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Referral practices to dermatologists for the treatment of radiation dermatitis in the USA: a call for a multidisciplinary approach

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Abstract

Purpose

Acute radiation dermatitis (RD) is a disfiguring and painful rash that occurs in up to 95% of patients receiving radiation therapy (RT) for cancer. Treatment for RD varies among practitioners with no evidence-based gold standard for management. While a multi-disciplinary approach has been utilized to manage other cancer-related toxicities, RD is most often managed by the treating radiation oncologist.

Methods

This study evaluated the referral practices of radiation oncologists to dermatologists for management of RD utilizing a survey of radiation oncologists across the USA. The goal was to identify the referral practices of radiation oncologists for RD and any barriers to a multidisciplinary approach.

Results

Of the 705 respondents, 15% reported ever referring patients to dermatology. Private practitioners referred significantly less than providers in academic or oncology centers (p < 0.01). Practitioners in urban settings were more likely to refer (p < 0.01), and radiation oncologists in the Southeastern USA were less likely to refer (p < 0.01).

Conclusions

Lack of timely access to dermatologists in various geographic areas in addition to radiation oncologists’ preference to treat RD are barriers to multidisciplinary management of RD. Inclusion of dermatologists and wound care specialists in cancer treatment teams could improve patient care and stimulate needed research into strategies for treatment and prevention of RD.

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Data availability

The authors have full control of all primary data and agree to allow the journal view primary data upon request.

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Acknowledgements

The authors acknowledge Justin C. Voss, MD, and Prashoban Bremjit, MD, for gathering the physician contact information for this survey.

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Authors and Affiliations

  1. Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA

    Roya S. Nazarian, Loren Franco, Christos Zouzias, Shalom Kalnicki & Beth N. McLellan

  2. Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY, 10029, USA

    Roya S. Nazarian

  3. Inova Melanoma and Skin Cancer Center, 8081 Innovation Park Drive, Fairfax, VA, 22031, USA

    Patricia Lucey

  4. Alta Bates Comprehensive Cancer Center, 2001 Dwight Way, Berkeley, CA, 94704, USA

    Sravana Chennupati

Authors
  1. Roya S. Nazarian
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  2. Patricia Lucey
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  3. Loren Franco
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  4. Christos Zouzias
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  5. Sravana Chennupati
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  6. Shalom Kalnicki
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  7. Beth N. McLellan
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Corresponding author

Correspondence to Beth N. McLellan.

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The institutional review board approved this study and found it tocomply with ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

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Nazarian, R.S., Lucey, P., Franco, L. et al. Referral practices to dermatologists for the treatment of radiation dermatitis in the USA: a call for a multidisciplinary approach. Support Care Cancer 28, 967–969 (2020). https://doi.org/10.1007/s00520-019-05167-4

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  • DOI: https://doi.org/10.1007/s00520-019-05167-4

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