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.

Department of Radiation Oncology, Santa Croce General Hospital, Cuneo, Italy. elviorussi@gmail.com

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2012 Sep

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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. 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. 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.

Citation

Elvio G Russi, Marco C Merlano, Gianmauro Numico, Renzo Corvò, Marco Benasso, Riccardo Vigna-Taglianti, Antonella Melano, Nerina Denaro, Stefano Pergolizzi, Ida Colantonio, Francesco Lucio, Rodolfo Brizio, Umberto Ricardi. 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. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2012 Sep;20(9):2141-7