Chan RJ, Webster J, Chung B, Marquart L, Ahmed M, Garantziotis S, et al.
BMC cancer. Date of publication 2014 Jan 31;volume 14():53.
1. BMC Cancer. 2014 Jan 31;14:53. doi: 10.1186/1471-2407-14-53.
Prevention and treatment of acute radiation-induced skin reactions: a systematic
review and meta-analysis of randomized controlled trials.
Chan RJ(1), Webster J, Chung B, Marquart L, Ahmed M, Garantziotis S.
Author information:
(1)Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street,
Herston Q4029, Australia. email.rchan@gmail.com.
BACKGROUND: Radiation-induced skin reaction (RISR) is a common side effect that
affects the majority of cancer patients receiving radiation treatment. RISR is
often characterised by swelling, redness, pigmentation, fibrosis, and ulceration,
pain, warmth, burning, and itching of the skin. The aim of this systematic review
was to assess the effects of interventions which aim to prevent or manage RISR in
people with cancer.
METHODS: We searched the following databases up to November 2012: Cochrane Skin
Group Specialised Register, CENTRAL (2012, Issue 11), MEDLINE (from 1946), EMBASE
(from 1974), PsycINFO (from 1806), CINAHL (from 1981) and LILACS (from 1982).
Randomized controlled trials evaluating interventions for preventing or managing
RISR in cancer patients were included. The primary outcomes were development of
RISR, and levels of RISR and symptom severity. Secondary outcomes were time taken
to develop erythema or dry desquamation; quality of life; time taken to heal, a
number of skin reaction and symptom severity measures; cost, participant
satisfaction; ease of use and adverse effects. Where appropriate, we pooled
results of randomized controlled trials using mean differences (MD) or odd ratios
(OR) with 95% confidence intervals (CI).
RESULTS: Forty-seven studies were included in this review. These evaluated six
types of interventions (oral systemic medications; skin care practices; steroidal
topical therapies; non-steroidal topical therapies; dressings and other).
Findings from two meta-analyses demonstrated significant benefits of oral
Wobe-Mugos E for preventing RISR (OR 0.13 (95% CI 0.05 to 0.38)) and limiting the
maximal level of RISR (MD -0.92 (95% CI -1.36 to -0.48)). Another meta-analysis
reported that wearing deodorant does not influence the development of RISR (OR
0.80 (95% CI 0.47 to 1.37)).
CONCLUSIONS: Despite the high number of trials in this area, there is limited
good, comparative research that provides definitive results suggesting the
effectiveness of any single intervention for reducing RISR. More research is
required to demonstrate the usefulness of a wide range of products that are being
used for reducing RISR. Future efforts for reducing RISR severity should focus on
promising interventions, such as Wobe-Mugos E and oral zinc.
DOI: 10.1186/1471-2407-14-53
PMCID: PMC3909507
PMID: 24484999 [Indexed for MEDLINE]
