Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study

Schmuth, Matthias; Wimmer, Monika; Hofer, Susanne; Sztankay, A.; Weinlich, Georg; Linder, Dennis; Pm, Elias; Fritsch, Peter; Fritsch, Esther

doi:10.1046/j.1365-2133.2002.04751.x

Cited by 168 publications

(157 citation statements)

References 51 publications

(57 reference statements)

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“…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%

“…The second most common tool in use was the U.S. National Cancer Institute's Common Toxicity Criteria (nci ctc), which is similar to the rtog and was used in nine studies 2,3,26,28,30,[37][38][39]46 . The remaining studies used a study-designed tool closely modeled after either the rtog or nci tool, with slight variations [18][19][20]23,31,43,49 .…”

Section: Resultsmentioning

confidence: 99%

“…There is some evidence to suggest that topical corticosteroid agents may be beneficial in decreasing the incidence of radiation dermatitis, especially grade 3 and 4 reactions 19,21 . The evidence for the use of nonsteroidal topical agents is conflicting: some trials were positive for nonsteroidal agents 30,33,35,37 ; others showed no statistical difference 34,36,38 .…”

Section: Prevention Of Acute Radiation-induced Skin Reactionsmentioning

confidence: 99%

“…In a randomized double-blind study, Schmuth et al compared two topical corticosteroid agents: 0.5% dexpanthenol cream and 0.1% methylprednisolone aceponate cream 19 . These authors found that although neither cream reduced the incidence of radiation dermatitis, fewer patients in the methylprednisolone group developed a reaction with a score of 4 or more (p < 0.05) on a rating scale that summed the scores for erythema, desquamation, erosion, induration, or hyperpigmentation (each assessed on a 4-point Likert scale: 0, none; 1, mild; 2, moderate; 3, severemaximum possible score, 15).…”

Section: Topical Corticosteroid Agentsmentioning

confidence: 99%

“…Four trials evaluated topical corticosteroids for the prevention of acute skin reactions [18][19][20][21] .…”

Section: Topical Corticosteroid Agentsmentioning

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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Prevention Of Acute Radiation-induced Skin Reactionsmentioning

confidence: 99%

Section: Topical Corticosteroid Agentsmentioning

confidence: 99%

“…Four trials evaluated topical corticosteroids for the prevention of acute skin reactions [18][19][20][21] .…”

Section: Topical Corticosteroid Agentsmentioning

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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Corticosteroids for the management of cancer-related pain in adults

Haywood

Good

Khan

et al. 2015

Cochrane Database of Systematic Reviews

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The evidence for the efficacy of corticosteroids for pain control in cancer patients is weak. Significant pain relief was noted in some studies, albeit only for a short period of time. This could be important for patients with poor clinical status. Further trials, with increased numbers of participants, are needed to evaluate the safety and effectiveness of corticosteroids for the management cancer pain in adults, and to establish an ideal dose, duration of therapy and route of administration.

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Radiation‐Induced Skin Reactions

Wong

Kassam

2013

Dermatologic Principles and Practice in Oncology

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Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study

Cited by 168 publications

References 51 publications

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

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

Corticosteroids for the management of cancer-related pain in adults

Radiation‐Induced Skin Reactions

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