Skin toxicity following Post-Mastectomy Radiotherapy (PMRT) and its impact on Quality Of Life (QOL)
by Ruth Bees
Poster Download
Background
PMRT reduces the risk of breast cancer recurrence. There are no nationally agreed guidelines for the use of bolus with PMRT; its use can be associated with significant acute and late skin toxicity. These toxicities can have substantial impact on the QOL of patients.
Method
We undertook this project to obtain baseline data prior to considering implementing changes to our PMRT protocol.
Quality Measure Indicators (QMIs) were collected for patients at the end of PMRT and for 6 weeks afterwards. QMI 1: Patient assessment of skin reaction using Radiation Therapy Oncology Group (RTOG) grading system. QMI 2: If, when and from whom advice was sought regarding skin toxicity. QMI 3: Impact of skin toxicity on QOL.
Surveys were given to 30 patients to complete on their last day of radiotherapy and again at 2, 4 and 6 weeks after radiotherapy.
Results
QM1: 79% and 58% patients reported ≥ grade 2 skin toxicity at 2 and 4 weeks after radiotherapy respectively. QM2: 50% patients sought advice regarding skin reaction after the end of radiotherapy. QM3: 50% patients stopped wearing their prosthesis; 48% felt unable to wear normal clothing.
Conclusion
Skin toxicity following PMRT with bolus in our department results in peak skin toxicity 2-4 weeks after radiotherapy and this has a negative impact on QOL. Patients need advice regarding skin toxicity after completion of PMRT. Further research is indicated into improved skin care products, the use of bolus for PMRT and skin toxicity review clinics in order to improve skin toxicity and QOL.