title: Acute skin toxicity management in head and neck cancer patients treated with radiotherapy and chemotherapy or EGFR inhibitors: Literature review and consensus.
abstract: The adverse effects of radiation therapy, often integrated with chemotherapy and/or targeted therapies, on the skin include severe acute and chronic dermatitis associated with pain, discomfort, itching, and burning, and may heavily affect patients' quality of life. The management of these skin adverse effects in head and neck cancer patients (HNCPs) are very heterogeneous due to the lack of shared rigorous classification systems and evidence based treatments. A multidisciplinary group of head and neck cancer specialists from Italy met with the aim of reaching a consensus on a clinical definition and management of dermatitis in HNCPs treated with radiotherapy with or without systemic therapies in order to improve skin toxicity management. The Delphi Appropriateness Method was used. External expert reviewers then evaluated the conclusions carefully according to their area of expertise. This paper offers contains seven clusters of statements about the management of dermatitis in HNCPs and a review of recent literature on these topics.
authors.affiliation: Radiation Oncology Department, AO. S. Croce e Carle, Cuneo, Italy. Electronic address: elviorussi@gmail.com.
authors.forename: Elvio G
authors.initials: EG
authors.lastname: Russi
authors.affiliation: Department of Radiotherapy, University of Turin, Italy. Electronic address: moretto.francesco@hotmail.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Moretto
authors.affiliation: Department of Radiotherapy, University of Turin, Italy. Electronic address: monicaramp100@gmail.com.
authors.forename: Monica
authors.initials: M
authors.lastname: Rampino
authors.affiliation: Departmento of Oncology, Ospedale San Paolo, Savona, Italy. Electronic address: m.benasso@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Benasso
authors.affiliation: Radio-Oncology Department, IRCCS San Martino - IST, Largo R Benzi 10, 16132 Genoa, Italy. Electronic address: almalina.bacigalupo@hsanmartino.it.
authors.forename: Almalina
authors.initials: A
authors.lastname: Bacigalupo
authors.affiliation: Department of Radiotherapy, University "La Sapienza", Rome Italy. Electronic address: vitaliana.desanctis@uniroma1.it.
authors.forename: Vitaliana
authors.initials: V
authors.lastname: De Sanctis
authors.affiliation: Medical Oncology Unit, Ospedale U. Parini, Viale Ginevra 3, 11100 Aosta, Italy. Electronic address: gnumico@ausl.vda.it.
authors.forename: Gianmauro
authors.initials: G
authors.lastname: Numico
authors.affiliation: Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: paolo.bossi@istitutotumori.mi.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bossi
authors.affiliation: Radiation Oncology Department, University of Brescia and Spedali Civili, Brescia, Italy. Electronic address: michela.buglione@unibs.it.
authors.forename: Michela
authors.initials: M
authors.lastname: Buglione
authors.affiliation: Nurse Department of ENT Molinette Hospital, Turin, Italy. Electronic address: alombardo@cittadellasalute.to.it.
authors.forename: Antonino
authors.initials: A
authors.lastname: Lombardo
authors.affiliation: Department of Oncology, Azienda Ospedaliera Citta' Della Salute E Della Scienza Di Torino, Italy. Electronic address: airoldim@yahoo.com.
authors.forename: Mario
authors.initials: M
authors.lastname: Airoldi
authors.affiliation: Medical Oncology Department, AO. S. Croce e Carle, Cuneo, Italy. Electronic address: mcmerlano@gmail.com.
authors.forename: Marco C
authors.initials: MC
authors.lastname: Merlano
authors.affiliation: Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: Lisa.Licitra@istitutotumori.mi.it.
authors.forename: Lisa
authors.initials: L
authors.lastname: Licitra
authors.affiliation: Medical Oncology Department, AO. S. Croce e Carle, Cuneo, Italy. Electronic address: nerinadenaro@gmail.com.
authors.forename: Nerina
authors.initials: N
authors.lastname: Denaro
authors.affiliation: Radiation Oncology Department, Unit of University of Messina, Italy. Electronic address: stpergolizzi@unime.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pergolizzi
authors.affiliation: Medical Oncology Unit, Azienda Ospedaliero-Universitaria di Parma Maggiore Hospital, Via Gramsci, 14 43100 Parma, Italy. Electronic address: cpinto@ao.pr.it.
authors.forename: Carmine
authors.initials: C
authors.lastname: Pinto
authors.affiliation: Department of Radiation Oncology, CHU Poitiers, Poitiers Cedex, France. Electronic address: Rene-Jean.BENSADOUN@chu-poitiers.fr.
authors.forename: Renè-Jean
authors.initials: RJ
authors.lastname: Bensadoun
authors.affiliation: Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy. Electronic address: giampiero.girolomoni@univr.it.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Girolomoni
authors.affiliation: Department of Radiation Oncology, University Medical Center Groningen, The Netherlands. Electronic address: j.a.langendijk@rt.umcg.nl.
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Langendijk
mesh_terms: D000068818:Cetuximab / Q000009:adverse effects; D059248:Chemoradiotherapy / Q000009:adverse effects*; D003872:Dermatitis / Q000209:etiology / Q000628:therapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D011537:Pruritus / Q000209:etiology; D012307:Risk Factors
chemical_list: D066246:ErbB Receptors; D000068818:Cetuximab
keywords: Biodermatitis; Cetuximab; Chemotherapy; EGFRi; Head and neck cancer; Radiotherapy; Skin toxicity