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Supportive Care in Cancer
Published in: Supportive Care in Cancer 9/2012

01-09-2012 | Original Article

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

Authors: 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

Published in: Supportive Care in Cancer | Issue 9/2012

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Abstract

Purpose

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.

Results

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.

Conclusions

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
Literature
1.
Harari PM, Huang S (2001) Head and neck cancer as a clinical model for molecular targeting of therapy: combining EGFR blockade with radiation. Int J Radiat Oncol Biol Phys 49:427–433PubMedCrossRef
2.
Tejwani A, Wu S, Jia Y et al (2009) Increased risk of high-grade dermatologic toxicities with radiation plus epidermal growth factor receptor inhibitor therapy. Cancer 115:1286–1299PubMedCrossRef
3.
Woodworth CD, Michael E, Marker D et al (2005) Inhibition of the epidermal growth factor receptor increases expression of genes that stimulate inflammation, apoptosis, and cell attachment. Mol Cancer Ther 4:650–658PubMedCrossRef
4.
Busam K, Capodieci P, Motzer R et al (2001) Cutaneous side-effects in cancer patients treated with the antiepidermal growth factor receptor antibody C225. Br J Dermatol 144:1169–1176PubMedCrossRef
5.
Albanell J, Rojo F, Averbuch S et al (2002) Pharmacodynamic studies of the epidermal growth factor receptor inhibitor ZD1839 in skin from cancer patients: histopathologic and molecular consequences of receptor inhibition. J Clin Oncol 20:110–124PubMedCrossRef
6.
Budach W, Bolke E, Homey B (2007) Severe cutaneous reaction during radiation therapy with concurrent cetuximab. N Engl J Med 357:514–515PubMedCrossRef
7.
Russi EG, Merlano MC, Comino A, Numico G (2007) Ultrathin hydrocolloid dressing in skin damaged from alternating radiotherapy and chemotherapy plus cetuximab in advanced head and neck cancer (G.O.N.O. AlteRCC Italian Trial): In Regard to Macmillan et al. (Int J Radiat Oncol Biol Phys 2007;68:864–872). Int J Radiat Oncol Biol Phys 69:638–639PubMedCrossRef
8.
Eaby B, Culkin A, Lacouture M (2008) An interdisciplinary consensus on managing skin reactions associated with human epidermal growth factor receptor inhibitors. Clin J Oncol Nurs 12:283–290PubMedCrossRef
9.
Melosky B, Burkes R, Rayson D et al (2009) Management of skin rash during egfr-targeted monoclonal antibody treatment for gastrointestinal malignancies: Canadian recommendations. Curr Oncol 16:16–26PubMedCrossRef
10.
Pryor DI, Porceddu SV, Burmeister BH et al (2009) Enhanced toxicity with concurrent cetuximab and radiotherapy in head and neck cancer. Radiother Oncol 90:172–176PubMedCrossRef
11.
Merlano M, Russi E, Benasso M et al (2011) Cisplatin-based chemoradiation plus cetuximab in locally advanced head and neck cancer: a phase II clinical study. Ann Oncol 22:712–717PubMedCrossRef
12.
Studer G, Brown M, Salgueiro EB et al (2011) Grade 3/4 dermatitis in head and neck cancer patients treated with concurrent Cetuximab and IMRT. Int J Radiat Oncol Biol Phys 81:110–117PubMedCrossRef
13.
Lee N, Chuang C, Quivey JM et al (2002) Skin toxicity due to intensity-modulated radiotherapy for head-and-neck carcinoma. Int J Radiat Oncol Biol Phys 53:630–637PubMedCrossRef
14.
Curran D, Giralt J, Harari PM et al (2007) Quality of life in head and neck cancer patients after treatment with high-dose radiotherapy alone or in combination with cetuximab. J Clin Oncol 25:2191–2197PubMedCrossRef
15.
Joshi SS, Ortiz S, Witherspoon JN et al (2010) Effects of epidermal growth factor receptor inhibitor-induced dermatologic toxicities on quality of life. Cancer 116:3916–3923PubMedCrossRef
16.
Wagner LI, Lacouture ME (2007) Dermatologic toxicities associated with EGFR inhibitors: the clinical psychologist’s perspective. Impact on health-related quality of life and implications for clinical management of psychological sequelae. Oncology (Williston Park) 21(11 Suppl 5):34–36
17.
Page DL, Fleming ID, Fritz A et al (2002) AJCC cancer staging manual, 6th edn. Springer, New York
18.
Merlano M, Benasso M, Corvò R et al (1996) Five-year update of a randomized trial of alternating radiotherapy and chemotherapy compared with radiotherapy alone in treatment of unresectable squamous cell carcinoma of the head and neck. J Natl Cancer Inst 88:583–589PubMedCrossRef
19.
20.
Noble-Adams R (1999) Radiation-induced skin reactions. 2: development of a measurement tool. Br J Nurs 8:1208–1211PubMed
21.
Noble-Adams R (1999) Radiation-induced skin reactions. 3: evaluating the RISRAS. Br J Nurs 8:1305–1312PubMed
22.
MacBride SK, Wells ME, Hornsby C et al (2008) A case study to evaluate a new soft silicone dressing, mepilex lite, for patients with radiation skin reactions. Cancer Nurs 31:E8–E14PubMedCrossRef
23.
Wells M, MacBride S (2004) Radiation skin reactions. In: Faithful S, Wells M (eds) Supportive care in radiotherapy. Churchill Livingstone, Edinburgh, pp 135–159
24.
Simon R (1989) Optimal two-stage designs for phase II clinical trials. Control Clin Trials 10:1–10PubMedCrossRef
25.
Bölke E, Gerber PA, Lammering G et al (2008) Development and management of severe cutaneous side effects in head-and-neck cancer patients during concurrent radiotherapy and cetuximab. Strahlenther Onkol 184:105–110PubMedCrossRef
26.
Noble-Adams R (1999) Radiation-induced reactions. 1: an examination of the phenomenon. Br J Nurs 8:1134–1140PubMed
27.
Pastore S, Mascia F, Mariotti F et al (2005) ERK1/2 regulates epidermal chemokine expression and skin inflammation. J Immunol 174:5047–5056PubMed
28.
Pastore S, Mascia F, Mariani V, Girolomoni G (2008) The epidermal growth factor receptor system in skin repair and inflammation. J Invest Dermatol 128:1365–1374PubMedCrossRef
29.
30.
Fayers P, Weeden S, Curran D, on behalf of the EORTC Quality of Life Study Group (1998) EORTC QLQ-C30 reference values. EORTC, Brussels
31.
32.
Bernier J, Russi EG, Homey B et al (2011) Management of radiation dermatitis in patients receiving cetuximab and radiotherapy for locally advanced squamous cell carcinoma of the head and neck: proposals for a revised grading system and consensus management guidelines. Ann Oncol 22:2191–2200PubMedCrossRef
Metadata
Title
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
Authors
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
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 9/2012
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-011-1324-4

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