Aim

To determine the skin characteristics of patients sustaining delayed epidermal damage when receiving radiotherapy for squamous cell carcinoma, basal cell carcinoma and breast cancer.

Method

Retrospective review of electronic medical records was performed to determine the prevalence of epidermal reaction / damage for this client cohort. Medical notes were examined for any reference to skin related insult as a direct result of radiation therapy. Skin appearance including epidermal reaction assessed using the Radiation Therapy Oncology Group (RTOG score Cox’95), the time from commencing radiotherapy to injury/s, plus variables such as total radiation dose, cytotoxic drug administration and haemoglobin were recorded.

Quantitative data was obtained using an anonymous, paper based questionnaire delivered via the mail. Skin type, personal skin management and perceived skin outcome was reported.

Results

Table 1

	RTOG Gr 0	RTOG Gr 1	RTOG Gr 2	RTOG Gr 3/4
Br Ca	20	17	9	4
Skin Ca	5	15	7	23

c² = 45.33 (DF=3) p<0.01

RTOG acute toxicity was evident in the skin cancer group compared to breast cancer group (table 1). Number of treatments was variable across the cohort but total Gy delivered illustrated diagnostic consistency.

Over half of the patient questionnaires (n=52) were returned. Fitzpatrick scale was individually assessed, smoking <10%, perfumed product use 12% and wound management product choice reported. Patients also offered a narrative of skin advice.

Conclusions

Skin characteristics and the effect of radiotherapy were obtained giving clear indication that many facets of skin assessment and management are a high priority for both patients and health practitioners.