A systematic review and meta-analysis of clinician-reported versus patient-reported outcomes of radiation dermatitis

• Published in: Breast (Edinburgh) 2020-04, Vol.50, p.125-134
• Main Authors: Lam, Emily, Yee, Caitlin, Wong, Gina, Popovic, Marko, Drost, Leah, Pon, Kucy, Vesprini, Danny, Lam, Henry, Aljabri, Saleh, Soliman, Hany, DeAngelis, Carlo, Chow, Edward
• Format: Article
• Language: English
• Subjects: Breast - radiation effects; breast cancer; Breast Neoplasms - radiotherapy; Edema - etiology; Fibrosis - etiology; Humans; Outcome Assessment, Health Care; Pain - etiology; Patient Reported Outcome Measures; Physicians; Radiation dermatitis; Radiodermatitis; Radiotherapy; Review
• ISSN: 0960-9776; 1532-3080
• DOI: 10.1016/j.breast.2019.09.009

Radiation dermatitis is a common adverse effect of radiotherapy (RT) in breast cancer patients. Although radiation dermatitis is reported by either the clinician or the patient, previous studies have shown disagreement between clinician-reported outcomes (CROs) and patient-reported outcomes (PROs). This review evaluated the extent of discordance between CROs and PROs for radiation dermatitis. Studies reporting both clinician and patient-reported outcomes for external beam RT were eligible. Nine studies met the inclusion criteria for the systematic review, while 8 of these studies were eligible for inclusion in a meta-analysis of acute and late skin toxicities. We found an overall agreement between CROs and PROs of acute skin colour change, fibrosis and/or retraction, and moist desquamation (p > 0.005). Reporting of late breast pain, breast edema, skin colour change, telangiectasia, fibrosis and/or retraction and induration/fibrosis alone (p > 0.005) were also in agreement between clinicians and patients. Our meta-analysis revealed a greater reporting of acute breast pain by patients (RR = 0.89, 95% CI 0.87–0.92, p