Phase III Randomized Pair Comparison of a Barrier Film vs. Standard Skin Care in Preventing Radiation Dermatitis in Post-lumpectomy Patients with Breast Cancer Receiving Adjuvant Radiation Therapy

Lam, Andrew C L; Yu, Edward; Vanwynsberghe, Danielle; O’Neil, Melissa; D’Souza, David; Cao, Jeffrey Q.; Lock, Michael

doi:10.7759/cureus.4807

Cited by 9 publications

(8 citation statements)

References 25 publications

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“…StrataXRT® or alternative product) have also been used in patients undergoing radiotherapy for head and neck cancer, lung cancer and cancer. 25,26 In the study by Chan et al, 25 at the end of treatment grade 2 skin reactions were identified in 80% of patients in the StrataXRT® arm and grade 3 in 28%, compared with 91% and 45% respectively in the control arm. After controlling for the cancer drug cetuximab, the Stra-taXRT® arm had a 12% lower risk of experiencing grade 2 skin toxicity (RRR ¼ 0.876, 95% CI 0.778e0.987) and a 36% lower risk of developing a grade 3 reaction (RRR ¼ 0.648, 95% CI 0.442e0.947).…”

Section: Discussionmentioning

confidence: 99%

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Radiation induced skin reactions during and following radiotherapy: A systematic review of interventions

2022

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Introduction: Radiation induced skin reactions (RISR) are a common adverse effect of radiotherapy that can impact on patient quality of life. The aim of this systematic review was to identify new research evidence on interventions for RISR to guide health practitioners on best practice skin care for people receiving radiotherapy. Methods: A narrative systematic review was adopted including published research since 2014. The MESH search terms used in the 2014 College of Radiographers skin care systematic review were supplemented with terms identified through a pearl growing search technique. Results: Thirty-three studies were identified and reviewed, 13(39.4%) were assessed as having a high risk of bias 6(18.2%) moderate risk of bias, and 13(39.4%) low risk of bias; one pilot study was not assessed. Twenty-one of the studies were randomised controlled trials, 2 feasibility studies, 9 non-randomised trials, and 1 a pilot study. Conclusion: Evidence from well conducted studies identified prophylactic use of steroid cream for patients, at high risk of RISR, as being the most efficacious in reducing acute skin reactions. Further research is needed on photo biomodulation therapy, studied within standard dose fractionation schedules, before it is recommended for use in practice. There is insufficient evidence to support the use of barrier films or any topical emollients currently in practice to reduce RISRs. Despite the number of new studies in this area there is limited good comparative research of RISR that accounts for predictive risk and new radiotherapy techniques. Implications for practice: Practitioners are encouraged to risk assess patients prior to radiotherapy to guide interventions and record and monitor patient skin toxicity regularly during treatment, comparing toxicity changes with scores recorded at baseline and support patient self-monitoring of skin reactions.

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Section: Discussionmentioning

confidence: 99%

“…Creams used as control comparators could potentially have influenced the results of these studies. In the study by Lam et al, 26 patients with breast cancer in the sample were treated with either a conventional fractionation (50Gy in 25 fractions) or a hypofractionated biologically equivalent dose.…”

Section: Discussionmentioning

confidence: 99%

Radiation induced skin reactions during and following radiotherapy: A systematic review of interventions

2022

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“…Radiodermatitis, an inflammatory skin disease, is one of the most common complications of radiotherapy in patients with breast cancer, head and neck cancer, as well as vulvar carcinoma. 8,9 Vulvar carcinoma is a malignant tumor of the female perineum, accounting for about 3% ~5% of female malignant tumors. It mainly occurs in postmenopausal women and tends to increase with age.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of dermatitis during radiation for vulvar carcinoma

Teng

Zhang

Zhi

et al. 2022

Precision Medical Sciences

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Radiodermatitis, inflammatory lesions of skin and mucosa caused by radiation, is a common adverse effect during the radiation therapy of vulvar carcinoma. The incidence of radiodermatitis is affected by various factors, and the purpose of this study was to investigate the risk factors of radiodermatitis in patients with vulvar carcinoma. Patients with vulvar tumors who received radiotherapy from January 2015 to December 2020 were included in this retrospective study. Radiodermatitis was graded according to the grading criteria of the American Center for Radiological Oncology, and then univariate analysis and logistic multivariate regression analysis were used to determine the risk factors of radiodermatitis. A total of 60 eligible patients were enrolled, including 3 (5%), 25 (41.7%), 28 (46.7%), and 4 (6.6%) patients with grade 0, 1, 2, and 3 radiodermatitis, respectively. Univariate analysis showed that the incidence of radiodermatitis was significantly correlated with age, therapeutic strategy, pathological stage and radiotherapy dose (p < .05). Multivariate regression analysis indicated that age, therapeutic strategy and radiotherapy dose were independent risk factors for radiodermatitis (p < .05). In the current study, we identified the independent risk factors for radiodermatitis in patients with vulvar carcinoma were age, therapeutic strategy and radiotherapy dose, which might be conducive to identify high-risk patients, so as to adjust their treatment plan in time and reduce the risk of radiation-induced skin toxicity.

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“…Only one of them demonstrated the superiority of this dressing over sorbolene cream in reducing the rates of moist desquamation and pruritus [43]. Two newer randomized controlled trials did not confirm these findings [44,45].…”

Section: Gel Dressingsmentioning

confidence: 94%

“…The following supporting information can be downloaded at: https: //www.mdpi.com/article/10.3390/pharmaceutics14061204/s1, Table S1: Proposed T.I.M.E. wound bed preparation for acute and chronic radiation dermatitis, Table S2: Dressings for prevention and treatment of acute radiation dermatitis [19][20][21][22][23][24][25][26][27][28][29][30][31][33][34][35][36][37][38][39][40][42][43][44][45][47][48][49][50][52][53][54][55][56]74].…”

Section: Supplementary Materialsmentioning

confidence: 99%

Modern Dressings in Prevention and Therapy of Acute and Chronic Radiation Dermatitis—A Literature Review

2022

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Radiotherapy is an integral part of modern oncology, applied to more than half of all patients diagnosed with cancer. It can be used alone or in combination with surgery or chemotherapy. However, despite the high precision of radiation delivery, irradiation may affect surrounding healthy tissues leading to the development of toxicity. The most common and clinically significant toxicity of radiotherapy is acute and chronic radiation dermatitis, which could result in desquamation, wounds, nonhealing ulcers, and radionecrosis. Moreover, preoperative radiotherapy impairs wound healing after surgery and may lead to severe wound complications. In this review, we comprehensively discuss available types of dressings used in the management of acute and chronic radiation dermatitis and address their efficacy. The most effective ways of preventing acute radiation dermatitis are film dressings, whereas foam dressings were found effective in its treatment. Data regarding dressings in chronic radiation dermatitis are scarce. This manuscript also contains authors’ consensus.

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Phase III Randomized Pair Comparison of a Barrier Film vs. Standard Skin Care in Preventing Radiation Dermatitis in Post-lumpectomy Patients with Breast Cancer Receiving Adjuvant Radiation Therapy

Cited by 9 publications

References 25 publications

Radiation induced skin reactions during and following radiotherapy: A systematic review of interventions

Radiation induced skin reactions during and following radiotherapy: A systematic review of interventions

Risk factors of dermatitis during radiation for vulvar carcinoma

Modern Dressings in Prevention and Therapy of Acute and Chronic Radiation Dermatitis—A Literature Review

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