Patient Reported Outcomes/Quality of Life

PV QA 4 - Poster Viewing Q&A 4

TU_43_3736 - Characterizing the Effects of Radiation Dermatitis on Quality of Life

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Characterizing the Effects of Radiation Dermatitis on Quality of Life
A. K. Rzepecki1, M. Birnbaum2, J. L. Fox3, R. Kabarriti4, M. K. Garg5, J. Daily2, W. R. Bodner III5, K. J. Mehta5, S. Kalnicki6, N. Ohri5, and B. N. McLellan2; 1University of Michigan Medical School, Ann Arbor, MI, 2Albert Einstein College of Medicine, New York City, NY, 3Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, 4Montefiore Medical Center, Bronx, NY, 5Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, 6Albert Einstein College of Medicine, Bronx, NY

Purpose/Objective(s): Radiation dermatitis (RD) is a common adverse event of radiation therapy (RT). Clinically, patients may experience skin changes, including erythema, edema, pigment changes, and dry or moist desquamation. However, little is known about how this radiation-induced skin toxicity can affect patients’ quality of life (QoL). This study aimed to 1) assess the impact of RD on QoL in patients undergoing RT, focusing on 3 domains: emotions, symptoms, and functioning, and 2) evaluate the change in QoL during RT and its association with the severity of RD.

Materials/Methods: We are presenting preliminary results from a prospective trial during which patients undergoing RT for treatment of cancers of the breast, head and neck, and anus completed the Skindex-16, a survey to measure the effects of their skin disease on QoL. Responses were recorded during initiation and upon completion of RT. Pre- and post-treatment Skindex-16 responses were compared using the sign test. Spearman rank correlation was used to assess associations between changes in Skindex scores and dermatitis grade, scored using CTCAE version 4.0.

Results: Forty-seven subjects with cancers of the breast (49%), head and neck (43%), and anus (8%) have completed RT to date and were included in the study. 60% developed grade 1 dermatitis, 32% developed grade 2 dermatitis, and 8% developed grade 3 dermatitis. Patients reported significantly higher Skindex scores for all 16 questions after completing RT (p<0.002). Dermatitis grade was significantly (p<0.05) associated with change in Skindex score for 7 out of 16 elements. These associations were most common for questions assessing the functional domain (4/5 elements) and less common for questions addressing symptomatic (1/4) and emotional (2/7) domains.

Conclusion: Patients can perceive a broad range of adverse dermatologic events during RT. Standard dermatitis grading assesses physical changes, but may not adequately capture changes in all domains. Evaluation using the Skindex-16 revealed that the severity of RD is significantly associated with impact on QoL, especially in the functional domain. Supportive interventions need to address the emotional, functional, and symptomatic domains in patients undergoing RT, with an increased focus on the functional domain.

Author Disclosure: A.K. Rzepecki: None. M. Birnbaum: None. J.L. Fox: None. R. Kabarriti: None. M.K. Garg: Speaker's Bureau; Varian, Covidien. K.J. Mehta: None. S. Kalnicki: Travel Expenses; Varian Oncology Systems. Committee Member; American College of Radiology. N. Ohri: None.

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