Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-27T09:17:38.305Z Has data issue: false hasContentIssue false
  • English
  • Français

Radiation dermatitis: the evaluation of a new topical therapy for the treatment and prevention of radiation-induced skin damage and moist desquamation: a multicentre UK case cohort study

Published online by Cambridge University Press:  09 February 2021

K. Johnson ,
G. Fenton  and
R. J. White
K. Johnson*
Affiliation:
Hull University Teaching Hospitals NHS Trust, UK
G. Fenton
Affiliation:
Hull University Teaching Hospitals NHS Trust, UK
R. J. White
Affiliation:
Plymouth Science Park, UK
*
Author for correspondence: Kirstie Johnson, Radiotherapy Department, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham, East Yorkshire HU16 5JQ, UK. Tel: 01482 461216. E-mail: Kirstie.Johnson@hey.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Radiotherapy is a mainstay of cancer therapy for a wide variety of anatomical areas. An unfortunate side effect of treatment can be radiation damage to the skin which can be a painful and debilitating problem. Previous experience from the experimental use of Flamigel® in two large-scale clinical studies on affected skin has proven sufficiently positive for the addition of a new product in the Flamigel® family (now commercially available in the UK as Flamigel RT®, Flen Health UK). The aim of this investigation is to evaluate the use of this new product to study how effective it is in the prevention and/or treatment of radiation-induced skin damage.

Materials and methods:

A survey was conducted among radiotherapy specialist teams in dedicated UK radiotherapy centres between 1 January 2017 and 31 October 2017. This report is of a preliminary evaluation conducted by UK-based specialists on 108 patients undergoing radiotherapy. The scoring system for skin reactions of the ‘Radiation Therapy Oncology Group’ was used.

Results:

Results show that the use of Flamigel® has the potential to soothe (p = 0·0001), reduce pain (p = 0·0001) and reduce pruritus (p = 0·004). The product met the expectations of the clinicians involved (p < 0·0001) of whom most were happy to continue use or to recommend its use to colleagues (p < 0·0001).

Conclusions:

Flamigel® is an effective treatment in the management of radiation-induced skin reactions. Erythema was unchanged through the study period (p = 0·42). No adverse reactions were reported after the use of Flamigel from twice to six times a day.

Keywords

breast cancermoist desquamationperineal cancerradiotherapyskin damage
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 4 , December 2021 , pp. 461 - 465
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Glover, D, Harmer, V. Radiotherapy-induced skin reactions: assessment and management. Br J Nurs 2014; 23 (S28): S30–S35.CrossRefGoogle ScholarPubMed
Seite, S, Bensadoun, RJ, Mazer, JM. Prevention and treatment of acute and chronic radiodermatitis. Breast Cancer 2017; 2 (9): 551–557.Google Scholar
Hopewell, JW. The skin: its structure and response to ionizing radiation. Int J Radiat Biol 1990; 57 (4): 751–773.CrossRefGoogle ScholarPubMed
Karbownik, M, Reiter, RJ. Antioxidative effects of melatonin in protection against cellular damage caused by ionizing radiation. Proc Soc Exp Biol Med 2000; 225 (1): 9–22.CrossRefGoogle ScholarPubMed
Koenig, TR, Wolff, D, Mettler, FA, Wagner, LK. Skin injuries from fluoroscopically guided procedures: part 1, characteristics of radiation injury. AJR Am J Roentgenol 2001; 177 (1): 3–11.CrossRefGoogle ScholarPubMed
Kinoshita, K, Ishimine, H, Shiraishi, K, et al. Cell and tissue damage after skin exposure to ionizing radiation: short- and long-term effects after a single and fractional doses. Cells Tissues Organs 2014; 200 (3–4): 240–252.CrossRefGoogle Scholar
Singh, M, Alavi, A, Wong, R, Akita, S. Radiodermatitis: a review of our current understanding. Am J Clin Dermatol 2016; 17 (3): 277–292.CrossRefGoogle ScholarPubMed
Turesson, I, Nyman, J, Holmberg, E et al. Prognostic factors for acute and late skin reactions in radiotherapy patients. Int J Radiat Oncol Biol Phys 1996; 36 (5): 1065–1075.CrossRefGoogle ScholarPubMed
McQuestion, M. Evidenced-based skin care management in radiation therapy. Semin Oncol Nurs 2006; 22 (3): 163–173.CrossRefGoogle Scholar
Rattay, T, Talbot, CJ. Finding the genetic determinants of adverse reactions to radiotherapy. Clin Oncol 2014; 26: 301–308.CrossRefGoogle ScholarPubMed
Sutherland, AE, Bennett, NC, Herst, PM. Psychological stress affects the severity of radiation-induced acute skin reactions in breast cancer patients. Eur J Cancer Care (Engl) 2017; 26 (6); doi: 10.1111/ecc.12737.CrossRefGoogle ScholarPubMed
Hymes, S, Strom, E, Fife, C. Radiation dermatitis: clinical presentation, pathophysiology, and treatment. J Am Acad Dermatol 2006; 54: 28–46.CrossRefGoogle ScholarPubMed
Salvo, N, Barnes, E, van Draanen, J et al. Prophylaxis and management of acute radiation-induced skin reactions: a systematic review of the literature. Curr Oncol 2010; 17 (4): 94–112.CrossRefGoogle ScholarPubMed
Roy, I, Fortin, A, Larochelle, M. The impact of skin washing with water and soap during breast irradiation: a randomized study. Radiother Oncol 2001; 58 (3): 333–339.CrossRefGoogle ScholarPubMed
Haruna, F, Lipsett, A, Marignol, L. Topical management of acute radiation dermatitis in breast cancer patients: a systematic review and meta-analysis. Anticancer Res 2017; 37 (10): 5343–5353.Google ScholarPubMed
Scott, A. Polymeric membrane dressings for radiotherapy-induced skin damage. Brit J Nurs 2014; 23 (10); S26–S31.CrossRefGoogle ScholarPubMed
Society of Radiographer (2015). Skin care advice for patients undergoing radical external beam megavoltage radiotherapy [on-line] https://www.sor.org/learning/document-library/skin-care-advice-patients-undergoing-radical-external-beam-megavoltage-radiotherapy-0. Accessed on 13th August 2019.Google Scholar
Censabella, S, Claes, S, Orlandini, M, Braekers, R, Thijs, H, Bulens, P. Retrospective study of radiotherapy-induced skin reactions in breast cancer patients: reduced incidence of moist desquamation with a hydroactive colloid gel versus dexpanthenol. Eur J Oncol Nurs 2014; 18 (5): 499–504.CrossRefGoogle ScholarPubMed
Censabella, S, Claes, S, Orlandini, M et al. Efficacy of a hydroactive colloid gel versus historical controls for the prevention of radiotherapy-induced moist desquamation in breast cancer patients. Eu J Oncol Nurs 2017; 29: 1–7.CrossRefGoogle ScholarPubMed
Cox, J, Stetz, J, Pajak, T. Toxicity criteria of the radiation therapy oncology group (RTOG) and the European Organisation for Research and Treatment of Cancer (EORTC). Int J Oncol Biol Phys 1995; 31 (5): 1341–1346.CrossRefGoogle Scholar
Brown, LD, Cai, TT, DasGupta, A. Interval estimation for a binomial proportion. Statist Sci 2001; 16 (2): 101–133.CrossRefGoogle Scholar