{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:36:20Z","timestamp":1793194580602,"version":"4.5.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Enhancing the quality of radiotherapy for skin cancer requires systematic evaluation of radiation-induced skin toxicity, particularly acute toxicity, which affects ~90% of patients receiving ionizing radiation. This study assessed the reliability of a newly developed visual grading tool, the Clinician Erythema Assessment\u2013Radiation Therapy (CEA-RT), designed to help radiation clinicians evaluate early radiation dermatitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and materials<\/jats:title>\n                    <jats:p>The CEA-RT tool utilizes a 5-point scale. Its reliability was evaluated by analyzing intra-rater and inter-rater agreement among clinicians, as well as its concordance with an expert reference standard against a reference standard. The assessment was conducted using digital images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study\u2019s results showed high intra-rater reliability, with 98% of scores falling within \u00b11 grade and consistent grading for regions of interest (ROI). However, inter-rater agreement was only fair, indicating variability among different clinicians. Concordance with an expert reference standard against a reference standard was moderate, with 25\u201330% of therapists achieving high concordance and over 50% showing moderate agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The findings support the CEA-RT scale as a reliable tool for individual use. However, study limitations included variable time gaps between sessions, recall bias, fatigue, and reliance on digital images. The results emphasize the need for additional training,\n                      <jats:italic>in vivo<\/jats:italic>\n                      validation, and inclusion of diverse skin types to improve overall accuracy and applicability.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1882432","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T04:22:52Z","timestamp":1786335772000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Reliability of radiotherapist assessment for radiation induced skin-toxicity: investigational study"],"prefix":"10.3389","volume":"16","author":[{"given":"Lilian","family":"Doerwald-Munoz","sequence":"first","affiliation":[{"name":"Juravinski Cancer Centre, Hamilton Health Sciences","place":["Hamilton, ON, 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