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

Behroozian, Tara; Goldshtein, Daniel; Wolf, Julie Ryan; Hurk, Corina van den; Finkelstein, Samuel; Lam, Henry; Patel, Partha; Kanee, Lauren; Lee, Shing Fung; Chan, Adrian Wai; Wong, Henry Chun Yip; Caini, Saverio; Mahal, Simran; Kennedy, Samantha; Chow, Edward; Bonomo, Pierluigi

doi:10.1016/j.eclinm.2023.101886

Cited by 24 publications

(20 citation statements)

References 248 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[19] The study concluded that according to the univariate and multivariate analyses, TV-V110% had predictive power over the incidence of RD and prophylactic topical treatment of irradiated skin signi cantly improves cutaneous tolerance to adjuvant RT. Therefore, the present study included 134 patients with adjuvant RT after radical mastectomy, and all patients received IMRT to the chest wall and upper and lower clavicle, together with skin care according to the guidelines [12,20,21] during RT.Patients received irradiation of the inner mammary area, and the rst 15 fractions of 1-cm bolus in the chest wall of patients was added to evaluate the relationship between clinical factors and dosimetry parameters and ARD. Takenaka et al also suggested that patient ARD was related to the volume of irradiation, and that v5 (whole body) 1360 cm 3 and v40 (skin volume) 45 cm 3 may be dose-volume limitations for ARD ≥ 2.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies have shown that ARD-related risk factors can be associated with age, nutritional status, the body mass index (BMI), radiation dose, dose fractionation, and other synchronous treatments. 7,8,9.10,11 The guidelines recommend the following treatments for ARD in people with breast cancer: photobiomodulation therapy and Mepitel lm Hydro lm, mometasone, betamethasone, and olive oil 12 ; however, the treatment e cacy is poor and ARD remains a major acute adverse effect plaguing postoperative adjuvant RT for breast cancer.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dose-volume predictors of radiation dermatitis in patients undergoing radiotherapy after radical mastectomy for breast cancer

han,

zhang,

et al. 2024

Preprint

View full text Add to dashboard Cite

Purpose To analyze incidence and dose-volume predictors of acute radiation dermatitis (ARD) in patients with breast cancer who undergo regional nodal irradiation. Methods and materials: Patients treated with Intensity-modulated radiation therapy (IMRT) in the chest wall, supraclavicular/subclavicular fossa, secondary axilla, and/or intramammary link after mastectomy were included. The prescribed dose was 50 Gy in 25 fractions. ARD was evaluated and graded once during radiotherapy(RT), 1 week after RT, and at the 1 month follow-up. Grading was performed according to the National Cancer Institute Common Toxicity Criteria for Adverse Events version 3.0. Total skin volume, mean dose, maximum dose, relative volume (RV5-RV45) and absolute volume (AV5-AV45) in patients receiving at least 5 to 45 Gy in 5 Gy increments were assessed. Univariate and multivariate logistic regression analyses were performed to identify risk factors for ARD and to obtain ROC curves. Thresholds for skin dosimetry parameters were determined. Results A total of 134 patients with breast cancer who received recruited RT were included in this analysis. Among all patients the incidence of ≥ 2 ARD was 33.58% (45/134), of which the incidence of grade 2 ARD was 32.09% (43/134), and the incidence of grade 3 RD was 1.49% (2/134). No grade 4 or 5 ARD was observed. After univariate and multivariate analyses, age, BMI, BSA, sex, tumor laterality, vascular cancer embolus, nerve invasion, adjuvant chemotherapy were not significantly associated with the risk of grade ≥ 2 ARD. Internal mammary nodal irradiation (IMNI) (P = 0.049) and targeted therapy (P = 0.005) were independent risk factors for ARD. AV35 (P = 0.030) and AV40 (P = 0.025)of the skin were significantly associated with the risk of grade ≥ 2 RD. According to the ROC curves, the optimum thresholds were 199 mL for AV35 and 181.8 mL for AV40, respectively. Conclusion The receipt of targeted therapy during radiation therapy and IMNI are risk factors for the development of grade 2 ARD. Maintaining AV35 on the upper skin at < 199 mL and AV40 at < 181.8 mL may decrease the risk of ARD.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dose-volume predictors of radiation dermatitis in patients undergoing radiotherapy after radical mastectomy for breast cancer

han,

zhang,

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…A meta-analysis on topical non-steroidal products showed that only Bia ne® could reduce ARD severity but not trolamine nor hyaluronic acid [43]. Regarding the natural agents, the MASCC expert panel only recommended olive oil for ARD prevention [13]. A meta-analysis on natural agents demonstrated that only oral enzymes and olive oil signi cantly reduced ARD severity, but not calendula [44].…”

Section: Discussionmentioning

confidence: 99%

“…An expert panel of the MASCC evaluated interventions for ARD prevention and management based on evidence of existing medical literature in 2023 [13,17]. Considering topical non-steroidal agents, no product was recommended for ARD prevention, but hydroactive colloid gel reached a near-consensus supporting recommendation [13]. A meta-analysis on topical non-steroidal products showed that only Bia ne® could reduce ARD severity but not trolamine nor hyaluronic acid [43].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple guidelines on ARD prevention and management are available from specialized organizations. To prevent skin dehydration, patients are instructed to use a topical emollient daily [13][14][15][16][17]. Based on the United States Cutaneous Oncodermatology Management (USCOM) algorithm, a topical skincare product for ARD should be moisturizing, free of allergens and scents, and have a physiological pH level [18,19].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A novel, multi-active emollient for the prevention of acute radiation dermatitis in breast cancer patients: A Randomized Clinical Trial

Robijns,

Bever,

Hermans

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose To investigate the efficacy of a novel, multi-active emollient in preventing and managing acute radiation dermatitis (ARD) in breast cancer patients undergoing moderate hypofractionated (HF) radiotherapy (RT) compared to standard of care. Methods A monocentric, open-label, randomized clinical trial (RCT) with breast cancer patients receiving moderate HF (dose: 40.05-55.86Gy, fractions:15-21) was conducted between January 2022 and May 2023. The experimental group received the novel emollient, while the control group received the standard skin care. Patients applied the skin care products twice daily during the complete RT course. The primary outcome was the severity of ARD at the final RT session measured by the modified Radiation Therapy Oncology Group (RTOG) criteria. Secondary outcomes included patient symptoms, quality of life (QoL), and treatment satisfaction. Results A total of 100 patients with 50 patients per group were enrolled. In the control group, 50% of the patients developed RTOG grade 1 ARD and 48% grade 2 or higher, while in the experimental group, the severity of ARD was significantly lower with 82% grade 1 and 16% grade 2 ARD (P = .013, χ2-test). The frequency and severity of xerosis were significantly lower in the experimental compared to the control group (Ps ≤ .036, Mann Whiney U-test). The impact of ARD on the QoL was low, and treatment satisfaction was high in both groups, with no significant difference. Conclusion This RCT shows that the novel, multi-active emollient significantly reduced the ARD RTOG grade. Research in a more diverse patient population is warranted. Trial registration number ClinicalTrials.gov:NCT04929808(11/06/2021)

show abstract

Staphylococcus aureus colonization as a risk factor for acute radiation dermatitis

Oji

2024

Strahlenther Onkol

View full text Add to dashboard Cite

Hintergrund Die akute Radiodermatitis (ARD) ist definiert als eine inflammatorische Hautveränderung, welche innerhalb von 90 Tagen nach Beginn einer Strahlentherapie auftritt. Die möglichen Schweregrade reichen von einem schwachen Erythem über trockene und feuchte Epitheliolysen bis hin zu Ulzerationen und Nekrosen. Sie ist eine der häufigsten Nebenwirkungen der Strahlentherapie und tritt in einem relevanten Maße insbesondere in der Radiotherapie maligner Brust-und Kopf-Hals-Tumoren auf. Eine ARD kann die Lebensqualität der Patientinnen und Patienten unter Radiotherapie negativ beeinflussen und zu Therapieunterbrechungen, -verzögerungen und -abbrüchen führen. Doch trotz dieser Bedeutung für die Lebensqualität und Therapieadhärenz der Patientinnen und Patienten ist die Evidenz für prophylaktische und therapeutische Ansätze ausgesprochen spärlich [1]. Ebenso ist die Pathogenese der ARD noch nicht vollständig geklärt. Die Rolle des Hautmikrobioms in der Entstehung der ARD ist dabei Gegenstand aktueller Untersuchungen [2-5]. Eine Dysbiose der Hautflora, zwischen kommensalen und fakultativ pathogenen Hautkeimen, scheint eine wesentliche Rolle zu spielen [3, 4]. Hypothesen gehen davon aus, dass eine bakteriel-

show abstract

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

Cited by 24 publications

References 248 publications

Dose-volume predictors of radiation dermatitis in patients undergoing radiotherapy after radical mastectomy for breast cancer

Dose-volume predictors of radiation dermatitis in patients undergoing radiotherapy after radical mastectomy for breast cancer

A novel, multi-active emollient for the prevention of acute radiation dermatitis in breast cancer patients: A Randomized Clinical Trial

Staphylococcus aureus colonization as a risk factor for acute radiation dermatitis

Contact Info

Product

Resources

About