ESTRO 2025 - Abstract Book

S1556

Clinical – Mixed sites & palliation

ESTRO 2025

3336

Mini-Oral An international Delphi consensus study to develop a revised acute radiation dermatitis scoring tool

Shirley SW Tse 1,2 , Julie Ryan Wolf 3 , Corina van den Hurk 4 , Raymond Chan 5 , Edward Chow 6 , Shing Fung Lee 7 , Isabelle J. Choi 8 , Jennifer YY Kwan 6 , Henry CY Wong 9 1 Department of Clinical Oncology, United Christian Hospital, Hong Kong, Hong Kong. 2 Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, Hong Kong. 3 Department of Dermatology, University of Rochester Medical Center, New York, USA. 4 Santeon, Utrecht, Utrecht, Netherlands. 5 Caring Futures Institute, Flinders University, Adelaide, Australia. 6 Department of Radiation Oncology, University of Toronto, Toronto, Canada. 7 Department of Radiation Oncology, National University Hospital, Singapore, Singapore. 8 Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA. 9 Department of Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong Purpose/Objective: Radiation dermatitis (RD) occurs in over 90% of patients undergoing radiation therapy. The existing Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG) scales exhibit variability in their metrics and lack patient-reported outcomes. Our Delphi consensus study seeks to develop a grading system that can better aid clinicians and researchers in accurate and objective measurement of acute RD severity and assessment of therapeutic efficacy in interventional clinical trials. Material/Methods: Based on a literature review on the limitations of existing scoring systems for acute RD, a Delphi consensus process was initiated through an electronic survey. International experts with clinical or research interests in RD from the Multinational Association of Supportive Care in Cancer (MASCC) were invited to participate. Additional participants were recruited through snowball sampling. Participants were asked their degree of agreement on statements related to the conceptualization and categorization of the tool, and components to include in the clinician- and patient-reported outcomes in a 5-point Likert scale. Consensus is defined as more than 75% agreement among participants for each statement. Statements that did not reach consensus will undergo revision, followed by a second round of voting. The study was granted an exemption for ethics review by the Western Institutional Board (ID: NYPC ERC#2024-060). Results: In the first round, 32 experts from 16 countries or regions participated in the survey. These experts represented five disciplines and most of them (27/32, 84%) had over 10 years of experience in managing RD. Twenty-four out of 35 statements (69%) reached consensus in the first round. Over 90% of the experts agreed or strongly agreed that the CTCAE and RTOG scales are inadequate in accurate assessment of acute RD severity and emphasised the need to include patient-reported outcomes in the revised scoring tool. More than 75% of participants agreed or strongly agreed to include patient-reported outcomes, including pain (94%), itchiness (88%), burning sensation (84%), change in pigmentation (81%), swelling (88%), skin dryness (78%), skin irritation (88%), rash (81%) and impairment of daily activities (84%), in the scoring tool. The second voting round is in progress and the final result will be presented at the 2025 ESTRO Annual Congress. Conclusion: This is the first Delphi consensus study to develop a revised scoring tool for the assessment of acute RD. Further studies are planned to validate the tool in a diverse group of patients and test its inter-rater reliability amongst patients, clinicians and researchers.

Keywords: Radiation dermatitis, Delphi study, Scoring tool