Emulsion of Olive Oil and Calcium Hydroxide for the Prevention of Radiation Dermatitis in Hypofractionation Post-Mastectomy Radiotherapy: A Randomized Controlled Trial

Abstract

Background: Most of the patients who have been treated by post-mastectomy radiotherapy (PMRT) experience skin toxicity. There have been few studies on acute radiation dermatitis in breast cancer patients who received hypofractionation PMRT. Methods: 62 patients were randomized to receive a general skin care regimen with or without the addition of an emulsion of olive oil and calcium hydroxide twice a day, from the initiation of PMRT to 2 weeks after radiotherapy. Adverse skin reactions and the Skindex-16 score were assessed. Results: At the 8th, 13th, and 16th fraction of PMRT, grade 1 dermatitis was found in 42, 90, and 90% of the control group and in 16, 30, and 71% of the intervention group. At the end of the study, the mean Skindex-16 score of the intervention group was significantly better than that of the control group (p = 0.019). Conclusions: Addition of an emulsion of olive oil and calcium hydroxide for patients undergoing hypofractionation PMRT yielded superior preventive results over a general skin care regimen alone, in terms of delaying skin toxicity, reducing the severity of acute radiation dermatitis, and a better quality of life in the intervention group. However, a larger number of patients will be required to confirm this result.

Dermatologic toxicities associated with radiation therapy in women with breast cancer

“…Recent studies have also demonstrated that barrier creams and films, as well as melatonin-based creams, may decrease the incidence of radiation dermatitis and moist desquamation and delay the development of radiation dermatitis-associated pruritus ( Ben-David et al, 2016 , Laffin et al, 2015 , Shaw et al, 2015 , Zetner et al, 2019 ). In addition, glutamine supplementation, olive oil/calcium hydroxide emulsions, and many other agents have been shown to reduce the incidence and severity of radiation dermatitis in small studies ( Chitapanarux et al, 2019 , Eda et al, 2016 ).…”

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

“… 29 PMRT might play a role in this difference, although hypofractionated radiotherapy was applied. 30 …”

Biological effects of the olive tree and its derivatives on the skin

“…In vivo (women with post-mastectomy radiotherapy): less dermatitis in patients treated with olive oil and calcium hydroxide emulsion during post-mastectomy radiotherapy sessions. 80…”

“…77 Some studies also suggest that the topical use of olive oil not only protects against the harmful effect of UV radiation, but may also be useful for cancer patients undergoing radiotherapy and radiochemotherapy, in order to delay the appearance of skin lesions associated with irradiation and reduce their severity, thus improving their quality of life. [78][79][80] In the same vein, Akarsu et al 81 observed in patients treated with phototherapy and photochemotherapy that topical application of EVOO before a session increased the minimum phototoxic dose, i.e. the minimum dose of UVA at which noticeable erythema occurs.…”