Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Institute of Experimental Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany.
Strahlenther Onkol. 2023 Oct;199(10):891-900. doi: 10.1007/s00066-023-02074-w. Epub 2023 Apr 26.
Radiation dermatitis (RD) represents one of the most frequent side effects in radiotherapy (RT). Despite technical progress, mild and moderate RD still affects major subsets of patients and identification and management of patients with a high risk of severe RD is essential. We sought to characterize surveillance and nonpharmaceutical preventive management of RD in German-speaking hospitals and private centers.
We conducted a survey on RD among German-speaking radiation oncologists inquiring for their evaluation of risk factors, assessment methods, and nonpharmaceutical preventive management of RD.
A total of 244 health professionals from public and private institutions in Germany, Austria, and Switzerland participated in the survey. RT-dependent factors were deemed most relevant for RD onset followed by lifestyle factors, emphasizing the impact of treatment conceptualization and patient education. While a broad majority of 92.8% assess RD at least once during RT, 59.0% of participants report RD at least partially arbitrarily and 17.4% stated to classify RD severity solely arbitrarily. 83.7% of all participants were unaware of patient-reported outcomes (PROs). Consensus exists on some lifestyle recommendations like avoidance of sun exposure (98.7%), hot baths (95.1%), and mechanical irritation (91.8%) under RT, while deodorant use (63.4% not at all, 22.1% with restrictions) or application of skin lotion (15.1% disapproval) remain controversial and are not recommended by guidelines or evidence-based practices.
Identification of patients at an increased risk of RD and subsequent implementation of adequate preventive measures remain relevant and challenging aspects of clinical routines. Consensus exists on several risk factors and nonpharmaceutical prevention recommendations, while RT-dependent risk factors, e.g., the fractionation scheme, or hygienic measures like deodorant use remain controversial. Surveillance is widely lacking methodology and objectivity. Intensifying outreach in the radiation oncology community is needed to improve practice patterns.
放射性皮炎（RD）是放疗（RT）中最常见的副作用之一。尽管技术不断进步，但轻度和中度 RD 仍会影响大部分患者，因此识别和管理重度 RD 高危患者至关重要。我们旨在描述德国讲德语地区医院和私人中心对 RD 的监测和非药物预防管理。
我们对德国讲德语的放射肿瘤学家进行了一项关于 RD 的调查，询问他们对 RD 危险因素的评估、评估方法以及 RD 的非药物预防管理。
共有来自德国、奥地利和瑞士的公立和私立机构的 244 名卫生专业人员参与了这项调查。RT 相关因素被认为是 RD 发病的最重要因素，其次是生活方式因素，这强调了治疗概念化和患者教育的影响。虽然绝大多数（92.8%）在 RT 期间至少评估一次 RD，但 59.0%的参与者报告 RD 部分是任意评估的，17.4%的参与者仅任意分类 RD 严重程度。所有参与者中有 83.7%不知道患者报告的结果（PROs）。一些生活方式建议得到了共识，例如在 RT 期间避免日晒（98.7%）、洗热水澡（95.1%）和避免机械刺激（91.8%），而使用除臭剂（63.4%完全不使用，22.1%有使用限制）或使用皮肤乳液（15.1%不推荐）仍有争议，也没有被指南或循证实践推荐。
识别 RD 风险增加的患者并随后实施适当的预防措施仍然是临床常规的重要和具有挑战性的方面。对一些危险因素和非药物预防建议达成了共识，而 RT 相关的危险因素，如分割方案或卫生措施，如使用除臭剂，仍存在争议。监测在方法和客观性方面广泛缺乏。需要加强在放射肿瘤学领域的宣传，以改善实践模式。
