Treatment Of Radiation Dermatitis Research Articles

53557 Pumping Up Dermatologic Drug Reformulation: A Novel Phase II/III Clinical Trial of Topically Reformulated Proton-Pump-Inhibitor Esomeprazole for Prevention and Treatment of Radiation Dermatitis in Breast Cancer

53557 Pumping Up Dermatologic Drug Reformulation: A Novel Phase II/III Clinical Trial of Topically Reformulated Proton-Pump-Inhibitor Esomeprazole for Prevention and Treatment of Radiation Dermatitis in Breast Cancer

Perceptions of healthcare professionals on the use of Mepitel Film for the prevention of acute radiation dermatitis in breast cancer.

Randomized clinical trials support Mepitel Film (MF) as a prophylactic treatment for radiation dermatitis (RD) in patients undergoing breast radiotherapy. Although several studies have canvassed the opinion of patients on using MF, no such studies have been done to investigate the perception of healthcare professionals (HCPs). The objective of this study was therefore to investigate the perceptions of HCPs on MF as a treatment option for RD. Anonymized responses to a web-based survey sent to HCPs at a single institution managing patients using MF during breast radiotherapy were analyzed. Of the 28 HCPs contacted, 22 completed the survey, including 6 radiation oncologists (ROs), 11 radiation therapists (RTTs), and 5 nurses. Most HCPs reported MF was better at preventing severe RD than the standard of care and improved radiation-induced skin reactions (n = 20/22, 91%, and n = 19/22, 86%, respectively). MF was recommended for mastectomy patients without reconstruction (n = 15/21, 71%). The majority of HCPs believed that patients' families could be trained to apply and remove MF (n = 19/22, 86%). Many HCPs perceived that implementation of MF would be difficult in terms of maintaining patient flow and wide-scale implementation within their institution (n = 11/22, 50%, and n = 10/22, 46%, respectively). Most HCPs perceived that fewer than 50% of their patients could afford MF if priced at $100 CAD (n = 15/20, 75%). These findings provide insights into the possibility of MF to be incorporated into standard practice of care for RD. Although most HCPs were satisfied with MF as a prophylactic treatment for RD, there are concerns about its resource-intensive operationalization and financial accessibility to patients. Future research should focus on ways to improve HCP experience with MF and to improve its implementation into clinical settings as standard of care.

StrataXRT for the prevention and treatment of radiation dermatitis: a critical review.

The primary objective is to systematically review primary studies, such as randomized control trials (RCTs), feasibility, exploratory, and case studies; and the secondary objective is to evaluate all secondary articles, such as reviews, guidelines, and editorials, relevant to the use of StrataXRT for the prevention and/or management of radiation dermatitis (RD) in cancer patients. A literature search was conducted up to February 26, 2023, for articles investigating the use of StrataXRT for the prevention and treatment of RD, in the following databases: Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar. The keywords "StrataXRT", "dermatitis", "radiotherapy", and "radiation" were used to identify relevant articles. Twenty-seven articles from 2018 to 2022 were identified to fulfill the inclusion criteria of this review, of which nine are primary studies and 18 are secondary papers. Significant heterogeneity was observed in the current literature studying the effects of StrataXRT, making it difficult to make cross-trial comparisons. There is a suggestion of the efficacy of StrataXRT in the prevention and treatment of RD. The findings of this review recommend further adequately powered RCTs with robust methodology including patient and clinician assessments to determine the efficacy of StrataXRT in preventing and treating RD. This is essential to improve the quality of life of patients and identify which groups of patients would benefit most from StrataXRT.

Topical corticosteroids for the prevention of severe radiation dermatitis: a systematic review and meta-analysis.

Radiation dermatitis (RD) is a frequently occurring adverse reaction during radiotherapy in cancer patients. While the use of topical corticosteroids (TCs) is common for the treatment of RD, its role in preventing severe reactions remains unclear. This systematic review and meta-analysis aim to evaluate the evidence on the use of TCs as prophylaxis of RD. A systematic search was conducted using OVID MedLine, Embase, and Cochrane databases (between 1946 and 2023) to identify studies examining TC use in the prevention of severe RD. Statistical analysis was completed using RevMan 5.4 to calculate pooled effect sizes and 95% confidence intervals. Forest plots were then developed using a random effects model. Ten RCTs with a total of 1041 patients met the inclusion criteria. Six studies reported on mometasone furoate (MF) and four studies reported on betamethasone. Both TCs were associated with a significant improvement in the prevention of moist desquamation [OR = 0.34, 95% CI [0.25, 0.47], p < 0.00001], but betamethasone was found to be more effective than MF [OR = 0.29, 95% CI [0.18, 0.46], p < 0.00001 and OR = 0.39, 95% CI [0.25, 0.61], p < 0.0001, respectively]. A similar finding was seen in reducing the development of grade 2 or higher RD according to the Radiation Therapy Oncology Group scale. The current evidence supports the use of TCs in preventing severe reactions of RD. Both MF and betamethasone were found to be effective; however, betamethasone, a higher potency TC, is more effective despite MF being more commonly reported in literature.

PO-1220 Feasibility and compliance of StrataXRT in treatment of radiation dermatitis in head and neck cancer

PO-1220 Feasibility and compliance of StrataXRT in treatment of radiation dermatitis in head and neck cancer

Non-Invasive Physical Plasma for Preventing Radiation Dermatitis in Breast Cancer: A First-In-Human Feasibility Study.

Radiation dermatitis (RD) is the most common acute side effect of breast irradiation. More than a century following the therapeutic utilisation of X-rays, potent preventative and therapeutic options are still lacking. Non-invasive physical plasma (NIPP) is an emerging approach towards treatment of various dermatological disorders. In this study, we sought to determine the safety and feasibility of a NIPP device on RD. Thirty patients undergoing hypofractionated whole-breast irradiation were included. Parallel to radiation treatment, the irradiated breast was treated with NIPP with different application regimens. RD was assessed during and after NIPP/radiation, using clinician- and patient-reported outcomes. Additionally, safety and feasibility features were recorded. None of the patients was prescribed topical corticosteroids and none considered the treatment to be unpleasant. RD was less frequent and milder in comparison with standard skin care. Neither NIPP-related adverse events nor side effects were reported. This proven safety and feasibility profile of a topical NIPP device in the prevention and treatment of RD will be used as the framework for a larger intrapatient-randomised double-blind placebo-controlled trial, using objective and patient-reported outcome measures as an endpoint.

Topical Role of Ozonated Aloe vera Oil in Radiation Dermatitis: Expression of TGF-β and Collagen Density

BACKGROUND: The effect of ozonated Aloe vera in the treatment of radiation dermatitis has not been studied, while long-term use of topical steroids can cause some side effects. AIM: The aim of the study was to analyze the effect of topical administration of ozonated Aloe vera oil on the expression of TGF-β and collagen density in the treatment of radiation dermatitis. METHODS: 36 Sprague Dawley rats were randomized into six groups, namely, K1 (negative control-without therapy), K2 (positive control-hydrocortisone cream 2.5%), P1 (Aloe vera oil), P2, P3, and P4 (ozonized Aloe vera oil 300/600/1200 mg/ml). Termination and immunohistopathological analysis of TGF-β expression and collagen density were performed after 7 days of treatment. RESULTS: Measurement of TGF-β expression by ANNOVA test showed a significant difference between groups p = 0.001. The Post Hoc LSD test showed significant differences between groups K1 and P1, P2, P3, and P4 also between groups K2 and P2, P3, and P4. Measurement of collagen density by Kruskal–Wallis test showed a significant difference between the treatment groups p &lt; 0.001. Post hoc Mann–Whitney test of collagen density found a significant difference between groups K1 and P1, P2, P3, and P4 also between groups K2 and P2, P3, and P4. Spearman’s rho correlation test showed a strong and unidirectional relationship between TGF-β and collagen (p &lt; 0.001 and r = 0.722). CONCLUSION: Topical ozonated Aloe vera oil increased TGF-β expression and collagen density in radiation dermatitis.

Non-steroidal topical preparations for treatment of radiation dermatitis: a WHAM evidence summary

Non-steroidal topical preparations for treatment of radiation dermatitis: a WHAM evidence summary

How to manage radiation-induced dermatitis?

Radiotherapy is one of the treatment methods available for cancer patients. More than half of all cancer patients tre­ated with radiotherapy will experience radiodermatitis during their treatment. There are two commonly used scales to evaluate clinical manifestations: Common Terminology Criteria for Adverse Events (CTCAE) and the Radiation Therapy Oncology Group (RTOG) scale. According to them, the severity of radiation dermatitis ranges from mild erythema to moist desquamation and ulceration. Prevention methods for radiation dermatitis include proper skin hygiene, the use of topical corticosteroids, other non-corticosteroid agents and systemic drugs. Treatment of radiation dermatitis is guided by the severity of skin damage. In grade 1 it can be limited to moisturising the irritated skin field but in more severe reactions (grade 2–4) the use of dressing is essential. There is still a need to investigate new products, techniques or novel approaches to minimize, prevent or treat radiation dermatitis in patients undergoing radiotherapy.

Barrier film for prevention and treatment of radiation dermatitis: a WHAM evidence summary

Barrier film for prevention and treatment of radiation dermatitis: a WHAM evidence summary

IGF-I and Hyaluronic Acid Mitigate the Negative Effect of Irradiation on Human Skin Keratinocytes.

Simple SummaryPatients undergoing radiation therapy for the treatment of various types of cancer often experience side effects such as radiation dermatitis. A gold standard treatment is still lacking. The objective of the present study was to find novel therapeutic strategies for the regeneration and repair of damaged skin areas after irradiation. An in vitro 2D and 3D primary keratinocyte model was used to test the effect of insulin-like growth factor I (IGF-I), keratinocyte growth factor (KGF), platelet lysate (PL), hyaluronic acid (HA), and adipose-derived stem cell (ADSC) conditioned medium on the functional abilities (viability, migration) and the gene expression of irradiated keratinocytes. Hyaluronic acid and IGF-I effectively reduced the irradiation damage of primary keratinocytes by stimulating viability and migration and reducing cell apoptosis and necrosis. These findings indicate that the negative effects of irradiation on keratinocytes located in the patient’s skin can be counterbalanced with HA and IGF-I treatment.Ionizing radiation has become an integral part of modern cancer therapy regimens. Various side effects, such as radiation dermatitis, affect patients in acute and chronic forms and decrease therapy compliance significantly. In this study, primary keratinocytes were irradiated in a 2-dimensional (2D) culture as well as on a 3-dimensional (3D) collagen-elastin matrix with doses of 2 and 5 Gy. The effect of different concentrations of IGF-I, KGF, platelet lysate (PL), high and low molecular weight hyaluronic acid (H-HA, L-HA), and adipose-derived stem cell (ADSC) conditioned medium was analyzed in respect to cell viability (WST-8), wound closure (migration), and the gene expression (quantitative real-time PCR) of 2D cultures. The 3D culture was evaluated by WST-8. A mixture of H-HA and L-HA, as well as IGF-I, could significantly stimulate the keratinocyte viability and migration which were severely reduced by irradiation. The MKI67and IL6 gene expression of irradiated keratinocytes was significantly higher after H-HA/L-HA treatment. The stimulating effects of H-HA/L-HA and IGF-I were able to be confirmed in 3D culture. A positive influence on cell viability, migration, and gene expression was achieved after the treatment with H-L-HA and IGF-I. These results open the possibility of a novel therapeutic method for both the prevention and the treatment of radiation dermatitis.

New photobiomodulation device for prevention and cure of radiotherapy-induced oral mucositis and dermatitis: results of the prospective Safe PBM study.

Purpose The study aims to assess the feasibility, safety, and tolerability of CareMin650, a new photobiomodulation device, in patients treated by radiotherapy (RT) and to collect preliminary data on efficacy for prevention and treatment of oral mucositis (OM) and radiation dermatitis (RD).MethodsSafe PBM is a French, multicentric, prospective, non-comparative study which include patients with head and neck cancer (H&NC, cohort A) or breast cancer (BC, cohort B) treated in prophylactic (cohorts A1 and B1) or curative setting (cohort A2 and B2). Prophylactic treatment was administered from D1 to end of RT, at a dose of 3 J/cm2. Curative treatment started when a grade 1 to grade 3 lesion had occurred and was pursued until end of RT. Primary endpoint was incidence of device-related adverse events (AEs). OM and RD lesions were graded according to CTCAE V3.ResultsOverall, 72 patients were included (22, 9, 23, and 18 in cohorts A1, A2, B1, and B2, respectively). No device-related AE was reported after 1312 CareMin650 sessions. In cohorts A1 and B1, median time to first OM or RD lesion was 20 days. One BC patient developed G3 RD after completion of RT and discontinuation of CareMin650. Four H&NC patients developed G3 OM. In cohorts A2 and B2, lesions improved or stabilized in 71% of patients. Rates of satisfaction were high among patients and users.ConclusionCareMin650 is feasible, safe, and well tolerated for preventive or curative treatment of OM and RD in cancer patients treated with RT. Preliminary efficacy results are promising.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-021-06574-2.

Effectiveness of photobiomodulation therapy in radiation dermatitis: A systematic review and meta-analysis.

To evaluate the effectiveness of photobiomodulation therapy (PBMT) in the prevention and treatment of radiation dermatitis (RD). A systematic review was conducted using seven databases and the gray literature. We performed a meta-analysis to summarize the effect sizes of response rates (RRs). We included seven clinical trials. Breast cancer patients receiving PBMT developed more grade 1 RD than the control group (RR 1.55, 95 % CI 1.14-2.10, I2 = 51 %). PBMT appears to prevent RD grade 2 (RR 0.33, 95 % CI 0.09-1.23, I2 = 85 %) and RD grade 3 (RR 0.21, 95 % CI 0.05-0.94, I2 = 0%) with very low certainty of evidence. There is very low certainty of evidence that PBMT was effective in the prevention of RD. However, PBMT showed a significant effect to prevent grade 3 RD in breast cancer patients. Thus, further randomized clinical trials are required to confirm the promising effect of PBMT in RD.

Topical corticosteroids for prevention and treatment of radiation dermatitis: a WHAM evidence summary

Topical corticosteroids for prevention and treatment of radiation dermatitis: a WHAM evidence summary

Radiation dermatitis: A narrative review of the Indian perspective

One of the common and visible symptoms of radiation toxicity is radiation-induced dermatitis, which varies in intensity from slight erythema to dry and moist desquamation, ulceration, and sometimes skin necrosis. Radiation depletes the basal cell layer of the skin and initiates a complex sequence of events, leading to dose-dependent acute or late sequelae. These skin reactions may cause irritation and pain, delay treatment, and also reduce the quality of life of the patient undergoing radiotherapy. It is also a subject of major concern for female patients undergoing radiotherapy for the treatment of head-and-neck and breast cancers. Despite the technological advancements achieved in planning and delivery in the field of radiotherapy, most patients still experience radiation dermatitis (RD) as a side effect of the treatment. The severity of RD depends on multiple patient- and treatment-related factors. Although severe RD is rare in the current practice of megavoltage radiotherapy, some occasions necessitate active intervention by a multidisciplinary group to manage both acute and late radiation effects over the epidermis and sometimes the dermis. Management policies vary as per the institutional guidelines and personal preferences and are mostly based on individual experiences and reviews. This is a narrative literature review of the various articles focusing on the diverse spectrum of RD. The primary search for the articles was carried out via Google Scholar, PubMed, and MEDLINE with keywords such as “radiation dermatitis,” “radiation-induced skin toxicity,” and “radiation recall phenomenon,” “radiation erythema,” and “radionecrosis.” Additional articles were found through references from the relevant articles. In this review, we discuss the incidence of RD, its presentation, the key aspects that put Indian patients at an increased risk of RD, and the management strategies for the prevention and treatment of radiation dermatitis.

Moisturizer efficacy: A new development in the treatment of radiation dermatitis

Moisturizer efficacy: A new development in the treatment of radiation dermatitis

Referral practices to dermatologists for the treatment of radiation dermatitis in the USA: a call for a multidisciplinary approach.

Acute radiation dermatitis (RD) is a disfiguring and painful rash that occurs in up to 95% of patients receiving radiation therapy (RT) for cancer. Treatment for RD varies among practitioners with no evidence-based gold standard for management. While a multi-disciplinary approach has been utilized to manage other cancer-related toxicities, RD is most often managed by the treating radiation oncologist. This study evaluated the referral practices of radiation oncologists to dermatologists for management of RD utilizing a survey of radiation oncologists across the USA. The goal was to identify the referral practices of radiation oncologists for RD and any barriers to a multidisciplinary approach. Of the 705 respondents, 15% reported ever referring patients to dermatology. Private practitioners referred significantly less than providers in academic or oncology centers (p < 0.01). Practitioners in urban settings were more likely to refer (p < 0.01), and radiation oncologists in the Southeastern USA were less likely to refer (p < 0.01). Lack of timely access to dermatologists in various geographic areas in addition to radiation oncologists' preference to treat RD are barriers to multidisciplinary management of RD. Inclusion of dermatologists and wound care specialists in cancer treatment teams could improve patient care and stimulate needed research into strategies for treatment and prevention of RD.

Reducing radiation dermatitis during ongoing radiation therapy: an innovative film-forming wound dressing

This multicenter study focuses on the use of a film-forming wound dressing in the form of a gel that can be applied directly to the area affected by radiation dermatitis, especially after skin breakdown. The primary objective of the study was to validate the efficacy of an innovative film-forming wound dressing used as monotherapy in the treatment of radiation dermatitis in patients with RTOG score 2.5 (± 0.5) confirmed by the investigator. Fifty-four patients undergoing radiation therapy for different cancer types and developing radiation dermatitis were recruited in the study; they were treated with the film-forming wound dressing when reaching an RTOG score of 2.5 (± 0.5). The evaluation of radiation dermatitis during ongoing radiation therapy was performed using the RISRAS, which includes investigator-assessed items (erythema, dry desquamation, moist desquamation, necrosis) and patient-assessed items (pain, itch, burning sensation, affection of daily activities). The following study shows a statistically significant clinical improvement (p < 0.05) of the RISRAS score (− 16.9%), as well as of specific clinical outcomes, such as erythema (− 20.6%), pain (− 20.5%), itch (− 22.2%), and burning sensation (−24.7%), after the treatment with the film-forming wound dressing during ongoing radiation therapy. Other radiation dermatitis markers, such as inflammation (− 28.9%) and hydration (26.0%), appeared to be significantly influenced. The use of the innovative film-forming wound dressing for radiation dermatitis treatment shows first time evidence of improving the RISRAS score during ongoing radiation therapy, showing major improvements in patients’ quality of life.

Use of trolamine to prevent and treat acute radiation dermatitis: a systematic review and meta-analysis.

ABSTRACTObjective: to evaluate the effects of trolamine in the prevention or treatment of radiation dermatitis. Method: systematic review and meta-analysis. Detailed individual search strategies for Cinahl, Cochrane Library Central, LILACS, PubMed, and Web of Science were developed in January 2016. A manual search was also performed to find additional references. A grey literature search was executed by using Google Scholar. Two researchers independently read the titles and abstracts from every cross-reference. The risk of bias of the included studies was analyzed by the Cochrane Collaboration Risk of Bias Tool. The quality of evidence and grading of strength of recommendations was assessed using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: seven controlled clinical trials were identified. The controls used were calendula, placebo, institutional preference / usual care, Aquaphor®, RadiaCare™, and Lipiderm™. The studies were pooled using frequency of events and risk ratio with 95% confidence intervals, in subgroups according to radiation dermatitis graduation. Conclusion: based on the studies included in this review, trolamine cannot be considered as a standardized product to prevent or treat radiation dermatitis in patients with breast and head and neck cancer.

The Use of an Innovative Film-Forming Wound Dressing in the Treatment of Radiation Dermatitis during Concomitant Chemotherapy

There is currently no consensus regarding the management of acute cutaneous reactions emerging from a concurrent treatment of radio-and chemotherapy, the goal of this case study series is to provide scientific evidence based on clinical practice regarding the efficacy of a film-forming wound dressing for patients receiving combined cancer therapy, in particular examples where the reactions are expected to be intense. In all the described cases, management of acute skin reactions allowed the cancer therapy to be finalized, instead of being interrupted due to an increase in the severity of the reactions. It has been shown in the current literature that the lack of compliance with treatment plans correlates with poorer clinical outcome. Evidence from the cases presented suggest that the studied dressing is safe and efficacious in the treatment and the prevention of acute cutaneous reactions arising from combined cancer therapy.