Abstract 2559: An analysis of patient-reported outcomes of radiation dermatitis in a multiracial/ethnic breast cancer population
Authors: Acosta Laura G. , Takita Cristiane , Wright Jean L. , Reis Isildinha M. , Yang George R. , Hu Jennifer J. 
Published: July 2021

More than half of cancer patients are treated with radiotherapy (RT), and many patients will develop acute radiation dermatitis (ARD) or skin reactions at some point during their treatment. In breast cancer, RT is a common adjuvant treatment and acute RT-induced dermatitis or skin reactions is a frequent side effect. Most acute RT-induced skin reactions resolve after several weeks, but some side effects persist and can cause serious complications. RD is reported by either the radiation oncologist or the patient and previous studies reported that there are disagreements between clinician-reported outcomes (CROs) and patient-reported outcomes (PROs). We have previously reported skin toxicity results using the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE). The current study focused on PROs of ARD symptoms that most frequently affect breast cancer patients and the degree that treatment impacted their normal daily activities. We evaluate the quality of life questionnaire administered on the last day of RT to 516 breast cancer patients receiving RT. Participants were asked to rate ARD-related symptoms on a 5-point Likert scale (0=Not bothered at all to 4=Very much). The symptoms measured were breast tenderness, pain, itching, warmth to touch, swelling, hyperpigmentation, blistering, thickening of the skin, hardness of breast, flaking, slow healing wounds, and erythema. Patients were also asked to rate the extent to which their treatment disrupted their normal daily activities on a 10-point Likert scale (0=Not all to 10=A lot). Hyperpigmentation was the most commonly reported symptom, with 25% of patients being highly bothered by the symptom. Erythema followed as the second most commonly reported symptom. Of the total 516 patients, 320 (77%) reported some form of disruption to their normal daily activities due to treatment. A number of the patient reported ARD-related symptoms differ by race/ethnicity, age, obesity, smoking history, and tumor stage. The results from a recent systematic review and meta-analysis, CROs and PROs of breast RD showed strong concordance. However, investigators concluded that clinicians reported significantly more acute edema, less acute breast pain, and less chronic breast shrinkage than patients. Considering the increasing combined application of CROs and PROs in clinical trials, our future research will highlight a critical issue regarding the accuracy of symptom reporting and subsequent management provided to patients. We will identify strategies to standardize items using a single tool to accurately and precisely estimate ARD from both the clinician and patient. Given the negative impact of ARD on patients' quality of life, further studies of ARD symptomology from both a patient and clinician standpoint are necessary to improve ARD management.

Citation Format: Laura G. Acosta, Cristiane Takita, Jean L. Wright, Isildinha M. Reis, George R. Yang, Jennifer J. Hu. An analysis of patient-reported outcomes of radiation dermatitis in a multiracial/ethnic breast cancer population [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2559.