A randomized, double-blind trial on the use of 1% hydrocortisone cream for the prevention of acute radiation dermatitis

Meghrajani, Chandra F; Co, Henri S; Arcillas, Jon G; Maano, Clarita C; Cupino, Nonette

doi:10.1586/17512433.2016.1126506

Cited by 22 publications

(38 citation statements)

References 25 publications

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“…Statistical Power was calculated in RCTs using a two-sided test of significance (8,26,27), test was not reported for in three RCTs (28,29) and no statistical power calculation was present for four (7,(30)(31)(32). Descriptive statistics were reported in all studies for age (quantitative numerical data) including mean, median, and range (7,8,(26)(27)(28)(29)(30)(31)(32)(33). Other trials reported mean and range field size (29,33), field area (33), range of total radiation dose (7,26), median number of nodes and range (8).…”

Section: Methodsmentioning

confidence: 99%

“…Descriptive statistics were reported in all studies for age (quantitative numerical data) including mean, median, and range (7,8,(26)(27)(28)(29)(30)(31)(32)(33). Other trials reported mean and range field size (29,33), field area (33), range of total radiation dose (7,26), median number of nodes and range (8).…”

Section: Methodsmentioning

confidence: 99%

“…The factors used were age, radiotherapy field size and field arrangement and type and number of chemotherapy courses prescribed before radiotherapy. The method of ensuring homogeneity was unclear in other RCTs however the authors stated that the features of the two groups were comparable and balanced (7,8,(26)(27)(28)(29)(30)(31)(32).…”

Section: Methodsmentioning

confidence: 99%

“…The differences in mean responses of patients reported symptoms and Qol were analysed using the Kruskal-Wallis test. The intention-to-treat principle and two tailed tests were used in two studies (8,29). In one of the two studies the Mann-Whitney U-test was used for the statistical analyses of RD and patients reported symptoms (8).…”

Section: Methodsmentioning

confidence: 99%

“…In one of the two studies the Mann-Whitney U-test was used for the statistical analyses of RD and patients reported symptoms (8). In scoring RD observed in participants, a modified RTOG (27), a standard RTOG score (28,(31)(32)(33) and CTCAE version 3.0 was used (26,29). Clinical scales were used in 3 RCTs (7,8,30).…”

Section: Methodsmentioning

confidence: 99%

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Topical Management of Acute Radiation Dermatitis in Breast Cancer Patients: A Systematic Review and Meta-Analysis

Haruna

Lipsett

Marignol

2017

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(OR: 0.29; p<0.0001) and reducing the mean RD score p<0.00001 Radiation induces damage to the skin, activating inflammatory pathways and causing cytokines overproduction (1, 2). Radiation dermatitis is a common acute side-effect that occurs within hours to weeks after the start of radiotherapy (3, 4) and affects more than 87% of patients (2, 5). Radiation dermatitis can limit the therapeutic dose delivered to patients and can, sometimes, lead to a break in treatment, thus potentially compromising local control and survival outcome (1, 6). It can also have a considerable impact on patients' quality of life (7,8). Despite significant development in radiotherapy techniques, efficacious interventions in the prevention of acute skin reactions is still lacking and current evidence is unable to provide adequate guidelines for the management of this sideeffect (9, 10). Studies have examined numerous topical agents such as Aloe Vera, aqueous cream, Calendula, petrolatum and sulcrafate cream as a means to reducing the dehydrating effects of radiation dermatitis (6,11,12). However, the results in terms of managing radiation dermatitis and treatment related pain have not been clinically significant (13,14). Corticosteroids have anti-inflammatory properties and are known to down-regulate cytokine gene expression, making them ideal for managing radiation dermatitis (15-17). A systematic review by Bolderston et al. concluded that there is limited evidence to support or oppose the use of topical agents for the management of acute radiation dermatitis (18).Skin care advice given to breast cancer patients varies among institutions (19). No gold-standard for the appropriate management of this side-effect exists and in most cases the decision of care is left at the discretion of the health care professional rather than clinical evidence (20,21). Clinical advice is often given based on anecdotal evidence (22).The present systematic review and meta-analysis was conducted to assess the potential efficacy of corticosteroids in the management of RD and its impact on pain and quality of life in female breast cancer patients. However, the anticipated adverse effect associated with steroids is not evaluated and is beyond the scope of this review. We restricted our review to one site only due to radiotherapy dose variations used in different sites. Materials and MethodsSearch strategy for identification of studies. The electronic literature search was conducted up to and including March 2017. The search terms used were corticosteroid, radiation dermatitis, breast cancer, management, and prevention. The reference lists of potentially eligible studies were subsequently hand searched to identify 5343

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Topical Management of Acute Radiation Dermatitis in Breast Cancer Patients: A Systematic Review and Meta-Analysis

Haruna

Lipsett

Marignol

2017

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Management of Acute Toxicity

Cao

Shahadi

2022

Breast Cancer Radiation Therapy

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Utility of topical agents for radiation dermatitis and pain: a randomized clinical trial

Wolf

Gewandter

Bautista

et al. 2019

Support Care Cancer

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Purpose-Although topical agents are often provided during radiation therapy, there is limited consensus and evidence for their use prophylactically to prevent or reduce radiation dermatitis. Methods-This was a multi-site, randomized, placebo-controlled, blinded study of 191 breast cancer patients to compare the prophylactic effectiveness of three topical agents (Curcumin, HPR Plus™, and Placebo) for reducing radiation dermatitis and associated pain. Patients applied the topical agent to their skin in the radiation area site three times daily starting the first day of radiation therapy (RT) until 1 week after RT completion. Results-Of the 191 randomized patients, 171 patients were included in the final analyses (87.5% white females, mean age = 58 (range = 36-88)). Mean radiation dermatitis severity (RDS) scores did not significantly differ between study arms (Curcumin = 2.68 [2.49, 2.86]; HPR Plus™ = 2.64 [2.45, 2.82]; Placebo = 2.63 [2.44, 2.83];p = 0.929). Logistic regression analyses showed Julie Ryan Wolf,

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A randomized, double-blind trial on the use of 1% hydrocortisone cream for the prevention of acute radiation dermatitis

Cited by 22 publications

References 25 publications

Topical Management of Acute Radiation Dermatitis in Breast Cancer Patients: A Systematic Review and Meta-Analysis

Topical Management of Acute Radiation Dermatitis in Breast Cancer Patients: A Systematic Review and Meta-Analysis

Management of Acute Toxicity

Utility of topical agents for radiation dermatitis and pain: a randomized clinical trial

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