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ONS Guidelines Article

ONS Guidelines™ for Cancer Treatment–Related Skin Toxicity

Loretta A. Williams
Pamela K. Ginex
George L. Ebanks Jr.
Karren Ganstwig
Kathryn Ciccolini
Bernice Y. Kwong
Jeanene (Gigi) Robison
Gary Shelton
Jenna Strelo
Kathleen Wiley
Christine Maloney
Kerri A. Moriarty
Mark Vrabel
Rebecca L. Morgan
ONF 2020, 47(5), 539-556 DOI: 10.1188/20.ONF.539-556

Background: Management of cancer treatment–related skin toxicities can minimize treatment disruptions and improve patient well-being.

Objectives: This guideline aims to support patients and clinicians in decisions regarding management of cancer treatment–related skin toxicities.

Methods: A panel developed a guideline for management of cancer treatment–related skin toxicities using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) for certainty of evidence and the National Academies of Sciences, Engineering, and Medicine criteria for trustworthy guidelines. The Cochrane risk-of-bias tool assessed risk of bias. A quantitative or narrative synthesis of the evidence was completed.

Results: The panel issued seven conditional recommendations for epidermal growth factor receptor inhibitor rash, hand-foot skin reaction, hand-foot syndrome, and chemotherapy-induced alopecia. The panel suggested strategies for prevention and treatment for all toxicities except hand-foot syndrome, which only has a prevention recommendation.

Implications for Nursing: Cancer treatment–related skin toxicities can significantly affect quality of life. Incorporation of these interventions into clinical care can improve patient outcomes.

Supplementary material can be found at

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