Journal of Community Nursing - page 24

24 JCN
2013,Vol 27, No 4
SKIN CARE
common side-effects of external
beam radiotherapy. Modern
machinery and advanced delivery
techniques have gone some way
to reducing the severity of
radiation-induced skin reactions.
However, they still occur in a large
number of patients undergoing
radical treatment.
Additionally, many patients
have fears and anxieties about
these reactions based on historical
misconceptions that they will be
‘burnt’. Understanding the effect
of radiation on tissue viability
and wound healing is pivotal
to ensuring a positive patient
experience.
The use of an evidence-
based skin care protocol and
assessment tool can provide a
consistent approach to radiation
skin reaction management,
including appropriate product
selection. As radiotherapy is
primarily an outpatient treatment,
patient education cannot be
over-emphasised, and teaching
self-management interventions
to minimise discomfort, prevent
further trauma and promote
healing is essential to optimise
symptom control.
However, there still remains
a paucity of literature and well-
designed studies evaluating the
effectiveness of interventions for
the management of radiation-
induced skin reactions and more
randomised controlled trials are
needed (Harris et al, 2011).
References
Byrne P, Copeland L, Mansell J, et
al (2010) Radiotherapy Skin Care
Guidelines. St James’s Institute of
Oncology. Leeds Teaching Hospitals
NHS Trust. Available at: www.
yorkshire-cancer-net.org.uk/html/
publications/guidelines_rt.php
Cancer Research UK (2009) Achieving
a world-class radiotherapy service
across the UK. Available at: www.
cancerresearchuk.org/prod_consump/
groups/cr_common/@nre/@
pol/documents/generalcontent/
crukmig_1000ast-3360.pdf
Cork MJ, Danby S (2011) Aqueous cream
damages the skin barrier.
Br J Dermatol
164(6):
1179–80
Cox JD, Stetz J, Pajak TF (1995) Toxicity
criteria of the Radiation Therapy
Oncology Group (RTOG) and the
European Organisation for Research
and Treatment of Cancer (EORTC).
Int J
Radiat Oncol Biol Phys
31(5):
1341–6
Department of Health (2008) Best Practice
Guidance on joint working between
the NHS and pharmaceutical industry
and other commercial organisations.
DH, London. Available at: www.
dh.gov.uk/en/Publicationsandstatistics/
PublicationsPolicyandGuidance/
DH_082370
Department of Health (2012)
Radiotherapy services in England
2012. DH, London. Available at:
/
system/uploads/attachment_data/
file/213151/Radiotherapy-Services-in-
England-2012.pdf
Faithfull S, Hilton M, Booth K (2002)
Survey of information leaflets on advice
for acute radiation skin reactions in UK
radiotherapy centres: a rationale for a
systematic review of the literature.
Eur J
Oncol Nurs
6(3): 176–8
Ginot A, Doyen J, Hannoun-Levi JM, et
al (2010) Normal tissue tolerance to
external beam radiation therapy: skin.
Cancer Radiother
14(4–5):
379–85
Harris R, Probst H, Beardmore C, et al
(2011) Radiotherapy skin care: a survey
of practice in the UK. Radiography.
Available at:
.
radi.2011.10.040
Hornsby C, Fletcher J, Blyth CM (2005)
The production of a best practice
statement in the skincare of patients
receiving radiotherapy.
J Radiother
Practice
4(2–3):
126–30
Kumar S, Juresic E, Barton M, et al (2001)
Management of skin toxicity during
radiation therapy: A review of the
evidence.
J Med Imaging Radiation Oncol
54:
264–79
McQuestion M (2006) Evidence-based
skin care management in radiation
therapy.
22(3):
163–73
National Health Service, Quality
Improvement Scotland (2010) Skincare
of Patients Receiving Radiotherapy.
Best Practice Statement. NHS Quality
Improvement Scotland, Edinburgh
Noble-Adams R. (1999) Radiation-
induced skin reactions 3: evaluating the
RISRAS.
Br J Nurs
8(19):
1305–12
Patel AN, Vama S, Batchelor JM, et al
(2013) Why aqueous cream should not
be used in radiotherapy-induced skin
reactions.
Letter Clin Oncol
25(4):
272
Ryan JL, Bole C, Hickok JT, et al (2007)
Post-treatment skin reactions reported
by cancer patients differ by race, not by
treatment or expectations.
Br J Cancer
97:
14–21
Salvo N, Barnes E, van Draanen J, et al
(2010) Prophylaxis and management of
acute radiation-induced skin reactions:
a systematic review of the literature.
Curr Oncol
17(4):
94–112
Stone HB, Coleman CN, Anscher MS, et
al (2003) Effects of radiation on normal
tissue: consequences and mechanisms.
Lancet Oncol
4:
529–36
Symonds P, Deeham C, Meredith C, et
al (2012)
Walter and Miller’s Textbook
of Radiotherapy: Radiation Physics,
Therapy & Oncology
. 7th edn. Churchill
Livingstone, London
Trueman E (2012) Skin reactions in
radiotherapy.
Nurs Times
108(6):
17
Trueman E, The Princess Royal
Radiotherapy Review Team (2011)
Managing radiotherapy-induced skin
reactions. A toolkit for healthcare
professionals. St James’s Institute Of
Oncology, Leeds
Wells M, MacBride S (2003) Radiation
skin reactions. In: Faithfull S,Wells M,
eds.
Supportive Care in Radiotherapy
.
Elsevier Science Ltd: chap 8
JCN
KEY POINTS
One of the most common
radiotherapy-induced side-effects
is an acute skin reaction, which
can range from mild erythema to
confluent moist desquamation.
All patients receiving external
beam radiotherapy are at
potential risk of developing a
skin reaction.
The use of an evidence-based
assessment tool can provide
consistent radiation skin
reaction management.
As radiotherapy is primarily an
outpatient treatment, patient
education cannot be over-
emphasised.
Many patients have fears
and anxieties about these
reactions, based on historical
misconceptions that they will
be ‘burnt’.
1...,14,15,16,17,18,19,20,21,22,23 25,26,27,28,29,30,31,32,33,34,...116