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The following is a summary of “Delphi consensus-based recommendations of tools and outcomes for the assessment of radiation dermatitis severity,” published in the May 2025 issue of Radiotherapy and Oncology by Rahman et al.

Acute radiation dermatitis (ARD) is a prevalent adverse effect of radiation therapy (RT) in patients with cancer, often leading to significant discomfort and reduced quality of life. Despite its clinical importance, the assessment of ARD severity remains inconsistent across studies due to the diverse range of assessment tools and outcome measures utilized in clinical trials. This variability hinders the comparability of study results and limits the development of standardized management strategies. To address this issue, the study employed a modified Delphi consensus survey to gather expert opinions on the most commonly used assessment tools and outcomes for evaluating ARD severity. A panel of 30 experts in the fields of radiation oncology, dermatology, and supportive cancer care was invited to participate in a structured two-round Delphi process. 

The survey, conducted via the REDCap platform, systematically assessed 32 existing evaluation tools and 11 key outcome measures relevant to ARD severity. Of the invited participants, 80% (24/30) completed the first round, while 92% (22/24) participated in the second round. Tools and outcomes that achieved a consensus threshold of ≥70% agreement among experts were considered for recommendation. The expert panel identified four validated assessment tools—RTOG (Radiation Therapy Oncology Group), CTCAE (Common Terminology Criteria for Adverse Events), RISRAS (Radiation-Induced Skin Reaction Assessment Scale), and Skindex-16—as the most suitable for evaluating ARD severity. Additionally, consensus was reached on eight key outcome measures, including moist desquamation, pain, quality of life (QoL), erythema, dry desquamation, pruritus/itching, necrosis/ulceration, and burning. 

Notably, no biophysical parameters reached the consensus threshold due to limited supporting evidence, underscoring the need for further research in this area. Furthermore, experts recommended modifications to existing assessment tools to improve their applicability across diverse patient populations, particularly for individuals with varying skin types. This study represents a critical first step in establishing standardized ARD severity assessment criteria based on expert consensus. However, the findings also highlight the necessity of refining and validating existing tools to enhance accuracy, reproducibility, and inclusivity in ARD evaluation. Future research should focus on the development of a comprehensive, universally applicable ARD severity assessment tool that integrates both clinical and patient-reported outcomes while addressing current limitations in measurement consistency.

Source: thegreenjournal.com/article/S0167-8140(25)00141-0/abstract