title: Measuring postirradiation subcutaneous soft-tissue fibrosis: state-of-the-art and future directions.
abstract: Clinician-based rating scales and quantitative instruments used to quantify the severity of soft-tissue fibrosis were reviewed to determine if they were reliable and valid measures for clinical and research use. Existing clinician-based measures, the Medical Research Council (MRC) and European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group (EORTC/RTOG), have preliminary testing of reliability and validity such that they provided a basis for the development of a revised measure. The revised measure, designed for use in National Cancer Institute-Common Toxicity Criteria for Adverse Events v3.0, evaluates subcutaneous and deep-tissue fibrosis separately and each is graded on a 5-point scale. The revised measure needs to be tested for reliability and validity, and it is recommended that it be used in concert with the MRC and/or EORTC/RTOG scales until such evidence is available and its utility can be determined. Quantitative measures, although attractive from a research perspective, will have limited clinical and multisite utility because of the apparatus required and the associated costs. Finally, a framework for evaluating fibrosis and the consequences of fibrosis is presented.
authors.affiliation: Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada. davis.aileen@torontorehab.on.ca
authors.forename: Aileen M
authors.initials: AM
authors.lastname: Davis
authors.forename: Stanley
authors.initials: S
authors.lastname: Dische
authors.forename: Lynn
authors.initials: L
authors.lastname: Gerber
authors.forename: Michelle
authors.initials: M
authors.lastname: Saunders
authors.forename: Sing Fai
authors.initials: SF
authors.lastname: Leung
authors.forename: Brian
authors.initials: B
authors.lastname: O'Sullivan
mesh_terms: D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D017564:Radiation Pneumonitis / Q000175:diagnosis* / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D017695:Soft Tissue Injuries / Q000209:etiology*