Modified Delphi consensus on interventions for radiation dermatitis in breast cancer: A Canadian expert perspective

BackgroundAcute radiation dermatitis is a prevalent adverse effect of radiotherapy in patients with breast cancer, and there is a lack of high-quality data regarding its prevention and management. This study employs a modified Delphi consensus process to compile the perspectives of Canadian dermatology and breast cancer radiation oncology experts, aiming to establish consensus-based recommendations for the prevention and management of acute radiation dermatitis in breast cancer patients.MethodsA four-round modified Delphi consensus process was organized with the participation of 19 Canadian experts. The process involved a systematic review of existing literature on the prevention and treatment of acute radiation dermatitis in breast cancer, from January 1946 to July 2023. After review of the literature, participants first provided their opinions on the strength and quality of the evidence for the identified interventions. A second round assessed the degree to which the intervention would be recommended in either low- or high-risk settings. Two more consolidated consensus.ResultsAfter the first round, consensus for evidence of recommendation or suggestion in support of use of a product was reached for 4 prevention interventions. With regards to the management of acute radiation dermatitis, there was consensus about the strength of evidence for 1 product. After the fourth round, consensus for recommendation was reached for 3 prevention interventions in both low- and high-risk patients: washing, moisturizing, and prevention education. For the high-risk settings, 3 additional prevention interventions reached consensus: barrier films, betamethasone and mometasone. With regards to the management of acute radiation dermatitis, there was consensus for recommendation for: foam dressings, betamethasone and mometasone.ConclusionsThis pan-Canadian modified Delphi consensus initiative provides expert-reviewed and evidence-based recommendations for interventions to prevent and manage acute radiation dermatitis in breast cancer patients. The endorsed interventions offer valuable guidance for clinicians, highlighting areas where consensus among experts has been achieved.Legal entity responsible for the studyFisika Groups.FundingLa Roche-Posay Canada.DisclosureT. Hijal, H. Dahn, V. Theberge, V. Panet-Raymond, E. Wiebe, I. Kong, D. Rodin, N. Logie, E. Chow, B. Bashir, P. Wright, J. Caudrelier, J. Bourque, M. Yassa, M. Sauder, J. Claveau, C.H. Avella Bolivar, S. Marchuk, J. Cao: Financial Interests, Personal, Funding: L'Oreal Canada. N. Dayeh: Financial Interests, Personal, Affiliate: L'Oreal Canada.