Abstract 684: Effects of preventive interventions on radiotherapy-induced skin toxicity in women with breast cancer: A systematic review and meta-analysis of randomized controlled trials

Abstract

Abstract Radiation therapy (RT)-induced skin toxicity occurs in 95% of patients undergoing RT for breast cancer. Severe cases can interrupt the original treatment regimen and affect many individuals' overall treatment efficacy and quality of life. Many interventions have been tested for the prevention of RT-induced skin toxicity; however, there are no standard recommendations yet determined. This meta-analysis aimed to evaluate the effect of different preventive interventions for RT-induced skin toxicity among breast cancer patients. We searched PubMed, Web of Science, CINAHL, and PsycINFO databases for randomized controlled trials (RCTs) meeting the inclusion criteria and published until December 2019 following the PRISMA reporting guidelines and the PICO statements. The intervention's effect on the incidence of grade ≥2 acute skin toxicity, moist desquamation, and severity score was estimated using the random-effects meta-analyses. Among 6885 publications identified, 38 studies were included in analyses. A total of 3,380 women age 42-88 years diagnosed with stage 0-III who were undergoing RT for breast cancer from all over the world were included. Identified preventive interventions included non-steroid topical agents, topical steroid agents, oral supplements, laser therapy, and films. The meta-analyses showed that interventions significantly reduced the mean severity score by 0.64 (standardized mean difference=-0.64, 95% CI=-0.85, -0.43; I2=57.6%), the incidence of grade ≥2 skin toxicity by 18% (Risk ratio [RR]=0.82, 95% CI=0.74, 0.90; I2=68.4%), and moist desquamation by 55% (RR=0.45, 95% CI=0.27-0.77, I2=48.2%). Subgroup analyses showed that oral supplements were most promising in preventing grade ≥2 skin toxicity (RR=0.32, 95% CI=0.07-1.34, I2=83.1%), suggesting further replications are needed before definitive conclusions are made. This analysis provided evidence of the effectiveness of interventions on the prevention of RT-induced skin toxicity. The effect was greater in reducing the incidence of more severe cases of moist desquamation. More replicative studies are needed to establish the standard preventive care of RT-induced skin toxicity for women with breast cancer, which can help patients comply with RT regimens and improve patients' quality of life. Citation Format: Claudia R. Figueroa, Rose N. Gelin, Sereen J. Khourshid, Eunkyung Lee. Effects of preventive interventions on radiotherapy-induced skin toxicity in women with breast cancer: A systematic review and meta-analysis of randomized controlled trials [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 684.