Does aqueous or sucralfate cream affect the severity of erythernatous radiation skin reactions? A randomised controlled trial

M Wells, M Macmillan, G Raab, S MacBride, N Bell, Karen MacKinnon, H MacDougall, Leslie Samuel, Alasdair Munro

Research output: Contribution to journalArticle

115 Citations (Scopus)

Abstract

Background and purpose: Evidence on which to base decisions about the management of radiation skin reactions is lacking. The purpose of this study was to investigate whether sucralfate or aqueous cream reduced acute skin toxicity during radiotherapy to the head and neck, breast or anorectal area (phase A), and to evaluate the effect of hydrogels and dry dressings on moist desquamation (phase B). This paper presents the results of phase A.

Patients and methods: Three hundred and fifty seven patients were randomised to apply aqueous cream, sucralfate cream or no cream to the irradiated area from day one of radical radiotherapy treatment. All patients were instructed to wash using unperfumed soap. Acute skin toxicity was measured using a modified radiation therapy oncology group (RTOG) score, reflectance spectrophotometry, patient diary card and dermatology life quality index (DLQI). A cost minimisation approach was used to compare the costs of each skin care approach.

Results: No consistent differences were found in the severity of skin reactions or levels of discomfort suffered by patients in each of the randomised groups. Patients with a higher body mass index, who smoked, received concomitant chemotherapy, boost or bolus during treatment were more likely to develop skin reactions.

Conclusions: There is no evidence to support the prophylactic application of either of the creams tested for the prevention of radiation skin reactions. Our results show that it is possible to predict which patients are at greatest risk of skin reactions. We suggest that known risk factors should be incorporated into future study protocols. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)153-162
Number of pages10
JournalRadiotherapy and Oncology
Volume73
Issue number2
DOIs
Publication statusPublished - Nov 2004

Keywords

  • radiotherapy
  • skin care
  • acute toxicity
  • breast-cancer patients
  • aloe-vera gel
  • double-blind
  • phase-III
  • prophylactic agent
  • neck-cancer
  • toxicity
  • therapy
  • smoking

Cite this

Does aqueous or sucralfate cream affect the severity of erythernatous radiation skin reactions? A randomised controlled trial. / Wells, M ; Macmillan, M ; Raab, G ; MacBride, S ; Bell, N ; MacKinnon, Karen; MacDougall, H ; Samuel, Leslie; Munro, Alasdair.

In: Radiotherapy and Oncology, Vol. 73, No. 2, 11.2004, p. 153-162.

Research output: Contribution to journalArticle

Wells, M ; Macmillan, M ; Raab, G ; MacBride, S ; Bell, N ; MacKinnon, Karen ; MacDougall, H ; Samuel, Leslie ; Munro, Alasdair. / Does aqueous or sucralfate cream affect the severity of erythernatous radiation skin reactions? A randomised controlled trial. In: Radiotherapy and Oncology. 2004 ; Vol. 73, No. 2. pp. 153-162.
@article{359e40823bb04084b6864ada29d61164,
title = "Does aqueous or sucralfate cream affect the severity of erythernatous radiation skin reactions? A randomised controlled trial",
abstract = "Background and purpose: Evidence on which to base decisions about the management of radiation skin reactions is lacking. The purpose of this study was to investigate whether sucralfate or aqueous cream reduced acute skin toxicity during radiotherapy to the head and neck, breast or anorectal area (phase A), and to evaluate the effect of hydrogels and dry dressings on moist desquamation (phase B). This paper presents the results of phase A.Patients and methods: Three hundred and fifty seven patients were randomised to apply aqueous cream, sucralfate cream or no cream to the irradiated area from day one of radical radiotherapy treatment. All patients were instructed to wash using unperfumed soap. Acute skin toxicity was measured using a modified radiation therapy oncology group (RTOG) score, reflectance spectrophotometry, patient diary card and dermatology life quality index (DLQI). A cost minimisation approach was used to compare the costs of each skin care approach.Results: No consistent differences were found in the severity of skin reactions or levels of discomfort suffered by patients in each of the randomised groups. Patients with a higher body mass index, who smoked, received concomitant chemotherapy, boost or bolus during treatment were more likely to develop skin reactions.Conclusions: There is no evidence to support the prophylactic application of either of the creams tested for the prevention of radiation skin reactions. Our results show that it is possible to predict which patients are at greatest risk of skin reactions. We suggest that known risk factors should be incorporated into future study protocols. (C) 2004 Elsevier Ireland Ltd. All rights reserved.",
keywords = "radiotherapy, skin care, acute toxicity, breast-cancer patients, aloe-vera gel, double-blind, phase-III, prophylactic agent, neck-cancer, toxicity, therapy, smoking",
author = "M Wells and M Macmillan and G Raab and S MacBride and N Bell and Karen MacKinnon and H MacDougall and Leslie Samuel and Alasdair Munro",
year = "2004",
month = "11",
doi = "10.1016/j.radonc.2004.07.032",
language = "English",
volume = "73",
pages = "153--162",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

TY - JOUR

T1 - Does aqueous or sucralfate cream affect the severity of erythernatous radiation skin reactions? A randomised controlled trial

AU - Wells, M

AU - Macmillan, M

AU - Raab, G

AU - MacBride, S

AU - Bell, N

AU - MacKinnon, Karen

AU - MacDougall, H

AU - Samuel, Leslie

AU - Munro, Alasdair

PY - 2004/11

Y1 - 2004/11

N2 - Background and purpose: Evidence on which to base decisions about the management of radiation skin reactions is lacking. The purpose of this study was to investigate whether sucralfate or aqueous cream reduced acute skin toxicity during radiotherapy to the head and neck, breast or anorectal area (phase A), and to evaluate the effect of hydrogels and dry dressings on moist desquamation (phase B). This paper presents the results of phase A.Patients and methods: Three hundred and fifty seven patients were randomised to apply aqueous cream, sucralfate cream or no cream to the irradiated area from day one of radical radiotherapy treatment. All patients were instructed to wash using unperfumed soap. Acute skin toxicity was measured using a modified radiation therapy oncology group (RTOG) score, reflectance spectrophotometry, patient diary card and dermatology life quality index (DLQI). A cost minimisation approach was used to compare the costs of each skin care approach.Results: No consistent differences were found in the severity of skin reactions or levels of discomfort suffered by patients in each of the randomised groups. Patients with a higher body mass index, who smoked, received concomitant chemotherapy, boost or bolus during treatment were more likely to develop skin reactions.Conclusions: There is no evidence to support the prophylactic application of either of the creams tested for the prevention of radiation skin reactions. Our results show that it is possible to predict which patients are at greatest risk of skin reactions. We suggest that known risk factors should be incorporated into future study protocols. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

AB - Background and purpose: Evidence on which to base decisions about the management of radiation skin reactions is lacking. The purpose of this study was to investigate whether sucralfate or aqueous cream reduced acute skin toxicity during radiotherapy to the head and neck, breast or anorectal area (phase A), and to evaluate the effect of hydrogels and dry dressings on moist desquamation (phase B). This paper presents the results of phase A.Patients and methods: Three hundred and fifty seven patients were randomised to apply aqueous cream, sucralfate cream or no cream to the irradiated area from day one of radical radiotherapy treatment. All patients were instructed to wash using unperfumed soap. Acute skin toxicity was measured using a modified radiation therapy oncology group (RTOG) score, reflectance spectrophotometry, patient diary card and dermatology life quality index (DLQI). A cost minimisation approach was used to compare the costs of each skin care approach.Results: No consistent differences were found in the severity of skin reactions or levels of discomfort suffered by patients in each of the randomised groups. Patients with a higher body mass index, who smoked, received concomitant chemotherapy, boost or bolus during treatment were more likely to develop skin reactions.Conclusions: There is no evidence to support the prophylactic application of either of the creams tested for the prevention of radiation skin reactions. Our results show that it is possible to predict which patients are at greatest risk of skin reactions. We suggest that known risk factors should be incorporated into future study protocols. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

KW - radiotherapy

KW - skin care

KW - acute toxicity

KW - breast-cancer patients

KW - aloe-vera gel

KW - double-blind

KW - phase-III

KW - prophylactic agent

KW - neck-cancer

KW - toxicity

KW - therapy

KW - smoking

U2 - 10.1016/j.radonc.2004.07.032

DO - 10.1016/j.radonc.2004.07.032

M3 - Article

VL - 73

SP - 153

EP - 162

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

SN - 0167-8140

IS - 2

ER -