An evidence based protocol for skin management for breast cancer patients receiving radiation therapy -

Abstract

Radiation dermatitis (RD) is one of the most common side effects for the majority of breast cancer patients receiving external beam radiation therapy. RD affects not only the integrity of the skin but also the sense of well-being of the majority of women with breast cancer. The pain, discomfort, the itch and burning may lead to halting the treatment, thus compromising the treatment outcomes. The purpose of this project was to: 1) review the available literature on the assessment and the impact of available RD treatments on patients’ outcomes; and 2) develop a protocol that can be followed with breast cancer patients treated at the American University of Beirut Medical Center who are undergoing radiation treatment. A thorough search using the databases Academic Search Complete, MedLine and CINAHL. The key terms used for this search were: “breast cancer”, “radiation therapy”, “radiation dermatitis”, “protocol”, “guidelines”, and “skin care”. All articles presenting approaches for prevention, assessment and treatment of RD for breast cancer patients receiving radiation therapy were included. Many tools are used for assessment of RD, but only a few are tested for validity and reliability. A number of investigators tested various prevention and treatment measures for RD. However, recommendations for RD management were weak as they were not based on the strongest level of evidence. One recent guideline developed by the Society and College of Radiographers (SCoR), emphasized the importance of using a standardized assessment tool for RD but did not favor one product over another for its treatment. The proposed protocol includes an assessment tool based on two tools from the literature, and a treatment algorithm targeting each grade of RD. Plans for protocol implementation and evaluation plan for the protocol are suggested. Radiation dermatitis is an important problem in breast cancer patients receiving radiation therapy. Applying a stand