Use of trolamine to prevent and treat acute radiation dermatitis: a systematic review and meta-analysis

Abstract

Objective: to evaluate the effects of trolamine in the prevention or treatment of radiation dermatitis. Method: systematic review and meta-analysis. Detailed individual search strategies for Cinahl, Cochrane Library Central, LILACS, PubMed, and Web of Science were developed in January 2016. A manual search was also performed to find additional references. A grey literature search was executed by using Google Scholar. Two researchers independently read the titles and abstracts from every cross-reference. The risk of bias of the included studies was analyzed by the Cochrane Collaboration Risk of Bias Tool. The quality of evidence and grading of strength of recommendations was assessed using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: seven controlled clinical trials were identified. The controls used were calendula, placebo, institutional preference / usual care, Aquaphor®, RadiaCare™, and Lipiderm™. The studies were pooled using frequency of events and risk ratio with 95% confidence intervals, in subgroups according to radiation dermatitis graduation. Conclusion: based on the studies included in this review, trolamine cannot be considered as a standardized product to prevent or treat radiation dermatitis in patients with breast and head and neck cancer.

Effectiveness of skin protectors and calendula officinalis for prevention and treatment of radiodermatitis: an integrative review

“…Another result obtained in this review showed greater effectiveness of Calendula officinalis in relation to Trolamine and EFA. This is in line with the results of a systematic review with meta-analysis on Trolamine use, which concluded that Trolamine is not recommended as a standard alternative for prevention or treatment of radiodermatitis in patients with breast and head and neck cancer (30) .…”

Calendula officinalis: Potential Roles in Cancer Treatment and Palliative Care

“… 38 However, in a recent study, trolamine proved to be ineffective in the prevention of radiotherapy-associated dermatitis. 40 In the second clinical trial, Sharp et al 41 found no differences in the prevention of ARSR when comparing the standard Calendula cream and a topical aqueous cream often prescribed during radiation treatment. None of these studies use a vehicle-controlled placebo; thus, the effectiveness of the Calendula -based treatments is not actually assessed.…”

“… 38 Albeit the effectiveness of Calendula was better than that of trolamine, it should be noted that the choice of trolamine as a reference was not based on its effectiveness in the treatment of radiotherapy-induced dermatitis, but on the data of the randomized RTOG (Radiation Therapy Oncology Group) study, which suggest its curative properties. 39 Moreover, in a recent meta-analysis, trolamine was found to be ineffective in the prevention and treatment of radiation dermatitis 40 ; thus, its usage as a control in such a clinical trial is questionable.…”

Efectividad de los productos empleados en la prevención de la radiodermatitis en pacientes con cáncer de mama. Revisión Sistemática

“…La Guía de Práctica Clínica publicada por la Oncology Nursing Society(10) evidencia la eficacia durante la radioterapia de: 1) medidas higiénicas (uso de jabones con pH neutro, desodorante y secado suave), y 2) recomendaciones de seguridad (evitar la exposición solar o usar ropa sin fibras sintéticas). Así pues La Guía de Práctica Clínica publicada por la Oncology Nursing Society(10) concluye que no se pueden establecer recomendaciones sobre productos que prevengan la aparición de la radiodermatitis, debido a la gran diversidad y heterogeneidad de productos tópicos empleados en el control de las reacciones cutáneas (11).…”