A feasibility study of low-cost, self-administered skin care interventions in patients with head and neck cancer receiving chemoradiation.
Current evidence for the management of radiation skin toxicities demonstrates equivocal outcomes using a variety of interventions, leaving substantial gaps in knowledge. Skin toxicities can lead to treatment delays, infection, pain, and increased costs for the patient. Patients with head and neck cancers receiving chemoradiation (N = 100), a population particularly vulnerable to disruptions in skin integrity, were enrolled into a prospective, descriptive study. Data collection was conducted and photographs were taken at baseline and weekly throughout treatment. Patients received skin care kits, instructions, and a diary to record adherence. Skin toxicity was measured and validated by at least three observers using serial photographs with 100% interrater agreement. Data were analyzed using descriptive statistics, graphs, and bivariate analysis. Adherence to both washing and moisturizing was consistently high. Although a correlation existed between the radiation dose and skin toxicity at week 6, no correlation existed between skin toxicity and adherence. Given the rate of grade 3 toxicities at week 6 and product costs, this proved to be an affordable regimen to which patients could easily adhere. Positive patient outcomes can be promoted through teaching and reinforcement of self-care measures to reduce skin toxicity.
Department of Radiation Oncology, Massachusetts General Hospital in Boston, USA. cmannix@partners.org
Catherine Marie
CM
Mannix
Marian Mahin
MM
Bartholomay
Carol S
CS
Doherty
Maryellen
M
Lewis
Mary-Liz Connors
ML
Bilodeau
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000009:adverse effects*; D003365:Costs and Cost Analysis; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D011832:Radiation Injuries / Q000517:prevention & control*; D012648:Self Care / Q000191:economics*; D012867:Skin / Q000528:radiation effects*; D017592:Skin Care / Q000191:economics*; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult