PREVENTION AND MANAGEMENT OF ACUTE RADIATION DERMATITIS BY THE TOPICAL AGENTS : A LITERATURE REVIEW
Abstract
Objectives: To review historical and current published studies on prevention and management of acute radiation dermatitis. Data sources: Research studies, Review articles, Standard text books Conclusion: The literature showed no standard recommendation for the use of specifi c topical agents for prevention or management of acute radiation dermatitis. The researches studied on aloe vera gel, biafi ne cream, almond ointment, chamomile cream, Thêta-Cream® and topical vitamin E cream demonstrated negative results for prevention and reduction of radiation induced skin alteration. Some evidence suggested the use of topical steroid, topical sucralfate/ sucralfate derivatives, hyaluronic acid cream and MDS065D. However, more studies are needed to support the fi rm recommendation.
References
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David H. Chu. Development and Structure of Skin. In Klaus Wolff, Lowell A.Goldsmith, Stephen I. Katz, Barbara A. Gilchrest, Amy S. Paller, David J. Leffell, editors. Fitzpatrick’s Dermatology in General Medicine. 7th edition. United States of America. The McGraw-Hill Companies, Inc.; 2008. pp.857-62.
Jacaueline M. Junkins-Hopkins. Radiation-induced skin alteration. In David E. Elder, Rosalie Elenitsas, Bernett L. Johnson, Jr., George F. Murphy, Xiaowei Xu, editors. Lever’s Histopathology of the Skin. 10th edition. Philadelphia. Lippincott Williams & Wilkins, a Wolter Kluwer business; 2009. pp. 348-52.
Richard B. ODOM, William D. James, Timothy G. Berger. Radiodermatitis. In Elisabeth M. Fathman, Ellen Baker Geisel, editors. Andrew’s Diseases of the Skin Clinical Dermatology. 9th edition. Philadelphia. W.B. Saunders Company; 2000. pp.40-41.
Carlos A. Perez, MD, Luther W. Brady, MD. Principles and Practice of Radiation Oncology, 4th edition. Philadelphia. Lippincott Williams & Wilkins; 2004. pp. 367-70.
The National Cancer Institute. Common Terminology Criteria for Adverse Events version 3.0 [homepage on the internet]. C2006 [updated 2006 August 9; cited 2009 December 12]. Available from: http://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/ctcaev3.pdf
Sharon R. Hymes, MD, Eric A. Strom, MD, Caroline Fife, MD. Radiation dermatitis : Clinical presentation, pathophysiology, and treatment 2006. J Am Acad Dermatol. 2006; 54:28-46.
Amanda Bolderson, Nancy S. Lloyd, Rebecca K. S. Wong, Lori Holden, Linda Robb-Blenderman and the Supportive Care Guidelines Group of Cancer Ontario Program in Evidence-based Care. The prevention and management of acute skin reactions related to radiation therapy : a systematic review and practice guideline. Supportive Care Cancer 2006; 14:802-17.
Mihkaila Maurine Wickline, RN, MN, AOCN®, CNS. Prevention and Treatment of Acute Radiation Dermatitis: A Literature Review. Oncology Nursing Forum 2004; 31: 237-44.
Maurene McQuestion. Evidence-Based Skin Care Management in Radiation Therapy. Seminars in Oncology Nursing 2006; 22: 163-73.
Alf Björnberg, Lars Hellgren, Bertil Magnusson, Inger Mattsson and Bengt Rosengren. Topical treatment of radiation dermatitis with bethamethasone-17-valerate, vaseline and eucerine - A double-blind comparison. Clinical Radiology 1967; 18: 463-4. (Abstract)
A. Bostrom, H. Lindman, C. Swartling, B. Berne and J. Bergh, Potent corticosteroid cream (mometasone furoate) signifi cantly reduces acute radiation dermatitis: results from a double-blind, randomized study, Radiother Oncol 2001; 59:257–65.
Shukla PN, Gairola M, Mohanti BK, Rath GK. Prophylactic beclomethasone spary to th skin during postoperative radiotherapy of carcinoma breat: A prospective randomized study. Indian Journal of Cancer 2006; 43(4):180-4.
Shapour Omidvari, Hojjatollah Saboori, Mohammad Mohammadianpanah, Ahmad Mosalaei, Niloofar Ahmadloo, Mohammad Amin Mosleh-Shirazi, et al. Topical betamethasone for prevention of radiation dermatitis. Indian Journal of Dermatology, Venereology and Leprology 2007; 73: 209-15.
J.P. Glees, H. Mameghan-Zadeh and C.G. Sparkes, Effectiveness of topical steroids in the control of radiation dermatitis: a randomised trial using 1% hydrocortisone cream and 0.05% clobetasone butyrate (Eumovate). Clin Radiol 1979; 30:397–403.
Løkkevik E, Skovlund E, Reitan JB et al. Skin treatment with bepanthen cream versus no cream during radiotherapy. Acta Oncol 1996; 35:1021–6.
M. Schmuth, M.A. Wimmer, S. Hofer, A. Sztankay, G. Weinlich and D.M. Linder et al., Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study. Br J Dermatol 2002; 146:983–91.
Maiche A, Isokangas O, Grohn P. Skin protection by sucralfate cream during electron beam therapy. Acta Oncol 1994; 33:201–3.
Delaney, G. Fisher, R., Hook, C., Barton, M. Sucralfate cream in the management of moist desquamation during radiotherapy. Australian Radiology 1997; 41: 270-5.
Evensen JF, Bjordal K, Jacobsen A, et al. Effects of Na-sucrose octasulfate on skin and mucosa reactions during radiotherapy of head and neck cancers. Acta Oncol 2001; 40:751–5.
Mary Wells, Maureen Macmillan, Gillian Raab, Shiela MacBride, Nancy Bell, Karen MacKinnon, et al. Does aqueous or sucralfate cream affect the severity of erythematous radiation skin reactions? A randomized controlled trial. Radiotherapy and Oncology 2004; 73:153-62.
De Rauglaudre G, Courdi A, Delaby-Chagrin F, d'Hombres A, Hannoun-Levi JM, Moureau-Zabotto L, et al. Tolerance of the association sucralfate / Cu-Zn salts in radiation dermatitis. Ann Dermatol Venereol. 2008; 1:11-5. (Abstract)
M.S. Williams, M. Burk, C.L. Loprinzi, M. Hill, P.J. Schomberg and K. Nearhood et al., Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Int J Radiat Oncol Biol Phys 1996; 36:345–9.
Vogler, B., Ernst, E. Aloe vera: A systematic review of its clinical effectiveness. British Journal of General Practice 1999; 49: 823-8.
Dudek DJ, Thompson J, Meegan MM, et al. Pilot study to investigate the toxicity of aloe Vera gel in the management of radiation induced skin reactions for post-operative primary breast cancer. J Radiother Pract 2000; 1:197-203.
Olsen DL, Raub W, Bradley C, et al. The effect of aloe vera gel/mild soap alone in preventing skin reaction in patients undergoing radiation therapy. Oncol Nurs Forum 2001; 28:543–7.
S. Heggie, G.P. Bryant, L. Tripcony, J. Keller, P. Rose and M. Glendenning et al., A Phase III study on the efficacy of topical aloe vera gel on irradiated breast tissue. Cancer Nurs 2002; 25:442–51.
Richardson J, Smith JE, Mclntyre M, Thomas R, Pilkington K. Aloe vera for Preventing radiation-induced skin reaction: a systematic literature review 2005; 17(6):478-84.
Fisher J, Scott C, Stevens R, et al. Randomized phase III study comparing best supportive care to biafine as a prophylactic agent for radiation-induced skin toxicity for women undergoing breast irradiation: radiation therapy oncology group (RTOG) 97-13. Int J Radiat Oncol Biol Phys 2000: 48:1307–10.
Szumacher E, Wighton A, Franssen E, et al. Phase II study assessing the effectiveness of biafine cream as a prophylactic agent for radiation-induced acute skin toxicity to the breast in women undergoing radiotherapy with concomitant CMF chemotherapy. Int J Radiat Oncol Biol Phys 2001; 51:81–6.
Fenig E, Brenner B, Katz A, et al. Topical biafine and lipiderm for the prevention of radiation dermatitis: a randomized prospective trial. Oncol Rep 2001; 8:305–9.
P. Pommier, F. Gomez, M.P. Sunyach, A. D’Hombres, C. Carrie, X. Montbarbon. Journal of Clinical Oncology 2004; 22(8): 1447-53.
V. Liguori, C. Guillemin, G.F. Pesce, R.O. Mirimanoff and J. Bernier, Double-blind, randomized clinical study comparing hyaluronic acid cream to placebo in patients treated with radiotherapy. Radiother Oncol 1997: 42:155–61.
Mak, S., Molassiotis, A., Wan, W., Lee, I., Chan, E. The effects of hydrocolloid dressing and gentian violet on radiation-induced moist desquamation wound healing. Cancer Nursing 2000; 23:220-9.
Barbara Röper, Danielle Kaisig, Florian Auer, Ertan Mergen and Michael Molls. Thêta-Cream® versus Bepanthol® Lotion in Breast Cancer Patients under Radiotherapy. Strahlentherapie und Onkologie 2004; 180:315-22.
A. Dirier, M. Akmansu, H. Bora and M. Gurer. The effect of vitamin E on acute skin reaction caused by radiotherapy. Clinical and Experimental Dermatology 2007; 32:571-3.
Asavametha N, Suwannalai T, Puvabanditsin P, Shoosanglertwijit J. Effect of topical vitamin E on radiation-induced skin alteration in head and neck cancer patients. Chula Med J. 2004; 48(5): 275-87.
Thomas E Merrchant , Christina Bosly , Julie Smith, Pam Baratti, David Prichard, Tina Davis, et al. A phase III trial comparing an aniomic phospholipids – based cream and aloe vera – based gel in the prevention of vadiation dermatitis in pediatric patients. Radiation Oncology 2007;2(45):1-8.
Maria Cristina Leonardi, Silvia Gariboldi, Giovanni Battista Ivaldi, Annamaria Ferrari, Flavia Serafi ni, Florence Didier, et al. A double-blind, randomised, vehicle-controlled clinical study to evaluate the effi cacy of MAS065D in limiting the effects of radiation on the skin: interim analysis. Eur J Dermatol. 2008; 18(3): 317-21.
David H. Chu. Development and Structure of Skin. In Klaus Wolff, Lowell A.Goldsmith, Stephen I. Katz, Barbara A. Gilchrest, Amy S. Paller, David J. Leffell, editors. Fitzpatrick’s Dermatology in General Medicine. 7th edition. United States of America. The McGraw-Hill Companies, Inc.; 2008. pp.857-62.
Jacaueline M. Junkins-Hopkins. Radiation-induced skin alteration. In David E. Elder, Rosalie Elenitsas, Bernett L. Johnson, Jr., George F. Murphy, Xiaowei Xu, editors. Lever’s Histopathology of the Skin. 10th edition. Philadelphia. Lippincott Williams & Wilkins, a Wolter Kluwer business; 2009. pp. 348-52.
Richard B. ODOM, William D. James, Timothy G. Berger. Radiodermatitis. In Elisabeth M. Fathman, Ellen Baker Geisel, editors. Andrew’s Diseases of the Skin Clinical Dermatology. 9th edition. Philadelphia. W.B. Saunders Company; 2000. pp.40-41.
Carlos A. Perez, MD, Luther W. Brady, MD. Principles and Practice of Radiation Oncology, 4th edition. Philadelphia. Lippincott Williams & Wilkins; 2004. pp. 367-70.
The National Cancer Institute. Common Terminology Criteria for Adverse Events version 3.0 [homepage on the internet]. C2006 [updated 2006 August 9; cited 2009 December 12]. Available from: http://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/ctcaev3.pdf
Sharon R. Hymes, MD, Eric A. Strom, MD, Caroline Fife, MD. Radiation dermatitis : Clinical presentation, pathophysiology, and treatment 2006. J Am Acad Dermatol. 2006; 54:28-46.
Amanda Bolderson, Nancy S. Lloyd, Rebecca K. S. Wong, Lori Holden, Linda Robb-Blenderman and the Supportive Care Guidelines Group of Cancer Ontario Program in Evidence-based Care. The prevention and management of acute skin reactions related to radiation therapy : a systematic review and practice guideline. Supportive Care Cancer 2006; 14:802-17.
Mihkaila Maurine Wickline, RN, MN, AOCN®, CNS. Prevention and Treatment of Acute Radiation Dermatitis: A Literature Review. Oncology Nursing Forum 2004; 31: 237-44.
Maurene McQuestion. Evidence-Based Skin Care Management in Radiation Therapy. Seminars in Oncology Nursing 2006; 22: 163-73.
Alf Björnberg, Lars Hellgren, Bertil Magnusson, Inger Mattsson and Bengt Rosengren. Topical treatment of radiation dermatitis with bethamethasone-17-valerate, vaseline and eucerine - A double-blind comparison. Clinical Radiology 1967; 18: 463-4. (Abstract)
A. Bostrom, H. Lindman, C. Swartling, B. Berne and J. Bergh, Potent corticosteroid cream (mometasone furoate) signifi cantly reduces acute radiation dermatitis: results from a double-blind, randomized study, Radiother Oncol 2001; 59:257–65.
Shukla PN, Gairola M, Mohanti BK, Rath GK. Prophylactic beclomethasone spary to th skin during postoperative radiotherapy of carcinoma breat: A prospective randomized study. Indian Journal of Cancer 2006; 43(4):180-4.
Shapour Omidvari, Hojjatollah Saboori, Mohammad Mohammadianpanah, Ahmad Mosalaei, Niloofar Ahmadloo, Mohammad Amin Mosleh-Shirazi, et al. Topical betamethasone for prevention of radiation dermatitis. Indian Journal of Dermatology, Venereology and Leprology 2007; 73: 209-15.
J.P. Glees, H. Mameghan-Zadeh and C.G. Sparkes, Effectiveness of topical steroids in the control of radiation dermatitis: a randomised trial using 1% hydrocortisone cream and 0.05% clobetasone butyrate (Eumovate). Clin Radiol 1979; 30:397–403.
Løkkevik E, Skovlund E, Reitan JB et al. Skin treatment with bepanthen cream versus no cream during radiotherapy. Acta Oncol 1996; 35:1021–6.
M. Schmuth, M.A. Wimmer, S. Hofer, A. Sztankay, G. Weinlich and D.M. Linder et al., Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study. Br J Dermatol 2002; 146:983–91.
Maiche A, Isokangas O, Grohn P. Skin protection by sucralfate cream during electron beam therapy. Acta Oncol 1994; 33:201–3.
Delaney, G. Fisher, R., Hook, C., Barton, M. Sucralfate cream in the management of moist desquamation during radiotherapy. Australian Radiology 1997; 41: 270-5.
Evensen JF, Bjordal K, Jacobsen A, et al. Effects of Na-sucrose octasulfate on skin and mucosa reactions during radiotherapy of head and neck cancers. Acta Oncol 2001; 40:751–5.
Mary Wells, Maureen Macmillan, Gillian Raab, Shiela MacBride, Nancy Bell, Karen MacKinnon, et al. Does aqueous or sucralfate cream affect the severity of erythematous radiation skin reactions? A randomized controlled trial. Radiotherapy and Oncology 2004; 73:153-62.
De Rauglaudre G, Courdi A, Delaby-Chagrin F, d'Hombres A, Hannoun-Levi JM, Moureau-Zabotto L, et al. Tolerance of the association sucralfate / Cu-Zn salts in radiation dermatitis. Ann Dermatol Venereol. 2008; 1:11-5. (Abstract)
M.S. Williams, M. Burk, C.L. Loprinzi, M. Hill, P.J. Schomberg and K. Nearhood et al., Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Int J Radiat Oncol Biol Phys 1996; 36:345–9.
Vogler, B., Ernst, E. Aloe vera: A systematic review of its clinical effectiveness. British Journal of General Practice 1999; 49: 823-8.
Dudek DJ, Thompson J, Meegan MM, et al. Pilot study to investigate the toxicity of aloe Vera gel in the management of radiation induced skin reactions for post-operative primary breast cancer. J Radiother Pract 2000; 1:197-203.
Olsen DL, Raub W, Bradley C, et al. The effect of aloe vera gel/mild soap alone in preventing skin reaction in patients undergoing radiation therapy. Oncol Nurs Forum 2001; 28:543–7.
S. Heggie, G.P. Bryant, L. Tripcony, J. Keller, P. Rose and M. Glendenning et al., A Phase III study on the efficacy of topical aloe vera gel on irradiated breast tissue. Cancer Nurs 2002; 25:442–51.
Richardson J, Smith JE, Mclntyre M, Thomas R, Pilkington K. Aloe vera for Preventing radiation-induced skin reaction: a systematic literature review 2005; 17(6):478-84.
Fisher J, Scott C, Stevens R, et al. Randomized phase III study comparing best supportive care to biafine as a prophylactic agent for radiation-induced skin toxicity for women undergoing breast irradiation: radiation therapy oncology group (RTOG) 97-13. Int J Radiat Oncol Biol Phys 2000: 48:1307–10.
Szumacher E, Wighton A, Franssen E, et al. Phase II study assessing the effectiveness of biafine cream as a prophylactic agent for radiation-induced acute skin toxicity to the breast in women undergoing radiotherapy with concomitant CMF chemotherapy. Int J Radiat Oncol Biol Phys 2001; 51:81–6.
Fenig E, Brenner B, Katz A, et al. Topical biafine and lipiderm for the prevention of radiation dermatitis: a randomized prospective trial. Oncol Rep 2001; 8:305–9.
P. Pommier, F. Gomez, M.P. Sunyach, A. D’Hombres, C. Carrie, X. Montbarbon. Journal of Clinical Oncology 2004; 22(8): 1447-53.
V. Liguori, C. Guillemin, G.F. Pesce, R.O. Mirimanoff and J. Bernier, Double-blind, randomized clinical study comparing hyaluronic acid cream to placebo in patients treated with radiotherapy. Radiother Oncol 1997: 42:155–61.
Mak, S., Molassiotis, A., Wan, W., Lee, I., Chan, E. The effects of hydrocolloid dressing and gentian violet on radiation-induced moist desquamation wound healing. Cancer Nursing 2000; 23:220-9.
Barbara Röper, Danielle Kaisig, Florian Auer, Ertan Mergen and Michael Molls. Thêta-Cream® versus Bepanthol® Lotion in Breast Cancer Patients under Radiotherapy. Strahlentherapie und Onkologie 2004; 180:315-22.
A. Dirier, M. Akmansu, H. Bora and M. Gurer. The effect of vitamin E on acute skin reaction caused by radiotherapy. Clinical and Experimental Dermatology 2007; 32:571-3.
Asavametha N, Suwannalai T, Puvabanditsin P, Shoosanglertwijit J. Effect of topical vitamin E on radiation-induced skin alteration in head and neck cancer patients. Chula Med J. 2004; 48(5): 275-87.
Thomas E Merrchant , Christina Bosly , Julie Smith, Pam Baratti, David Prichard, Tina Davis, et al. A phase III trial comparing an aniomic phospholipids – based cream and aloe vera – based gel in the prevention of vadiation dermatitis in pediatric patients. Radiation Oncology 2007;2(45):1-8.
Maria Cristina Leonardi, Silvia Gariboldi, Giovanni Battista Ivaldi, Annamaria Ferrari, Flavia Serafi ni, Florence Didier, et al. A double-blind, randomised, vehicle-controlled clinical study to evaluate the effi cacy of MAS065D in limiting the effects of radiation on the skin: interim analysis. Eur J Dermatol. 2008; 18(3): 317-21.
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2010-06-29
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Suwannalai T. PREVENTION AND MANAGEMENT OF ACUTE RADIATION DERMATITIS BY THE TOPICAL AGENTS : A LITERATURE REVIEW. J Thai Assn of Radiat Oncol [Internet]. 2010 Jun. 29 [cited 2024 Jul. 3];16(1):27-40. Available from: https://he01.tci-thaijo.org/index.php/jtaro/article/view/203513
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