Roya S Nazarian1,2, Patricia Lucey3, Loren Franco1, Christos Zouzias1, Sravana Chennupati4, Shalom Kalnicki1, Beth N McLellan5. 1. Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA. 2. Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY, 10029, USA. 3. Inova Melanoma and Skin Cancer Center, 8081 Innovation Park Drive, Fairfax, VA, 22031, USA. 4. Alta Bates Comprehensive Cancer Center, 2001 Dwight Way, Berkeley, CA, 94704, USA. 5. Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA. bmclella@montefiore.org.
Abstract
PURPOSE: Acute radiation dermatitis (RD) is a disfiguring and painful rash that occurs in up to 95% of patients receiving radiation therapy (RT) for cancer. Treatment for RD varies among practitioners with no evidence-based gold standard for management. While a multi-disciplinary approach has been utilized to manage other cancer-related toxicities, RD is most often managed by the treating radiation oncologist. METHODS: This study evaluated the referral practices of radiation oncologists to dermatologists for management of RD utilizing a survey of radiation oncologists across the USA. The goal was to identify the referral practices of radiation oncologists for RD and any barriers to a multidisciplinary approach. RESULTS: Of the 705 respondents, 15% reported ever referring patients to dermatology. Private practitioners referred significantly less than providers in academic or oncology centers (p < 0.01). Practitioners in urban settings were more likely to refer (p < 0.01), and radiation oncologists in the Southeastern USA were less likely to refer (p < 0.01). CONCLUSIONS: Lack of timely access to dermatologists in various geographic areas in addition to radiation oncologists' preference to treat RD are barriers to multidisciplinary management of RD. Inclusion of dermatologists and wound care specialists in cancer treatment teams could improve patient care and stimulate needed research into strategies for treatment and prevention of RD.
PURPOSE: Acute radiation dermatitis (RD) is a disfiguring and painful rash that occurs in up to 95% of patients receiving radiation therapy (RT) for cancer. Treatment for RD varies among practitioners with no evidence-based gold standard for management. While a multi-disciplinary approach has been utilized to manage other cancer-related toxicities, RD is most often managed by the treating radiation oncologist. METHODS: This study evaluated the referral practices of radiation oncologists to dermatologists for management of RD utilizing a survey of radiation oncologists across the USA. The goal was to identify the referral practices of radiation oncologists for RD and any barriers to a multidisciplinary approach. RESULTS: Of the 705 respondents, 15% reported ever referring patients to dermatology. Private practitioners referred significantly less than providers in academic or oncology centers (p < 0.01). Practitioners in urban settings were more likely to refer (p < 0.01), and radiation oncologists in the Southeastern USA were less likely to refer (p < 0.01). CONCLUSIONS: Lack of timely access to dermatologists in various geographic areas in addition to radiation oncologists' preference to treat RD are barriers to multidisciplinary management of RD. Inclusion of dermatologists and wound care specialists in cancer treatment teams could improve patient care and stimulate needed research into strategies for treatment and prevention of RD.
Authors: Gregory S Phillips; Azael Freites-Martinez; Meier Hsu; Anna Skripnik Lucas; Dulce M Barrios; Kathryn Ciccolini; Michael A Marchetti; Liang Deng; Patricia L Myskowski; Erica H Lee; Alina Markova; Mario E Lacouture Journal: J Am Acad Dermatol Date: 2017-12-19 Impact factor: 11.527
Authors: Susan L Boone; Alfred Rademaker; Dachao Liu; Carmen Pfeiffer; David J Mauro; Mario E Lacouture Journal: Oncology Date: 2007-12-21 Impact factor: 2.935