Tara Behroozian1, Lauren Milton1, Liying Zhang2, Julia Lou2, Irene Karam1, Emily Lam1, Gina Wong1, Ewa Szumacher1, Edward Chow3. 1. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada. 2. MacroStat Inc., Toronto, Canada. 3. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada. Electronic address: Edward.Chow@sunnybrook.ca.
Abstract
BACKGROUND AND PURPOSE: Breast cancer patients frequently develop radiation dermatitis (RD) when undergoing post-operative radiation therapy (RT). Traditional RD assessment methods measure clinician-reported outcomes (CROs), but patient-reported outcomes (PROs) have gained recent popularity. The purpose of this prospective analysis was to compare PROs with CROs of breast RD. MATERIALS AND METHODS: Demographic and treatment characteristics were prospectively collected for patients receiving post-operative RT between February 2018 to September 2020. Patients and clinicians completed a skin symptom assessment at baseline, weekly during RT, and at a one- to three-month follow-up visit. Skin treatments used by patients were collected. Concordance between each PRO and CRO was determined using percent concordance and concordance index (C-statistic) by logistic regression analysis. RESULTS: A total of 777 patients were included in the present study. All skin symptom assessment items were significantly underreported by clinicians in comparison to patients (p < 0.0001), with a low to moderate level of concordance (C-statistic range: 0.58-0.70; percent concordance range: 29-50%). The majority of patients used moisturizing creams as a prophylactic measure (65.1%), as per institutional guidelines. CONCLUSION: There were significant discrepancies between PROs and CROs when assessing breast RD. CROs alone are insufficient in measuring RD as they fail to capture the impact on patient quality of life. The study findings highlight the need for improved RD symptom assessment and support the development of a new tool with both patient and clinician components.
BACKGROUND AND PURPOSE:Breast cancerpatients frequently develop radiation dermatitis (RD) when undergoing post-operative radiation therapy (RT). Traditional RD assessment methods measure clinician-reported outcomes (CROs), but patient-reported outcomes (PROs) have gained recent popularity. The purpose of this prospective analysis was to compare PROs with CROs of breast RD. MATERIALS AND METHODS: Demographic and treatment characteristics were prospectively collected for patients receiving post-operative RT between February 2018 to September 2020. Patients and clinicians completed a skin symptom assessment at baseline, weekly during RT, and at a one- to three-month follow-up visit. Skin treatments used by patients were collected. Concordance between each PRO and CRO was determined using percent concordance and concordance index (C-statistic) by logistic regression analysis. RESULTS: A total of 777 patients were included in the present study. All skin symptom assessment items were significantly underreported by clinicians in comparison to patients (p < 0.0001), with a low to moderate level of concordance (C-statistic range: 0.58-0.70; percent concordance range: 29-50%). The majority of patients used moisturizing creams as a prophylactic measure (65.1%), as per institutional guidelines. CONCLUSION: There were significant discrepancies between PROs and CROs when assessing breast RD. CROs alone are insufficient in measuring RD as they fail to capture the impact on patient quality of life. The study findings highlight the need for improved RD symptom assessment and support the development of a new tool with both patient and clinician components.
Authors: Anne L Loeser; Lucy Gao; Aditya Bardia; Mark E Burkard; Kevin M Kalinsky; Jeffrey Peppercorn; Hope S Rugo; Martha Carlson; Janice Cowden; Lesley Glenn; Julia Maues; Sheila McGlown; Andy Ni; Natalia Padron; Maryam Lustberg Journal: Breast Cancer Res Treat Date: 2022-10-06 Impact factor: 4.624
Authors: Cheryl Duzenli; Elisa K Chan; Theodora Koulis; Sheri Grahame; Joel Singer; David Morris; Josslynn Spence; Terry Lee; Levi Burns; Robert A Olson Journal: Curr Oncol Date: 2022-07-07 Impact factor: 3.109