Abstract
Radiation dermatitis occurs frequently during adjuvant radiation therapy for breast cancer. Prevention of radiation dermatitis by applying various creams and ointments has a limited success, and Aqua cream which has urea as one of its active ingredients is used in many institutions as a preventive treatment. The primary goal of this study is to assess the effect of vitamin D (calcipotriol) ointment in prevention of radiodermatitis in breast cancer patients compared to Aqua cream. Twenty-three women with localized breast cancer who underwent breast-conserving surgery and opted to receive adjuvant radiotherapy to breast only were enrolled in this study. A cream containing an active vitamin D analog, calcipotriol (Daivonex), was randomly applied either to the medial or to the lateral half of the irradiated breast, while Aqua cream was applied to the complimentary half of the same breast along the whole treatment days, each day, after the delivery of radiation. Skin reaction was recorded and compared between the two halves of the breast. Vitamin D was well tolerated by patients with no local or systemic allergic reactions. Radiation dermatitis was not significantly different between both treatment arms. Topical vitamin D ointment is not superior to Aqua cream for prevention of radiation-induced dermatitis in women treated with adjuvant radiation for breast cancer.
Highlights
Breast cancer is the most frequent malignancy in women in the western world.[1]
We show that topical vitamin D is not superior to the skin hydrating ointment, Aqua cream, in preventing radiation-induced skin toxicity
Vitamin D ointment was well tolerated, and breast skin areas treated with it suffered from similar skin toxicities compared to those inspected in the Aqua cream treated parts
Summary
Breast cancer is the most frequent malignancy in women in the western world.[1]. Breast conserving surgery, followed by breast radiation was shown to be equivalent to total mastectomy, and turned to be a standard of care for patients with breast cancer.[2]. Acute side effects of breast radiation include radiation dermatitis which can range from mild to severe reactions.[3] Prevention of radiation dermatitis using local therapies is so far disappointing.[4]. We have previously showed that in laboratory conditions, the active vitamin D metabolite, calcitriol, protects proliferating keratinocytes from the damage inflicted by ionizing radiation.[5] Calcitriol inhibits both caspase-dependent and caspaseindependent programmed cell death and increases the colony formation capacity of irradiated keratinocytes.[5] These positive preliminary results, prompted us to evaluate the role of topical active vitamin D, calcipotriol, as a measure for preventing skininduced radiation dermatitis in breast cancer patients
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