity In Simultaneous Integrated Boost Vs Sequential Boost In Early

Abstract

Objectives: To compare the acute skin toxicity in hypo fractionated radiotherapy with sequential boost vs simultaneous integrated boost. Materials and Methods:  This Prospective comparative observational study was conducted in the Department of Radiation Oncology, CMH Rawalpindi from June 2024 to June 2025. After ethical approval, 50 eligible patients were enrolled with consent and divided into SIB and SEQ groups. SIB received 50.4 Gy with a simultaneous boost to 60.2 Gy, while SEQ received 50 Gy followed by 10–16 Gy sequential boost. Acute skin toxicity was assessed weekly using RTOG criteria by a blinded oncologist. Data were collected via a questionnaire and analyzed using SPSS version 25. Results: The mean patient age was 46.38 ± 12.22 years. Age distribution differed significantly between groups (p = 0.02). Higher-grade skin toxicity (Grade 3) was less frequent in the SIB group (12%) than SEQ (32%), but the overall difference in skin toxicity was not statistically significant (p = 0.16). Conclusion: It was concluded that the present study highlights the comparative safety of SIB versus SEQ in breast-conserving therapy, with a lower incidence of higher-grade skin toxicity seen in the SIB group despite no significant difference. Larger studies with longer follow-up are needed to confirm these findings and evaluate long-term outcomes..