Characterization of skin reactions and pain reported by patients receiving radiation therapy for cancer at different sites

Abstract

Background Skin reactions and pain are commonly reported side effects of radiation therapy (RT). Objective To characterize RT-induced symptoms according to treatment site subgroups and identify skin symptoms that correlate with pain. Methods A self-report survey, adapted from the MD Anderson Symptom Inventory and the McGill Pain Questionnaire, assessed RT-induced skin problems, pain, and specific skin symptoms. Wilcoxon Sign Ranked tests compared mean severity of pre- and post-RT pain and skin problems within each RT-site subgroup. Multiple linear regression (MLR) investigated associations between skin symptoms and pain. Results Survey respondents (n=106) were 58% female and on average 64 years old. RT sites included lung, breast, lower abdomen, head/neck/brain, and upper abdomen. Only patients receiving breast RT reported significant increases in treatment site pain and skin problems (p≤0.007). Patients receiving head/neck/brain RT reported increased skin problems (p<0.0009). MLR showed that post-RT skin tenderness and tightness were most strongly associated with post-RT pain (p=0.066 and p=0.122, respectively). Limitations Small sample size, exploratory analyses, and non-validated measure. Conclusions Only patients receiving breast RT reported significant increases in pain and skin problems at the RT site, while patients receiving head/neck/brain RT had increased skin problems, but not pain. These findings suggest that the severity of skin problems is not the only factor that contributes to pain, and interventions should be tailored to specifically target pain at the RT site, possibly by targeting tenderness and tightness. These findings should be confirmed in a larger sampling of RT patients.

Utility of topical agents for radiation dermatitis and pain: a randomized clinical trial

“…Throughout the course of the study, patients reported their pain intensity at the RT site on a scale of 0 to 10 in a self-report daily Pain Diary. The Skin-Pain Inventory was a 16-item questionnaire that evaluated the severity of skin problems and pain at the RT site, as well as 9 specific pain symptoms (i.e., itchy, achy, tender, hot-burning, tight, redness, flaking, bumpy) on a 6-point severity scale anchored by 0 ("Not Present") and 5 ("Very Severe") [11]. A Feedback Questionnaire consisted of 12 questions regarding likes and dislikes of the topical agent, perceived benefit for skin reactions or pain, use of standard care topical treatments, and their perceived assigned study arm.…”

Application of Forcing Functions to Electronic Health Records Is Associated With Improved Pain Control for Patients Undergoing Radiation Therapy for Bone Metastases

“…Because irradiation therapy damages healthy tissue and causes skin inflammation and treatment site pain, control of pain in these patients requires a more complex organization of therapeutic strategies. 20 Increasing pain documentation alone was not enough to significantly affect the prevalence of pain in these patients.…”

Mepitel film for the prevention of radiation dermatitis: A comprehensive review of its efficacy, side effects, physics measurements, patient- and clinician-reported outcomes

“…In severe cases when treating with high doses, skin breakdown may occur, leading to moist desquamation (MD) or, rarely, ulceration. 1 , 2 RD begins to appear in patients between 1 and 4 weeks into RT and peaks in severity 2–4 weeks after the completion of RT. 1 , 3 , 4 While acute RD can be extremely painful and uncomfortable, most patients recover within 3 months after the completion of RT.…”

“… 1 , 3 , 4 While acute RD can be extremely painful and uncomfortable, most patients recover within 3 months after the completion of RT. 2 However, RD can also persist chronically and may leave patients with permanent changes to their skin, such as dryness, hyperpigmentation, and telangiectasia. 5 These chronic changes may affect patients’ mobility, cause disfiguration, and negatively impact patient quality of life in the long term.…”