Does aqueous or sucralfate cream affect the severity of erythematous radiation skin reactions? A randomised controlled trial

Wells, Mary; Macmillan, Maureen S.; Raab, Gillian M.; MacBride, Sheila; Bell, Nancy J.; MacKinnon, Karen; MacDougall, Hugh; Samuel, Leslie; Munro, Alastair J.

doi:10.1016/j.radonc.2004.07.032

Cited by 159 publications

(151 citation statements)

References 22 publications

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“…The link between tobacco smoking and H&N cancer has been highlighted by others: Smoking during RT can reduce its efficacy (Meyer et al, 2008;Browman et al, 1993) and Edwards (2004) (Rugg et al, 1990) and smoking increased the severity of mucositis and acute skin reactions (Porock et al, 2004). Wells et al (2004) found that head and neck cancer patients who continued smoking during RT were more likely to develop skin reactions than former smokers and non-smokers. Non-smokers had lower skin toxicity scores (Wells et al 2004).…”

Section: Discussionmentioning

confidence: 96%

“…Wells et al (2004) found that head and neck cancer patients who continued smoking during RT were more likely to develop skin reactions than former smokers and non-smokers. Non-smokers had lower skin toxicity scores (Wells et al 2004). Sharp et al (2013) examined risk factors for severe acute radiation skin reactions in women undergoing RT for breast cancer.…”

Section: Discussionmentioning

confidence: 97%

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Changes in health related quality of life in women and men undergoing radiation treatment for head and neck cancer and the impact of smoking status in the radiation treatment period

Egestad

Emaus

2014

European Journal of Oncology Nursing

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Abstract:Purpose The aim of this study was to evaluate health-related quality of life (HRQOL) in women and men undergoing radiation treatment for head and neck cancer through the intervention period and examine if age, body mass index (BMI) and smoking status at baseline may modify changes in HRQOL. Results Most aspects of HRQOL declined substantially and significantly (p<0.001) with a magnitude of more than one standard deviation during the radiation treatment period irrespective of sex and age. Smoking status at baseline had some, albeit minor, influence on changes in HRQOL. Patients who continued smoking during therapy had significantly higher decline in several aspects of HRQOL, compared to patients who stopped smoking.Conclusions HRQOL decline with substantial magnitude in patients undergoing radiation treatment for head and neck cancer, but smoking cessation may modify the declining quality of life. IntroductionTreatments of head and neck (H&N) cancer include surgery, radiotherapy (RT), chemotherapy, target therapy or a combination of these modalities. The diagnosis and the following treatment may exert a severe impact on patient's quality of life (QOL) (So et al., 2012). The malignancy affects the most visible area of the body, and may influence the most fundamental activities of daily life in a negative way, such as speech, breathing, eating and drinking (Larsson and Hedelin, 2003;Wells 1998). H&N cancer patients' illness often involves physical symptoms, psychological distress, as well as side effects from RT (Archer et al., 2008). The treatment can result in dry mouth (xerostomia), oral discomfort, mucositis, recurrent microbial infections, difficulty in chewing and swallowing, increased incidence of dental caries, impaired taste, and an inability to wear dentures (Parsons et al., 1994). In addition, depression is reported to increase in H&N cancer patients undergoing RT (Neilson et al., 2010;Kelly et al., 2007).The interest in health-related quality of life (HRQOL) (i.e. the physical, mental, and social functioning and well-being) in H&N cancer patients has increased over the two decades (So et al., 2012). Even if the most important outcome for cancer patients is overall survival, the disease and its treatment often have a major impact on HRQOL and functional status (List et al., 2002). Reliable and valid HRQOL questionnaires are available (Aaronson et al., 1993; Bjordal et al., 2000;Ringash and Bezjak, 2001). The EORTC QLQ-H&N35 is widely used to measure quality of life in H&N cancer patients (Singer et al., 2013). Both prospective and cross-sectional studies (Bjordal et al., 2001;Hammerlid et al., 2001aHammerlid et al., , 2001bHammerlid et al., , 2001cNguyen et al., 2002;Talmi et al., 2002;Shepherd and Fisher, 2004) have documented reductions in HRQOL in populations of H&N cancer patients who have received RT. Several studies have also examined changes in HRQOL during the treatment period (Bjordal et al., 2001;Henson et al., 2001; Airolldi et al., 2004;Parliament et al., 2004;Jabbari et al., 2...

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Changes in health related quality of life in women and men undergoing radiation treatment for head and neck cancer and the impact of smoking status in the radiation treatment period

Egestad

Emaus

2014

European Journal of Oncology Nursing

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“…Of the thirty-three studies from which additional information was gathered, six trials analyzed patients by intention to treat 16,17,30,32,35,50 , and twenty-seven assessed only evaluable patients 2,3,18-21, 23,24,26-28,31,33,34,36,38-44,46-49,51 . Reasons for exclusion of patients from analysis included lack of compliance with the agent or dressing, withdrawal from the study, or failure to show up to clinic appointments.…”

Section: Resultsmentioning

confidence: 99%

“…Reasons for exclusion of patients from analysis included lack of compliance with the agent or dressing, withdrawal from the study, or failure to show up to clinic appointments. Skin reactions were often assessed by one evaluator, which was commonly a radiation oncologist, dermatologist, research nurse, research assistant, radiation therapist, principal investigator, or other medical professional 3,17,20,21,24,26,27,32,33,35,39,44,46,50 . A few studies incorporated an inter-rater reliability measure by having more than one evaluator assess the skin reactions 23,34,36,45,49,51 ; the remaining studies did not describe who assessed the radiated area or areas 2,16,19,25,28,30,31,38,[41][42][43]47,48 .…”

Section: Resultsmentioning

confidence: 99%

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Prophylaxis and Management of Acute Radiation-Induced Skin Reactions: A Systematic Review of the Literature

et al. 2010

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Radiation therapy is a common treatment for cancer patients. One of the most common side effects of radiation is acute skin reaction (radiation dermatitis) that ranges from a mild rash to severe ulceration. Approximately 85% of patients treated with radiation therapy will experience a moderate-to-severe skin reaction. Acute radiation-induced skin reactions often lead to itching and pain, delays in treatment, and diminished aesthetic appearance-and subsequently to a decrease in quality of life.Surveys have demonstrated that a wide variety of topical, oral, and intravenous agents are used to prevent or to treat radiation-induced skin reactions. We conducted a literature review to identify trials that investigated products for the prophylaxis and management of acute radiation dermatitis. Thirty-nine studies met the pre-defined criteria, with thirty-three being categorized as prophylactic trials and six as management trials.For objective evaluation of skin reactions, the Radiation Therapy Oncology Group criteria and the U.S. National Cancer Institute Common Toxicity Criteria were the most commonly used tools (65% of the studies). Topical corticosteroid agents were found to significantly reduce the severity of skin reactions; however, the trials of corticosteroids evaluated various agents, and no clear indication about a preferred corticosteroid has emerged. Amifostine and oral enzymes were somewhat effective in preventing radiation-induced skin reactions in phase ii and phase iii trials respectively; further large randomized controlled trials should be undertaken to better investigate those products. Biafine cream (Ortho-McNeil Pharmaceuticals, Titusville, NJ, U.S.A.) was found not to be superior to standard regimes in the prevention of radiation-induced skin reactions (n = 6).In conclusion, the evidence is insufficient to support the use of a particular agent for the prevention and management of acute radiation-induced skin reactions. Future trials should focus on comparing agents and approaches that, in phase i and ii trials, suggest efficacy. These future phase iii randomized controlled trials must clearly distinguish between preventive and management strategies for radiation-induced dermatitis. Only then can evidence-based guidelines be developed, with the hope of standardizing the approach across centres and of improving the prevention and management of radiation-induced dermatitis.

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Efficacy of Epigallocatechin-3-Gallate in Preventing Dermatitis in Patients With Breast Cancer Receiving Postoperative Radiotherapy

et al. 2022

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IMPORTANCE Safe and effective prophylactic therapies for radiation-induced dermatitis (RID) remain an unmet need.OBJECTIVE To determine if epigallocatechin-3-gallate (EGCG) solution reduces the incidence of RID in patients undergoing radiotherapy after breast cancer surgery. DESIGN, SETTING, AND PARTICIPANTSThis phase 2 double-blind, placebo-controlled randomized clinical trial enrolled 180 patients with breast cancer receiving postoperative radiotherapy at Shandong Cancer Hospital and Institute in Shandong, China, between November 2014 and June 2019. Data analysis was performed from September 2019 to January 2020.INTERVENTIONS Participants were randomly assigned (2:1) to receive either EGCG solution (660 μmol/L) or placebo (0.9% NaCl saline) sprayed to the whole radiation field from day 1 of the radiation until 2 weeks after radiation completion. MAIN OUTCOMES AND MEASURESThe primary end point was incidence of grade 2 or worse RID, defined by the Radiation Therapy Oncology Group scale. The secondary end points included RID index (RIDI), symptom index, changes in the skin temperature measured by infrared thermal images, and safety.RESULTS A total of 180 eligible patients were enrolled, of whom 165 (EGCG, n = 111; placebo, n = 54) were evaluable for efficacy (median [range] age, 46 [26-67] years). The occurrence of grade 2 or worse RID was significantly lower (50.5%; 95% CI, 41.2%-59.8%) in the EGCG group than in the placebo group (72.2%; 95% CI, 60.3%-84.1%) (P = .008). The mean RIDI in the EGCG group was significantly lower than that in the placebo group. Furthermore, symptom indexes were significantly lower in patients receiving EGCG. Four patients (3.6%) had adverse events related to the EGCG treatment, including grade 1 pricking skin sensation (3 [2.7%]) and pruritus (1 [0.9%]). CONCLUSIONS AND RELEVANCEIn this randomized clinical trial, prophylactic use of EGCG solution significantly reduced the incidence and severity of RID in patients receiving adjuvant radiotherapy for breast cancer. It has the potential to become a new choice of skin care for patients receiving radiotherapy.

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Does aqueous or sucralfate cream affect the severity of erythematous radiation skin reactions? A randomised controlled trial

Cited by 159 publications

References 22 publications

Changes in health related quality of life in women and men undergoing radiation treatment for head and neck cancer and the impact of smoking status in the radiation treatment period

Changes in health related quality of life in women and men undergoing radiation treatment for head and neck cancer and the impact of smoking status in the radiation treatment period

Prophylaxis and Management of Acute Radiation-Induced Skin Reactions: A Systematic Review of the Literature

Efficacy of Epigallocatechin-3-Gallate in Preventing Dermatitis in Patients With Breast Cancer Receiving Postoperative Radiotherapy

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