Effect of Heparinoid Moisturizer on Quality of Life in Patients with Acute Radiation Skin Damage Following Hypofractionated Radiation Therapy After Breast-Conserving Surgery: A Randomized Controlled Study

Abstract

Background With few research reports on the effects of moisturizer use for dry skin associated with radiotherapy after breast-conserving surgery on patient quality of life (QOL), we conducted a randomized controlled trial to investigate this effect. Methods Patients with breast cancer were randomly assigned to receive either heparinoid moisturizer (Group M) or no treatment (Group C). Group M was instructed to apply heparinoid moisturizer during 3 weeks of hypofractionated whole-breast irradiation with or without boost until 4 weeks after completion of irradiation. Skin-related QOL was assessed using the Dermatology Life Quality Index (DLQI) for 7 weeks. The primary endpoint was total DLQI score at 4 weeks after the start date. Results In total, 35 patients in Group M and 37 patients in Group C were analyzed. The DLQI total score (2.06 ± 2.17: mean ± SD) at 4 weeks in Group M was slightly lower than in Group C (2.16 ± 2.13) but with no significant difference ( p = 0.894). The “Symptoms and feelings” subscore indicated significant worsening at 3 weeks and maintained until 7 weeks in Group C. There was no significant change for this subscore during radiotherapy in Group M, and it significantly increased after radiotherapy (4–5 weeks) and returned to baseline in 7 weeks. The period of subscore worsening was shorter in Group M than in Group C. Conclusion Concomitant and extended use of heparinoid moisturizer with radiation therapy may improve the QOL of breast cancer patients impaired by dry skin for patients with breast cancer.

MASCC clinical practice guidelines for the prevention and management of acute radiation dermatitis: part 1) systematic review

“… 212 In light of this limitation, an updated search has been conducted from September 22nd, 2020 to January 21st, 2023 and revealed 65 new studies, of which 38 are RCTs; a list of the latest RCTs has been provided in Appendix E , along with a summary of RCT characteristics. RCTs were recently published on interventions already identified through the present review, such as Mepitel film, 258 topical corticosteroids, 259 , 260 heparinoid, 261 photobiomodulation, 257 , 262 , 263 aloe vera gel, 264 calendula, 256 and others. Additional RCTs were identified on new interventions not previously explored before September 2020, such as the use of compound Kushen injection, 265 epigallocatechin-3-gallate, 201 , 266 bacterial decolonization, 267 and others.…”

Green cocoon-derived sericin reduces cellular damage caused by radiation in human keratinocytes

“…As no standard care method has been established for skin damaged by radiation, these lesions are classified and treated as dry skin caused by damage to sebaceous glands in the skin. Therefore, application of moisturizers such as heparin analogs, which only treat symptoms, is currently used as a common treatment 4 . Indeed, moisturizers can improve skin dryness and desquamation and reduce pain.…”

Green cocoon-derived sericin reduces cellular damage caused by radiation in human keratinocytes

“…As no standard care method has been established for skin damaged by radiation, these lesions are classi ed and treated as dry skin caused by damage to sebaceous glands in the skin. Therefore, application of moisturizers such as heparin analogues, which only treat symptoms, is currently used as a common treatment [4]. Indeed, moisturizers can improve skin dryness and desquamation and reduce pain.…”