title: Management of skin toxicity associated with cetuximab treatment in combination with chemotherapy or radiotherapy.
abstract: BACKGROUND
  Cetuximab was demonstrated by clinical trials to improve response rate and survival of patients with metastatic and nonresectable colorectal cancer or carcinoma of the head and neck. Appropriate management of skin toxicity associated with epidermal growth factor receptor inhibitor (EGFR-i) therapy is necessary to allow adequate drug administration and to improve quality of life and outcomes.
  
  
  METHODS
  A group of Italian Experts produced recommendations for skin toxicity management using the RAND/UCLA Appropriateness Method. Statements were generated on the basis of a systematic revision of the literature and voted twice by a panel of 40 expert physicians; the second vote was preceded by a meeting of the panelists.
  
  
  RESULTS
  Skin toxicity included skin rash, skin dryness, pruritus, paronychia, hair abnormality, and mucositis. Recommendations for prophylaxis and therapeutic interventions for each type of toxicity were proposed.
  
  
  CONCLUSIONS
  Interventions that were considered appropriate to improve compliance and outcomes of cancer patients treated with EGFR-i were identified.
authors.affiliation: Medical Oncology Unit, S Orsola-Malpighi Hospital, Via Albertoni 15, 40138 Bologna, Italy. carmine.pinto@aosp.bo.it
authors.forename: Carmine
authors.initials: C
authors.lastname: Pinto
authors.forename: Carlo Antonio
authors.initials: CA
authors.lastname: Barone
authors.forename: Giampiero
authors.initials: G
authors.lastname: Girolomoni
authors.forename: Elvio Grazioso
authors.initials: EG
authors.lastname: Russi
authors.forename: Marco Carlo
authors.initials: MC
authors.lastname: Merlano
authors.forename: Daris
authors.initials: D
authors.lastname: Ferrari
authors.forename: Evaristo
authors.initials: E
authors.lastname: Maiello
mesh_terms: D000279:Administration, Cutaneous; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000068818:Cetuximab; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000556:secondary; D003131:Combined Modality Therapy / Q000009:adverse effects; D003875:Drug Eruptions / Q000209:etiology*; D066246:ErbB Receptors / Q000008:administration & dosage / Q000037:antagonists & inhibitors; D005076:Exanthema / Q000139:chemically induced; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D052016:Mucositis / Q000139:chemically induced; D010304:Paronychia / Q000139:chemically induced; D011537:Pruritus / Q000139:chemically induced; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D066246:ErbB Receptors; D000068818:Cetuximab