Topical non-steroidal agents for the prevention of radiation dermatitis: a systematic review and meta-analysis

Support Care Cancer. 2023 Mar 17;31(4):217. doi: 10.1007/s00520-023-07677-8.

Abstract

Purpose: Radiation dermatitis (RD) is a common side effect of radiation therapy, affecting a majority of breast and head and neck cancer patients with a negative impact on quality of life. Currently, no consensus exists regarding the prevention of RD.

Methods: PubMed, Embase and Cochrane databases (1946 to December 2022) were searched using PRISMA guidelines to identify randomized controlled trials (RCTs) that investigated the use of topical non-steroidal agents in the prevention of RD in patients undergoing radiotherapy.

Results: A total of six RCTs were included, comprising 627 patients. Among the topical non-steroidal agents analyzed, only the use of Biafine® in breast cancer patients was significant in preventing grade 4 and 3 + RD as classified by the Radiation Therapy Oncology group (RTOG) scale (OR = 0.07, 95% CI 0.01-0.63, p = 0.02, and OR 0.11, 95% CI 0.03-0.41, p < 0.01, respectively). The remaining agents (trolamine alone and hyaluronic acid/hyaluronan) did not significantly prevent the occurrence of RD.

Conclusion: The results of this systematic review and meta-analysis indicate that Biafine® can prevent grade 3 + RD in breast cancer patients. The use of trolamine and hyaluronic acid does not significantly affect the incidence of RD.

Keywords: Head and neck cancer; Non-steroidal agents, Breast cancer; Prevention; Radiation dermatitis; Radiation therapy; Topical agents.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Breast Neoplasms* / complications
  • Breast Neoplasms* / radiotherapy
  • Ethanolamines / therapeutic use
  • Female
  • Humans
  • Hyaluronic Acid / therapeutic use
  • Radiodermatitis* / etiology

Substances

  • triethanolamine
  • Hyaluronic Acid
  • Ethanolamines