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17.11.2020 | Review Article

Radiation dermatitis assessment tools used in breast cancer: A systematic review of measurement properties

verfasst von: Tara Behroozian, Lauren T. Milton, Neil H. Shear, Erin McKenzie, Yasmeen Razvi, Irene Karam, Kucy Pon, Henry Lam, Emily Lam, Edward Chow

Erschienen in: Supportive Care in Cancer | Ausgabe 5/2021

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Abstract

Purpose

This review aimed to assess the quality and efficacy of tools currently used in breast cancer patients to score radiation dermatitis (RD), a common debilitating side effect of radiotherapy (RT).

Methods

A search was conducted through Ovid Medline, Embase, and Cochrane Central Register of Controlled Trials databases on 14 February 2020. English articles that evaluated an instrument’s use in assessing RD among breast cancer patients receiving external beam RT were included. Studies that reported on the reliability, validity, or concordance of items between assessment tools were included in accordance with the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.

Results

Twelve studies were included in this review, with a total of 13 skin toxicity assessment tools discussed. Tools that assessed clinician-reported outcomes (CROs) mostly reported moderate correlation with biophysical parameter (BP) measurements and low correlation with patient-reported outcomes (PROs). Traditionally used CRO scoring tools demonstrated moderate inter-rater reliability between clinicians, likely due to the subjective nature of items on the grading scales. Most commonly used tools were found to be either insufficient or indeterminate in their measurement properties.

Conclusions

Current standardized tools that measure CROs are subject to clinician interpretation and fail to represent the patient experience. Tools designed to assess PROs are promising in their assessments of the impact of RT on patient quality of life; however, most PRO tools are generic to all skin conditions and require further validation for use in breast cancer. Among tools that measure CROs, PROs, and BPs, there is insufficient evidence on their measurement properties to establish a “gold standard” for the assessment of RD in breast cancer patients.

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Lee J, Park W, Choi DH, Huh SJ, Kim IR, Kang D, Cho J (2017) Patient-reported symptoms of radiation dermatitis during breast cancer radiotherapy: a pilot study. Qual Life Res 26(7):1713–1719. https://doi.org/10.1007/s11136-017-1526-4CrossRefPubMed

Spałek M (2016) Chronic radiation-induced dermatitis: challenges and solutions. Clin Cosmet Investig Dermatol 9:473–482. https://doi.org/10.2147/CCID.S94320CrossRefPubMedPubMedCentral

Singh M, Alavi A, Wong R, Akita S (2016) Radiodermatitis: a review of our current understanding. Am J Clin Dermatol 17(3):277–292. https://doi.org/10.1007/s40257-016-0186-4CrossRefPubMed

Leventhal J, Young MR (2017) Radiation dermatitis: recognition, prevention, and management. Oncology (Williston Park) 31(12):885–899

Pignol JP, Vu TTT, Mitera G, Bosnic S, Verkooijen HM, Truong P (2015) Prospective evaluation of severe skin toxicity and pain during postmastectomy radiation therapy. Int J Radiat Oncol Biol Phys 91(1):157–164. https://doi.org/10.1016/j.ijrobp.2014.09.022CrossRefPubMed

Berthelet E, Truong PT, Musso K, Grant V, Kwan W, Moravan V, Patterson K, Olivotto IA (2004) Preliminary reliability and validity testing of a new Skin Toxicity Assessment Tool (STAT) in breast cancer patients undergoing radiotherapy. Am J Clin Oncol 27(6):626–631. https://doi.org/10.1097/01.coc.0000138965.97476.0fCrossRefPubMed

Lam E, Yee C, Wong G, Popovic M, Drost L, Pon K, Vesprini D, Lam H, Aljabri S, Soliman H, DeAngelis C, Chow E (2020) A systematic review and meta-analysis of clinician-reported versus patient-reported outcomes of radiation dermatitis. Breast. 50:125–134. https://doi.org/10.1016/j.breast.2019.09.009CrossRefPubMed

Baines CR, McGuiness W, O’Rourke GA (2017) An integrative review of skin assessment tools used to evaluate skin injury related to external beam radiation therapy. J Clin Nurs 26(7-8):1137–1144. https://doi.org/10.1111/jocn.13430CrossRefPubMed

Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. PLoS Med 6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097CrossRefPubMedPubMedCentral

10.

Prinsen CAC, Mokkink LB, Bouter LM, Alonso J, Patrick DL, de Vet HCW, Terwee CB (2018) COSMIN guideline for systematic reviews of patient-reported outcome measures. Qual Life Res 27(5):1147–1157. https://doi.org/10.1007/s11136-018-1798-3CrossRefPubMedPubMedCentral

11.

Mokkink LB, de Vet HCW, Prinsen CAC, Patrick DL, Alonso J, Bouter LM, Terwee CB (2018) COSMIN Risk of bias checklist for systematic reviews of patient-reported outcome measures. Qual Life Res 27(5):1171–1179. https://doi.org/10.1007/s11136-017-1765-4CrossRefPubMed

12.

Kapur A, Evans C, Bloom B, Ames J, Morgenstern C, Raince J, Potters L (2013) Interrater variability in the assessment of skin reactions in breast cancer radiation therapy: impact of grading scales. Int J Radiat Oncol Biol Phys. 87(2):S494. https://doi.org/10.1016/j.ijrobp.2013.06.1306CrossRef

13.

Neben-Wittich MA, Atherton PJ, Schwartz DJ, Sloan JA, Griffin PC, Deming RL, Anders JC, Loprinzi CL, Burger KN, Martenson JA, Miller RC (2011) Comparison of provider-assessed and patient-reported outcome measures of acute skin toxicity during a Phase III trial of mometasone cream versus placebo during breast radiotherapy: the North Central Cancer Treatment Group (N06C4). Int J Radiat Oncol Biol Phys 81(2):397–402. https://doi.org/10.1016/j.ijrobp.2010.05.065CrossRefPubMed

14.

Huang CJ, Hou MF, Luo KH, Wei SY, Huang MY, Su SJ, Kuo HY, Yuan SSF, Chen GS, Chu-Sung Hu S, Chuang HY (2015) RTOG, CTCAE and WHO criteria for acute radiation dermatitis correlate with cutaneous blood flow measurements. Breast. 24(3):230–236. https://doi.org/10.1016/j.breast.2015.01.008CrossRefPubMed

15.

Shumway D, Walker EM, Kapadia NS, Do TT, Griffith KA, Feng MUS, DePalma B, Helfrich YR, Gillespie E, Miller A, Jagsi R, Pierce LJ (2015) Development of a new photonumeric scale for acute radiation dermatitis in patients with breast cancer. J Clin Oncol 33(28):86. https://doi.org/10.1200/jco.2015.33.28_suppl.86CrossRef

16.

Sandler KA, Mitchell SA, Basch E, Raldow AC, Steinberg ML, Sharif J, Cook RR, Kupelian PA, McCloskey SA (2018) Content validity of anatomic site-specific Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) item sets for assessment of acute symptomatic toxicities in radiation oncology. Int J Radiat Oncol Biol Phys 102(1):44–52. https://doi.org/10.1016/j.ijrobp.2018.04.048CrossRefPubMed

17.

Gonzalez Sanchis A, Brualla Gonzalez L, Sanchez Carazo JL et al (2017) Evaluation of acute skin toxicity in breast radiotherapy with a new quantitative approach. Radiother Oncol 122(1):54–59. https://doi.org/10.1016/j.radonc.2016.09.019CrossRefPubMed

18.

Kitajima M, Mikami K, Noto Y, Itaki C, Fukushi Y, Hirota Y, Mariya Y, Tsushima M, Kattou K, Osanai T (2020) Quantitative assessment of radiodermatitis through a non-invasive objective procedure in patients with breast cancer. Mol Clin Oncol 12(1):89–93. https://doi.org/10.3892/mco.2019.1948CrossRefPubMed

19.

Kapur A, Bloom BF, Potters L (2015) Interrater variability amongst radiation and medical oncologists in the assessment of radiation dermatitis for breast cancer patients. Int J Radiat Oncol Biol Phys 93(3):E48. https://doi.org/10.1016/j.ijrobp.2015.07.664CrossRef

20.

Trombetta M, Julian TB, Kim Y, Werts ED, Parda D (2009) The allegheny general modification of the Harvard Breast Cosmesis Scale for the retreated breast. Oncology (Williston Park) 23(11):954–956

21.

Beamer LC, Grant M (2019) Using the Dermatology Life Quality Index to assess how breast radiodermatitis affects patients’ quality of life. Breast Cancer (Aukl) 13:1178223419835547. https://doi.org/10.1177/1178223419835547CrossRef

22.

Hoeller U, Tribius S, Kuhlmey A, Grader K, Fehlauer F, Alberti W (2003) Increasing the rate of late toxicity by changing the score? A comparison of RTOG/EORTC and LENT/SOMA scores. Int J Radiat Oncol Biol Phys 55(4):1013–1018. https://doi.org/10.1016/S0360-3016(02)04202-5CrossRefPubMed

23.

Shumway D, Kapdia N, Do T, Griffith K, Feng M, Jagsi R, Helfrich Y, Liss A, Gillespie E, Miller A, Pierce L (2014) Development of a photonumeric scale for acute radiation dermatitis in breast cancer patients. Int J Radiat Oncol Biol Phys. 90(1):S238. https://doi.org/10.1016/j.ijrobp.2014.05.847CrossRef

24.

Hu SC-S, Hou M-F, Luo K-H, Chuang HY, Wei SY, Chen GS, Chiang W, Huang CJ (2014) Changes in biophysical properties of the skin following radiotherapy for breast cancer. J Dermatol 41(12):1087–1094. https://doi.org/10.1111/1346-8138.12669CrossRefPubMed

25.

Chren MM, Lasek RJ, Quinn LM, Mostow EN, Zyzanski SJ (1996) Skindex, a quality-of-life measure for patients with skin disease: Reliability, validity, and responsiveness. J Invest Dermatol 107(5):707–713. https://doi.org/10.1111/1523-1747.ep12365600CrossRefPubMed

26.

Howell D, Stevens S, Haji F, Ismail Z, Brundage M (2017) Feasibility of implementing EPIC-CP

27.

Kristensen N, Nymann C, Konradsen H (2016) Implementing research results in clinical practice- the experiences of healthcare professionals. BMC Health Serv Res 16:48. https://doi.org/10.1186/s12913-016-1292-yCrossRefPubMedPubMedCentral

28.

Griffiths CEM, Wang TS, Hamilton TA, Voorhees JJ, Ellis CN (1992) A photonumeric scale for the assessment of cutaneous photodamage. Arch Dermatol 128(3):347–351. https://doi.org/10.1001/archderm.1992.01680130061006CrossRefPubMed

29.

Herst PM, Bennett NC, Sutherland AE, Peszynski RI, Paterson DB, Jasperse ML (2014) Prophylactic use of Mepitel Film prevents radiation-induced moist desquamation in an intra-patient randomised controlled clinical trial of 78 breast cancer patients. Radiother Oncol 110(1):137–143. https://doi.org/10.1016/j.radonc.2014.01.005CrossRefPubMed

30.

Robijns J, Censabella S, Claes S, Pannekoeke L, Bussé L, Colson D, Kaminski I, Bulens P, Maes A, Noé L, Brosens M, Timmermans A, Lambrichts I, Somers V, Mebis J (2018) Prevention of acute radiodermatitis by photobiomodulation: a randomized, placebo-controlled trial in breast cancer patients (TRANSDERMIS trial). Lasers Surg Med 50(7):763–771. https://doi.org/10.1002/lsm.22804CrossRef

31.

Møller PK, Olling K, Berg M, Habæk I, Haislund B, Iversen AM, Ewertz M, Lorenzen EL, Brink C (2018) Breast cancer patients report reduced sensitivity and pain using a barrier film during radiotherapy – a Danish intra-patient randomized multicentre study. Tech Innov Patient Support Radiat Oncol 7:20–25. https://doi.org/10.1016/j.tipsro.2018.05.004CrossRefPubMedPubMedCentral

32.

Noble-Adams R (1999) Radiation-induced skin reactions. 3: evaluating the RISRAS. Br J Nurs 8(19):1305–1312. https://doi.org/10.12968/bjon.1999.8.19.1305CrossRefPubMed

Titel: Radiation dermatitis assessment tools used in breast cancer: A systematic review of measurement properties
verfasst von: Tara Behroozian
Lauren T. Milton
Neil H. Shear
Erin McKenzie
Yasmeen Razvi
Irene Karam
Kucy Pon
Henry Lam
Emily Lam
Edward Chow
Publikationsdatum: 17.11.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 5/2021
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-020-05889-w

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Radiation dermatitis assessment tools used in breast cancer: A systematic review of measurement properties