Evaluating the Effects of Aluminum-Containing and Non-Aluminum Containing Deodorants on Axillary Skin Toxicity During Radiation Therapy for Breast Cancer: A 3-Armed Randomized Controlled Trial

Lewis, Lucy; Carson, Sharron; Bydder, Sean; Athifa, Mariyam; Williams, Anne M.; Bremner, Alexandra

doi:10.1016/j.ijrobp.2014.06.054

Cited by 32 publications

(25 citation statements)

References 22 publications

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“…The literature has focused on the effect of antiperspirants for patients undergoing breast RT, with 2 dosimetric studies showing no difference in surface dose with antiperspirants 5,10 and several clinical trials showing no increased toxic effects with their use. 11,12 To our knowledge, the present study is the first dosimetric assessment of whether commonly used creams and ointments alter surface dose. It is somewhat surprising that there have been no studies assessing dose alterations resulting from cream or ointment use because this is an issue that affects not only patients with breast cancer but also most patients undergoing radiotherapy.…”

Section: Discussionmentioning

confidence: 93%

Assessing the Validity of Clinician Advice That Patients Avoid Use of Topical Agents Before Daily Radiotherapy Treatments

et al. 2018

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IMPORTANCE Radiation dermatitis is common and often treated with topical therapy. Patients are typically advised to avoid topical agents for several hours before daily radiotherapy (RT) out of concern that topical agents might increase the radiation dose to the skin. With modern RT's improved skin-sparing properties, this recommendation may be irrelevant. OBJECTIVE To assess whether applying either metallic or nonmetallic topical agents before radiation treatment alters the skin dose. DESIGN, SETTING, AND PARTICIPANTS A 24-question online survey of patients and clinicians was conducted from January 15, 2015, to March 15, 2017, to determine current practices regarding topical therapy use. In preclinical studies, dosimetric effect of the topical agents was evaluated by delivering 200 monitor units and measuring the dose at the surface and at 2-cm depth in a tissue-equivalent phantom with or without 2 common topical agents: a petroleum-based ointment (Aquaphor, petrolatum 41%) and silver sulfadiazine cream, 1%. Skin doses associated with various photon and electron energies, topical agent thicknesses, and beam incidence were assessed. Whether topical agents altered the skin dose was also evaluated in 24 C57BL/6 mice by using phosphorylated histone (γ-H2AX) immunofluorescent staining and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. Preclinical studies took place at the University of Pennsylvania. MAIN OUTCOMES AND MEASURES Patient and clinician survey responses; surface radiation dose readings in tissue-equivalent phantom; and γ-H2AX and TUNEL intensity measured in mice. RESULTS The 133 patients surveyed received RT for cancer and had a median (range) age of 60 (18-86) years; 117 (87.9%) were women. One hundred eight clinicians completed the survey with 105 reporting that they were involved in managing patient skin care during RT. One hundred eleven (83.4%) of the patients and 96 (91.4%) of the 105 clinicians received or gave the advice to avoid applying topical agents before RT treatments. Dosimetric measurements showed no difference in the delivered dose at either the surface or a 2-cm depth with or without a 1-to 2-mm application of either topical agent when using en face 6-or 15-megavoltage (MV) photons. The same application of topicals did not alter the surface dose as a function of beam incident angle from 15°to 60°, except for a 6% increase at 60°with the silver sulfadiazine cream. Surface dose for 6-and 15-MV beams were significantly increased with a thicker (Ն3-mm) topical application. For 6 MV, the surface dose was 1.05 Gy with a thick layer of petroleum-based ointment and 1.02 Gy for silver sulfadiazine cream vs 0.88 Gy without topical agents. For 15 MV, the doses were 0.70 Gy for a thick layer of petroleum-based ointment and 0.60 Gy for silver sulfadiazine cream vs 0.52 Gy for the controls. With 6-and 9-MeV electrons, there was a 2% to 5% increase in surface dose with the use of the topical agents. There were no dose differences at 2-cm depth. Irradiated skin in mice showed ...

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Section: Discussionmentioning

confidence: 93%

Assessing the Validity of Clinician Advice That Patients Avoid Use of Topical Agents Before Daily Radiotherapy Treatments

et al. 2018

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“…Table 3 lists the randomized studies on the prevention of acute radiation skin reactions in patients with breast cancer receiving radiotherapy in last 5 years. 4,[17][18][19][20][21][22][23][24][25][26][27][28] Randomized controlled studies have generated mostly negative results for use of skin care products in preventing or treating radiation dermatitis. Remarkably, patients receiving topical corticosteroids (mometasone furoate and betamethasone) during radiotherapy might experience reduced acute skin toxicity compared with placebo or moisturizing creams according to the result of three doubleblind studies with a larger population.…”

Section: Discussionmentioning

confidence: 99%

Phase I study of topical epigallocatechin-3-gallate (EGCG) in patients with breast cancer receiving adjuvant radiotherapy

Zhao¹,

Zhu²,

Li³

et al. 2016

BJR

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“…They are now commonly believed not to have a negative effect as it used to be thought before (27). Although the results of studies performed so far suggest that there was no difference between metallic and nonmetallic deodorants and that skin reactions occur as a consequence of irritating chemical ingredients of the product but not as a consequence of radiation, increased surface of radiation or bolus effect, the application of deodorants with aluminum must be further researched (28).…”

Section: Prevention Of Radiation Dermatitismentioning

confidence: 99%

“…It is important to include a psychologist in treatment of oncologic patient because it is known that patients prefer to undertake "an action" than do nothing (24). Recommendations given in more recent studies are contrary to traditional ones stating that the skin should not be washed and deodorants should not be used, which would affect life quality of patients in a way that they would worry about their body odor (25)(26)(27)(28)(29).…”

Section: Prevention Of Radiation Dermatitismentioning

confidence: 99%

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Radiodermatitis - review of treatment options

Spasić

Jovanović

Golušin

et al. 2018

Serbian Journal of Dermatology and Venereology

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Radiation dermatitis is one of the commonest side effects of ionizing radiation which is applied in radiotherapy of carcinoma of all localizations, most frequently of tumors of breast, head and neck region, lungs and soft tissue sarcomas. It usually occurs as a complication of breast radiotherapy and thus it is more often recorded in female patients on the skin in the region of breast subjected to radiation. Clinical manifestations of radiation dermatitis can be divided into four phases: acute phase (erythema, dry desquamation, moist desquamation, ulceration and necrosis with resulting re-epithelialization, residual post-inflammatory hyperpigmentation, reduction and suppression of sebaceous and sweat glands and epilation); subacute phase (hyperpigmentation and hypopigmentation, telangiectasia, skin atrophy, even ulceration); chronic phase (skin atrophy, dermal fibrosis and permanent skin epilation) and late phase (increased risk of skin cancer). In order to prevent radiation dermatitis, skin care products should be applied throughout radiotherapy that will decrease the frequency of skin reactions or block them and thus improve life quality. Although the therapy includes not only topical corticosteroids but numerous other products with active ingredients such as aloe vera, calendula, hyaluronic acid, sucralfat, sorbolene, mineral and olive oil, honey, vitamin C, zinc, antimicrobials and silver, common therapeutic consensus has not been reached on their application in radiation dermatitis. Therefore, the treatment should be conducted according to the basic guidelines but tailor-made for each individual patient.

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Evaluating the Effects of Aluminum-Containing and Non-Aluminum Containing Deodorants on Axillary Skin Toxicity During Radiation Therapy for Breast Cancer: A 3-Armed Randomized Controlled Trial

Cited by 32 publications

References 22 publications

Assessing the Validity of Clinician Advice That Patients Avoid Use of Topical Agents Before Daily Radiotherapy Treatments

Assessing the Validity of Clinician Advice That Patients Avoid Use of Topical Agents Before Daily Radiotherapy Treatments

Phase I study of topical epigallocatechin-3-gallate (EGCG) in patients with breast cancer receiving adjuvant radiotherapy

Radiodermatitis - review of treatment options

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