Role of Skin Management in Impairing QOL Among Individuals with Radiodermatitis As Compared with Other Dermatological Condition

Abstract

We compared the impact of management for breast radiodermatitis against similar benign dermatological conditions on skin-related quality of life (SRQOL). We prospectively studied women with breast cancer who were receiving normofractionated or accelerated external radiotherapy provided in the supine position using 3-dimensional conformal techniques at a community cancer center in northwestern Illinois, USA in this descriptive study. The comparison group included a subset of participants with skin conditions causing manifestations (i.e., eczema [n=234], atopic dermatitis [n=172], blistering conditions [n=66], pruritus [n=60]) similar to radiodermatitis from a cross-sectional multinational study by Balieva et al. (2018). SRQOL was assessed using the Dermatology Life Quality Index (DLQI), the first and most widely used instrument to measure this construct. The DLQI is a 10-question instrument that explores the participant’s perception of skin condition impact on quality of life. It was designed to minimize survey burden when used weekly, with higher scores indicating worsening QOL. DLQI question-10, “Over the last week, how much of a problem has the treatment for your skin been, for example by making your home messy, or by taking up time?” was used to examine the burden of dermatological treatment on SRQOL. Forty women (39 non-Hispanic White, 1 Asian) consented to the radiodermatitis study and no data were missing. Collectively, more than half of the participants with atopic dermatitis (63.4%), blistering conditions (53.0%), and breast radiodermatitis at 5 weeks on treatment (50%) indicated dermatological treatment had a negative impact on their SRQOL. Additionally, 43.3% of patients with pruritus and 43.1% with eczema were negatively affected by treatment for their skin condition. As expected, 0% of participants were negatively impacted by skin care treatment before the start of radiotherapy. Our results suggest breast cancer patients experiencing radiodermatitis have a negative effect on their skin-related quality of life. Furthermore, the amount of negative impact is fairly similar in magnitude to that experienced by individuals with atopic dermatitis, blistering conditions, pruritus, and eczema. While the multinational study was large, our study of radiodermatitis had a modest sample size. Larger studies including individuals with radiotherapy treatment sites other than breast are needed.