Chan, R.J., Webster, J., Chung, B., Marquart, L., Ahmed, M., & Garantziotis, S. (2014). Prevention and treatment of acute radiation-induced skin reactions: A systematic review and meta-analysis of randomized controlled trials. BMC Cancer, 14, 53-2407-14-53.

DOI Link

Purpose

STUDY PURPOSE: To assess the effects of interventions aiming to prevent or manage radiation-induced skin reactions (RISRs) in people with cancer
 
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: Cochrane Skin Group Specialized Register, CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL, and LILACS
 
KEYWORDS: Radiation-induced skin reactions; radiation dermatitis; systemic review; meta-analysis; randomized, controlled trials (RCTs)
 
INCLUSION CRITERIA:  All patients receiving external beam radiation; RCTs
 
EXCLUSION CRITERIA: None

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 8,599

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Risk of bias was assessed according to the Cochrane handbook

Sample Characteristics

FINAL NUMBER STUDIES INCLUDED =  47 studies were included in qualitative synthesis (six quantitative syntheses)
 
TOTAL PATIENTS INCLUDED IN REVIEW = 5,688
 
KEY SAMPLE CHARACTERISTICS: Receiving external beam radiation

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Results

Forty-seven studies on the six types of interventions for managing RISR were reviewed (oral systemic medications, skin care practice [washing and deodorant], steroidal topical ointment/cream, dressings, nonsteroidal cream/ointment, and LED vs sham treatment). The results of a meta-analysis of Wobe Mugos versus a control showed an odds ratio of 0.13 (p < 0.0004) in favor of Wobe Mugos. There was a mean difference of -09/92 (p < 0.0001) for Wobe Mugos treatment across two studies including 219 patients. Pentoxifylline was not shown to have an effect. Oral sucralfate and oral antioxidants did not show an effect. Various topical steroids showed mixed results. A meta-analysis of trolamine showed no significant benefit. Washing the skin and using deodorants did not affect skin toxicity scores. Evidence was restricted because of the variation of interventions as it was not easily detectable which products would be most effective. There was no strong evidence for any of the products included in the study. The study quality of most of the included RCTs was only fair, and there were few interventions that were examined in multiple studies.

Conclusions

Additional research studies establishing the effectiveness of multiple skin care products is needed. The findings of this meta-analysis in regard to Wobe Mugos were positive, suggesting that additional, well designed research is warranted.

Limitations

  • Small number of studies per interventions for a meta-analysis
  • Variation in products used
  • No clear information on anatomical sites where the products were used

Nursing Implications

Additional research on skin care products used to manage RISR is needed.

Legacy ID

5106