Inter-observer agreement between dermatologists and oncologists in assessing dermatological toxicities in patients with metastatic colorectal cancer treated by cetuximab-based chemotherapies: a pilot comparative study.
The aim of this study was to measure the inter-observer agreement between two teams of three dermatologists and oncologists in labelling and grading the cetuximab-induced dermatological toxicities from 98 photographs performed in a cohort of 15 patients with metastatic colorectal cancer receiving cetuximab-based chemotherapy. Kappa coefficient (κ) assessed inter-observer grading agreement. Both teams defined by the same terms eight of the 13 (62%) toxic effects reported together. Discrepancies concerned the labelling of rash desquamation, hand-foot syndrome and xerosis and the grading (different and often going in the opposite direction) of various toxicities such as paronychia, xerosis, desquamation and hand-foot syndrome (κ value less than 0.40). Acneiform eruption was recognised by both teams, but the grading allocated by oncologists was lower. Our results suggested the need for a real consensus between oncologists and dermatologists for labelling and grading these dermatological toxicities. Better training of oncologists by using a dermatological atlas would improve inter-observer agreement.
Duffour
Jacqueline
J
Department of Digestive Oncology, Val d'Aurelle, Regional Cancer Centre, Montpellier Cedex 5, France. jduffour@valdorel.fnclcc.fr
Thézenas
Simon
S
Dereure
Olivier
O
Garcin
Agnès
A
Caron
Julie
J
Samalin
Emmanuelle
E
Portales
Fabienne
F
Fiess
Catherine
C
Chalbos
Patrick
P
Gestin-Boyer
Christine
C
Ychou
Marc
M
Guillot
Bernard
B
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D000068818:Cetuximab; D002983:Clinical Competence / Q000592:standards*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003880:Dermatology / Q000592:standards*; D003875:Drug Eruptions / Q000209:etiology / Q000473:pathology*; D006801:Humans; D000077146:Irinotecan; D008495:Medical Oncology / Q000592:standards*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015588:Observer Variation; D010865:Pilot Projects
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000077146:Irinotecan; D000068818:Cetuximab; D002166:Camptothecin