Practice patterns for the prophylaxis and treatment of acute radiation dermatitis in the United States

Lucey, Patricia; Zouzias, Christos; Franco, Lola; Chennupati, S.K.; McLellan, Beth N.

doi:10.1007/s00520-017-3701-0

Cited by 25 publications

(22 citation statements)

References 12 publications

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“…In 2017 Lucey et al began another such study in the United States. They conclude that there is a considerably wide variety in the prevention and treatment of acute radiodermatitis [25]. At the same time, this type of research shows that, in fact, no recommendations are available yet.…”

Section: Prevention and Treatmentmentioning

confidence: 99%

“…However, since clinical experience shows that this process yields some effects, it requires confirmatory research. Lucey et al show that aloe vera, gentle soap, and topical glucocorticosteroids are most commonly used for the prevention of acute radiation injury [25]. When it comes to treatment, it is correlated with the degree of the development of radiodermatitis [25].…”

Section: Prevention and Treatmentmentioning

confidence: 99%

“…Lucey et al show that aloe vera, gentle soap, and topical glucocorticosteroids are most commonly used for the prevention of acute radiation injury [25]. When it comes to treatment, it is correlated with the degree of the development of radiodermatitis [25]. Dry desquamation is mostly treated with emollients and aloe vera [25].…”

Section: Prevention and Treatmentmentioning

confidence: 99%

“…When it comes to treatment, it is correlated with the degree of the development of radiodermatitis [25]. Dry desquamation is mostly treated with emollients and aloe vera [25]. For grade II and III, silver sulfadiazine cream is most commonly used.…”

Section: Prevention and Treatmentmentioning

confidence: 99%

“…For grade II and III, silver sulfadiazine cream is most commonly used. A comparison of procedures at different centers in the country showed that the procedures result from observation in 89% of cases, and only in 51,4% from scientifically confirmed studies [25]. There is evidently a need to carry out tests confirming the effectiveness of individual intervention.…”

Section: Prevention and Treatmentmentioning

confidence: 99%

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What is new when it comes to acute and chronic radiation-induced dermatitis in head and neck cancer patients?

Dudek

Rutkowski

Kamińska‐Winciorek

et al. 2020

Nowotwory. Journal of Oncology

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Head and neck cancer is a serious clinical and social problem. Surgery and radiotherapy play the most important role in treatment and give the chance of cure. Optimal treatment of patients with head and neck cancer should provide for the maximum destruction of cancerous tissue, saving as much healthy tissue as possible. Despite this, due to radiotherapy still almost 90% of patients develop skin symptoms. It seems that the mechanism of radiodermatitis is quite clear, but studies assume that its pathogenesis is not fully understood and there is much to be clarified. Acute and chronic dermatitis caused by radiotherapy is usually diagnosed according to clinical criteria. It seems that it would be useful to have a photographic classification that would facilitate and unify the clinical evaluation. In this article we shall summarize the current knowledge about the mechanisms of formation, risk factors, clinical classifications and methods for the prevention and treatment of acute and chronic radiation dermatitis. We have included clinical photos that depict individual stages according to the clinical classification of RTOG.

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Section: Prevention and Treatmentmentioning

confidence: 99%

Section: Prevention and Treatmentmentioning

confidence: 99%

Section: Prevention and Treatmentmentioning

confidence: 99%

Section: Prevention and Treatmentmentioning

confidence: 99%

Section: Prevention and Treatmentmentioning

confidence: 99%

See 3 more Smart Citations

What is new when it comes to acute and chronic radiation-induced dermatitis in head and neck cancer patients?

Dudek

Rutkowski

Kamińska‐Winciorek

et al. 2020

Nowotwory. Journal of Oncology

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Bacterial Decolonization for Prevention of Radiation Dermatitis

et al. 2023

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ImportanceEvidence-based approaches for the prevention of acute radiation dermatitis (ARD) are limited, and additional strategies are necessary to optimize care.ObjectiveTo determine the efficacy of bacterial decolonization (BD) to reduce ARD severity compared with standard of care.Design, Setting, and ParticipantsThis phase 2/3 randomized clinical trial was conducted from June 2019 to August 2021 with investigator blinding at an urban academic cancer center and enrolled patients with breast cancer or head and neck cancer receiving radiation therapy (RT) with curative intent. Analysis was performed on January 7, 2022.InterventionsIntranasal mupirocin ointment twice daily and chlorhexidine body cleanser once daily for 5 days prior to RT and repeated for 5 days every 2 weeks through RT.Main Outcomes and MeasuresThe primary outcome as planned prior to data collection was the development of grade 2 or higher ARD. Based on wide clinical variability of grade 2 ARD, this was refined to grade 2 ARD with moist desquamation (grade 2-MD).ResultsOf 123 patients assessed for eligibility via convenience sampling, 3 were excluded, and 40 refused to participate, with 80 patients in our final volunteer sample. Of 77 patients with cancer (75 patients with breast cancer [97.4%] and 2 patients with head and neck cancer [2.6%]) who completed RT, 39 were randomly assigned BC, and 38 were randomly assigned standard of care; the mean (SD) age of the patients was 59.9 (11.9) years, and 75 (97.4%) were female. Most patients were Black (33.7% [n = 26]) or Hispanic (32.5% [n = 25]). Among patients with breast cancer and patients with head and neck cancer (N = 77), none of the 39 patients treated with BD and 9 of the 38 patients (23.7%) treated with standard of care developed ARD grade 2-MD or higher (P = .001). Similar results were observed among the 75 patients with breast cancer (ie, none treated with BD and 8 [21.6%] receiving standard of care developed ARD grade ≥2-MD; P = .002). The mean (SD) ARD grade was significantly lower for patients treated with BD (1.2 [0.7]) compared with patients receiving standard of care (1.6 [0.8]) (P = .02). Of the 39 patients randomly assigned to BD, 27 (69.2%) reported regimen adherence, and only 1 patient (2.5%) experienced an adverse event related to BD (ie, itch).Conclusions and RelevanceThe results of this randomized clinical trial suggest that BD is effective for ARD prophylaxis, specifically for patients with breast cancer.Trial RegistrationClinicalTrials.gov Identifier: NCT03883828

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Association of Staphylococcus aureus Colonization With Severity of Acute Radiation Dermatitis in Patients With Breast or Head and Neck Cancer

et al. 2023

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ImportancePathogenesis of acute radiation dermatitis (ARD) is not completely understood. Pro-inflammatory cutaneous bacteria may contribute to cutaneous inflammation after radiation therapy.ObjectiveTo evaluate whether nasal colonization with Staphylococcus aureus (SA) before radiation therapy is associated with ARD severity in patients with breast or head and neck cancer.Design, Setting, and ParticipantsThis prospective cohort study with observers blinded to colonization status was conducted from July 2017 to May 2018 at an urban academic cancer center. Patients aged 18 years or older with breast or head and neck cancer and plans for fractionated radiation therapy (≥15 fractions) with curative intent were enrolled via convenience sampling. Data were analyzed from September to October 2018.ExposuresStaphylococcus aureus colonization status before radiation therapy (baseline).Main Outcomes and MeasuresThe primary outcome was ARD grade using the Common Terminology Criteria for Adverse Event Reporting, version 4.03.ResultsAmong 76 patients analyzed, mean (SD) age was 58.5 (12.6) years and 56 (73.7%) were female. All 76 patients developed ARD: 47 (61.8%) with grade 1, 22 (28.9%) with grade 2, and 7 (9.2%) with grade 3. The prevalence of baseline nasal SA colonization was higher among patients who developed grade 2 or higher ARD compared with those who developed grade 1 ARD (10 of 29 [34.5%] vs 6 of 47 [12.8%]; P = .02, by χ2 test).Conclusions and RelevanceIn this cohort study, baseline nasal SA colonization was associated with development of grade 2 or higher ARD in patients with breast or head and neck cancer. The findings suggest that SA colonization may play a role in the pathogenesis of ARD.

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Practice patterns for the prophylaxis and treatment of acute radiation dermatitis in the United States

Cited by 25 publications

References 12 publications

What is new when it comes to acute and chronic radiation-induced dermatitis in head and neck cancer patients?

What is new when it comes to acute and chronic radiation-induced dermatitis in head and neck cancer patients?

Bacterial Decolonization for Prevention of Radiation Dermatitis

Association of Staphylococcus aureus Colonization With Severity of Acute Radiation Dermatitis in Patients With Breast or Head and Neck Cancer

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