A potent steroid cream is superior to emollients in reducing acute radiation dermatitis in breast cancer patients treated with adjuvant radiotherapy. A randomised study of betamethasone versus two moisturizing creams

Ulff, Eva; Maroti, Marianne; Serup, Jørgen; Falkmer, Ursula Gerda Inge

doi:10.1016/j.radonc.2013.05.033

Cited by 67 publications

(70 citation statements)

References 17 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%

“…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%

“…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%

“…The Visual Analogue Scale (VAS) and the Skindex-16 questionnaire were used to measure subjective symptoms in six RCTs (7,8,26,28,29,32). The Dermatology Life Questionnaire Index (DLQI) was used to measure Qol in three (27)(28)(29).…”

Section: Methodsmentioning

confidence: 99%

“…The Dermatology Life Questionnaire Index (DLQI) was used to measure Qol in three (27)(28)(29). Pain was reported using the terms mild, moderate and severe (31).…”

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%

“…The Dermatology Life Questionnaire Index (DLQI) was used to measure Qol in three (27)(28)(29). Pain was reported using the terms mild, moderate and severe (31).…”

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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Cancer of the Skin

Lee¹,

Barnes²,

Tsao³

et al. 2017

Clinical Radiation Oncology

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Mepitel Film is superior to Biafine cream in managing acute radiation‐induced skin reactions in head and neck cancer patients: a randomised intra‐patient controlled clinical trial

Yan

Yuan

Wang

et al. 2020

J of Medical Radiation Sci

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Introduction We previously showed that Mepitel Film decreased the severity of acute radiation‐induced skin reactions in head and neck cancer patients. In the current study, we compared the effect of Mepitel Film and Biafine cream on skin reaction severity in a larger cohort of head and neck cancer patients. Methods A total of 44 head and neck cancer patients were recruited with 39 patients contributing full data sets for analysis. Patients received a dose of 50 Gy in 25 fractions to the bilateral lymph nodes in the neck. Left and right lymph node areas were randomised to either Mepitel Film or Biafine cream, applied prophylactically. Skin reaction severity was measured using Radiation‐Induced Skin Reaction Assessment Scale (RISRAS) and expanded Radiation Oncology group (RTOG) grades. Skin dose was measured using gafchromic Film. Results Skin reaction severity (combined RISRAS score) underneath Mepitel Film was decreased by 30% (P < 0.001) and moist desquamation rates by 41% (P < 0.001). Skin dose underneath Mepitel Film and Biafine cream was similar (P = 0.925) and unlikely to have affected skin reaction severity. The vast majority (80%) of patients preferred Mepitel Film over Biafine cream. Negative aspects of Mepitel Film included poor adherence (11/39) and discomfort (16/39) during hot weather and showering and itchy skin underneath Mepitel Film (12/39). Conclusions Mepitel Film was superior to Biafine cream in reducing the severity of acute radiation‐induced skin reactions and moist desquamation incidence in our head and neck patient cohort.

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A potent steroid cream is superior to emollients in reducing acute radiation dermatitis in breast cancer patients treated with adjuvant radiotherapy. A randomised study of betamethasone versus two moisturizing creams

Cited by 67 publications

References 17 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

Cancer of the Skin

Mepitel Film is superior to Biafine cream in managing acute radiation‐induced skin reactions in head and neck cancer patients: a randomised intra‐patient controlled clinical trial

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