New study identifies preferred method to assess patient reactions to radiation therapy

The North Shore-LIJ Health System Department of Radiation Medicine presented a novel study to evaluate the reliability of different systems used by caregivers to assess toxicity for patients receiving radiation therapy. The study will be presented at the 55th Annual Meeting of the American Society of Therapeutic Radiation Oncology in Atlanta, GA.

During the course of radiation therapy, patients may experience reactions to their treatments. Typically, the severity of reactions is assessed by a radiation oncologist and nurse using a formal grading scheme. Research conducted by North Shore-LIJ's radiation oncologists evaluated the reliability of these grading systems by independent caregivers. The study assessed whether independent caregivers would assign the same grade to the same adverse reaction using a common grading scheme. Images of breasts that had undergone radiation in 30 breast cancer patients on skin care protocols were presented to radiation oncologists and nurses who were asked to assign grades independently based on their evaluation of the images and provide feedback explaining their choices. The assessments were then analyzed and the level of agreement among caregivers was determined using statistical methods.

As presented at ASTRO, the study determined that overall there was a significantly better agreement in the assessments based on the use of the Common-Terminology-Criteria-for-Adverse Events (CTCAE) scale, which was developed by the National Cancer Institute to standardize the assignment of grades across various caregivers. Analysis of the comments provided by the caregivers revealed a reliance on assessment criteria that was not necessarily explicit in the grading definitions.

“Establishing the reliability of the scale used to assess adverse reactions among different caregivers is an important step to enhance uniformity and consistency of the care to our patients,” said Ajay Kapur, PhD, lead author of the study and director of medical physics research and education in the North Shore-LIJ Department of Radiation Medicine. “The specific grading scheme used must demonstrate a high level of reliability amongst various caregivers.”

The study's senior author and chair of radiation medicine, Louis Potters, MD, said, “In order to deliver the highest quality of care to our patients, we all need to speak the same language. This study enhances our ability to provide Consistent care to all our patients and further validates the CTCAE grading system.”

About North Shore-LIJ Health System

One of the nation's largest healthcare systems, North Shore-LIJ delivers world-class clinical care throughout the New York metropolitan area, pioneering research at The Feinstein Institute for Medical Research and a visionary approach to medical education highlighted by the Hofstra North Shore-LIJ School of Medicine. North Shore-LIJ cares for people at every stage of life at 16 hospitals and nearly 400 outpatient physician practices throughout the region. North Shore-LIJ's owned hospitals and long-term care facilities house more than 6,000 beds, employ more than 10,000 nurses and have affiliations with more than 9,400 physicians. With a workforce of more than 46,000, North Shore-LIJ is the largest employer on Long Island and the third-largest private employer in New York City. For more information, go to http://www.northshorelij.com