Referral practices to dermatologists for the treatment of radiation dermatitis in the USA: a call for a multidisciplinary approach.

PURPOSE: Acute radiation dermatitis (RD) is a disfiguring and painful rash that occurs in up to 95% of patients receiving radiation therapy (RT) for cancer. Treatment for RD varies among practitioners with no evidence-based gold standard for management. While a multi-disciplinary approach has been utilized to manage other cancer-related toxicities, RD is most often managed by the treating radiation oncologist. METHODS: This study evaluated the referral practices of radiation oncologists to dermatologists for management of RD utilizing a survey of radiation oncologists across the USA. The goal was to identify the referral practices of radiation oncologists for RD and any barriers to a multidisciplinary approach. RESULTS: Of the 705 respondents, 15% reported ever referring patients to dermatology. Private practitioners referred significantly less than providers in academic or oncology centers (p < 0.01). Practitioners in urban settings were more likely to refer (p < 0.01), and radiation oncologists in the Southeastern USA were less likely to refer (p < 0.01). CONCLUSIONS: Lack of timely access to dermatologists in various geographic areas in addition to radiation oncologists' preference to treat RD are barriers to multidisciplinary management of RD. Inclusion of dermatologists and wound care specialists in cancer treatment teams could improve patient care and stimulate needed research into strategies for treatment and prevention of RD.