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Rachel Harris; Heidi Probst; Charlotte Beardmore; Sarah James; Claire Dumbleton; Amanda Bolderston; Sara Faithfull; Mary Wells; Elizabeth Southgate.

The Society and College of Radiographers, 207 Providence Square, Mill Street, London, SE1 2EW in collaboration with the Department of Psychology, University of Exeter.


The primary objective of the survey was to evaluate clinical skin care practice at radiotherapy departments across the United Kingdom. The results will be used to review guidelines issued by The Society and College of Radiographers to aid continuity and consistency of patient care by advocating the use of evidence-based practice.

Methods and Sample

A link to an on-line survey, using the Survey MonkeyTM tool, was e-mailed to all radiotherapy department managers in the United Kingdom (N = 67) inviting them to provide one response per department. Sixty-one questions were grouped into eight themed sections.

Key results

Fifty-four departments responded within the allocated timeframe with a final response rate of 81%. Product use for skin conditions varies across departments and practice does not always reflect the current evidence base. Some outdated and unfounded practices are still being used. Limited data is collected routinely on skin toxicity making it difficult to quantify the extent of skin morbidity following radiotherapy with modern techniques.

Conclusions and recommendations

This survey offers a review of radiotherapy skin care practice across the United Kingdom. Existing skin care guidelines from the College of Radiographers require updating to ensure appropriate standardised care. It is recommended:

  • That all radiotherapy departments monitor and document skin morbidity in a systematic way. Best practice should have standard pre-treatment assessment, and baseline and weekly reviews using a particular tool and process.
  • Skin care practice should be agreed across the Cancer Network in line with the requirement for agreed radiotherapy protocols as recommended within the Cancer Peer Review Measures for Radiotherapy (England).
  • Further high quality trials to investigate interventions for dry or moist desquamation are supported.
  • National guidelines must be regularly reviewed and revised to ensure that they are consistent with emerging evidence.

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