title: 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.
abstract: 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.
authors.affiliation: Department of Digestive Oncology, Val d'Aurelle, Regional Cancer Centre, Montpellier Cedex 5, France. jduffour@valdorel.fnclcc.fr
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Duffour
authors.forename: Simon
authors.initials: S
authors.lastname: Thézenas
authors.forename: Olivier
authors.initials: O
authors.lastname: Dereure
authors.forename: Agnès
authors.initials: A
authors.lastname: Garcin
authors.forename: Julie
authors.initials: J
authors.lastname: Caron
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Samalin
authors.forename: Fabienne
authors.initials: F
authors.lastname: Portales
authors.forename: Catherine
authors.initials: C
authors.lastname: Fiess
authors.forename: Patrick
authors.initials: P
authors.lastname: Chalbos
authors.forename: Christine
authors.initials: C
authors.lastname: Gestin-Boyer
authors.forename: Marc
authors.initials: M
authors.lastname: Ychou
authors.forename: Bernard
authors.initials: B
authors.lastname: Guillot
mesh_terms: 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
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000077146:Irinotecan; D000068818:Cetuximab; D002166:Camptothecin