INDIVIDUAL ARTICLE: NECOM 3: A Practical Algorithm for the Management of Radiation Therapy-Related Acute Radiation Dermatitis

November 2023 | Volume 22 | Issue 11 | SF400354s3 | Copyright © November 2023


Published online October 11, 2023

Ada Girnita MD PhDa, Peter Bjerring MD PhD FEADVb, Sampsa Kauppi MDc, Charles W. Lynde MD FRCPCd, Maxwell B. Sauder MD FRCPC DABDe, Anneke Andriessen PhDf

aSkin Cancer Center Karolinska University Hospital, Stockholm, Sweden  
bDepartment of Dermatology, Aalborg University Hospital, Aalborg, Denmark  
cPrivate practice, Terveystalo and Epilaser Oy, Finland  
dDepartment of Medicine University of Toronto, Toronto, ON, Canada; Lynderm Research, Markham, ON, Canada  
ePrincess Margaret Cancer Centre, Toronto, ON, Canada; Department of Medicine University of Toronto, Toronto, ON, Canada
fRadboud UMC, Nijmegen and Andriessen Consultants, Malden, The Netherlands 

Abstract
Background: In the Nordic European countries in 2020, cancer diagnoses accounted for 175,925 patients. About 50% of cancer patients receive radiation therapy (RT), which may lead to radiation dermatitis (RD). Notably, patients with breast, head, neck, and anal cancers may be prone to developing RD. However, few algorithms exist for the prevention and treatment of RD.
Methods: The Nordic European Cutaneous Oncodermatology Management (NECOM) project aims to improve cancer patient outcomes by offering tools to prevent and treat cancer therapy-related cutaneous adverse events (cAEs). The first 2 NECOM papers presented various cAEs and skincare regimens involving hygiene, moisturization, sun protection, and camouflage products for preventing and managing cAEs. The NECOM 3 practical algorithm for preventing and managing acute RD (ARD) is intended to promote healthy skin and reduce RT-related ARD, improving cancer patient outcomes. 
Results: The NECOM advisors discussed the results of a systematic literature review and obtained consensus on the evidence and opinion-based practical algorithm for ARD to support all stakeholders in the Nordic European healthcare setting. The algorithm starts with skin-preserving therapy, followed by skin condition assessment and patient-specific interventions based on the grade of RD present. 
Conclusion: ARD may lead to symptoms of pruritus and pain, decreased QoL and morbidity, and treatment interruptions. Patient education on the prevention of RD and treatment recommendations given in the NECOM 3 algorithm may help prevent and manage RD and improve the overall care of patients receiving RT.

J Drugs Dermatol. 2023;22:11(Suppl 2):s3-s10.

INTRODUCTION

New cancer cases in 2020 in Europe, excluding non-melanoma skin cancer, are estimated at 4 million cases.1 Breast (530,000 patients), colorectal (520,000), lung (480,000), and prostate (470,000) cancer accounted for almost half of the overall cancer burden in Europe in 2020.1 The estimated number of cancer deaths in Europe was over 710,000 in males and 560,000 in females.1 An analysis over the past 50 years confirms the progress in improved cancer control; in 84% of patients, 5-year survival was over 60%.2 Metastases remain a challenge, emphasizing the need for early detection before metastasis occurs.2

In the Nordic European countries in 2020, all cancer diagnoses accounted for 175,925 patients.3,4 

Of the 1.92 million estimated United States patients diagnosed with cancer in 2022, approximately 50% require radiation therapy (RT).5 RT's most common side effect is radiation dermatitis (RD), particularly in patients with breast, head, neck, and anal cancers. RD may develop with a broad spectrum in severity and degree and considerable heterogeneity in its management.5 Few clinical treatment algorithms exist to prevent and treat RD, underscoring the need to develop uniform, evidence-directed recommendations.6,7 The Nordic European Cutaneous Oncodermatology Management (NECOM) practical algorithm for preventing and managing acute RD (ARD) in patients with cancer and survivors is intended to promote healthy skin and reduce cancer treatment-related cutaneous adverse events (cAEs). 
Close Menu