title: The effects on pain and activity of daily living caused by crusted exudation in patients with head and neck cancer treated with cetuximab and radiotherapy.
abstract: OBJECTIVE
  To date, the specific role of "in-field" crusting exudation on pain and on activity of daily living (ADL) in head and neck cancer (HNSCC) patients undergoing treatment with cetuximab and radiochemotherapy has been neglected. The purpose of the study was to evaluate the role of crusting exudation on the severity of pain and ADL METHODS: Thirty-seven of the 45 HNSCC patients enrolled in the alternating radiotherapy, chemotherapy, and cetuximab trial were evaluated in this study. The main radiodermatitis signs (the intensity of erythema, the extension of dry, and moist desquamation and of necrosis)--including crusting exudation severity--pain, ADL, and radiodermatitis scores were registered at least weekly during and after treatment. The correlation between crusting exudation and pain or ADL was evaluated.
  
  
  RESULTS
  The "in-field" crusting exudation score seemed to have the strongest correlation with pain (Spearman's rho = 0.897; p < 0.001) and the most intense influence on it (Co-B = 0.715; 95% C.I. = 0.643-0.787). However, it seemed to have a weaker correlation with ADL than the other clinical radiodermatitis signs.
  
  
  CONCLUSIONS
  Crusts have the strongest correlation with pain in patients with Cetuximab-related radiation dermatitis. Moreover, the presence of crusts can lead operators to misclassify dermatitis as score 4, causing unnecessary delays or interruptions in treatment.
authors.affiliation: Department of Radiation Oncology, Santa Croce General Hospital, Cuneo, Italy. elviorussi@gmail.com
authors.forename: Elvio G
authors.initials: EG
authors.lastname: Russi
authors.forename: Marco C
authors.initials: MC
authors.lastname: Merlano
authors.forename: Gianmauro
authors.initials: G
authors.lastname: Numico
authors.forename: Renzo
authors.initials: R
authors.lastname: Corvò
authors.forename: Marco
authors.initials: M
authors.lastname: Benasso
authors.forename: Riccardo
authors.initials: R
authors.lastname: Vigna-Taglianti
authors.forename: Antonella
authors.initials: A
authors.lastname: Melano
authors.forename: Nerina
authors.initials: N
authors.lastname: Denaro
authors.forename: Stefano
authors.initials: S
authors.lastname: Pergolizzi
authors.forename: Ida
authors.initials: I
authors.lastname: Colantonio
authors.forename: Francesco
authors.initials: F
authors.lastname: Lucio
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Brizio
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
mesh_terms: D000203:Activities of Daily Living; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000068818:Cetuximab; D005122:Exudates and Transudates; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D010146:Pain / Q000209:etiology / Q000503:physiopathology*; D011855:Radiodermatitis / Q000473:pathology / Q000503:physiopathology*; D012720:Severity of Illness Index
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068818:Cetuximab
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