title: Management of radiation dermatitis in patients receiving cetuximab and radiotherapy for locally advanced squamous cell carcinoma of the head and neck: proposals for a revised grading system and consensus management guidelines.
abstract: BACKGROUND
  Radiation dermatitis developing in patients receiving cetuximab concomitantly with radiotherapy for locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) is now recognized to have different pathophysiological and clinical characteristics to the radiation dermatitis associated with radiotherapy or concomitant chemotherapy and radiotherapy. Current grading tools were not designed to grade this type of radiation dermatitis; their use may lead to misclassification of reactions and inappropriate management strategies, potentially compromising cancer treatment.
  
  
  METHODS
  An advisory board of seven leading European specialists (three medical oncologists, three radiation oncologists and a dermatologist) with extensive experience of the use of cetuximab plus radiotherapy produced consensus guidelines for the grading and management of radiation dermatitis in patients receiving cetuximab plus radiotherapy.
  
  
  RESULTS
  Modifications to the current, commonly used National Cancer Institute-Common Terminology Criteria for Adverse Events version 4.3 for grading radiation dermatitis were proposed. Updated management guidelines, building on previously published guidelines from 2008, were also proposed.
  
  
  CONCLUSIONS
  The proposed revisions to the grading system and updated management guidelines described here represent important developments toward the more appropriate grading and effective management of radiation dermatitis in patients receiving cetuximab plus radiotherapy for LA SCCHN.
authors: Department of Radiation Oncology, University of Geneva, Clinique de Genolier, Genolier, Switzerland. jbernier@genolier.net
authors: J
authors: J
authors: Bernier
authors: E G
authors: EG
authors: Russi
authors: B
authors: B
authors: Homey
authors: M C
authors: MC
authors: Merlano
authors: R
authors: R
authors: Mesía
authors: F
authors: F
authors: Peyrade
authors: W
authors: W
authors: Budach