Boström A, Lindman H, Swartling C, Berne B, Bergh J
Department of Dermatology, University Hospital, S-751 85, Uppsala, Sweden.
Radiother Oncol. 2001 Jun;59(3):257-65. doi: 10.1016/s0167-8140(01)00327-9.
Radiation-induced dermatitis is a very common side effect of radiation therapy, and may necessitate interruption of the therapy. There is a substantial lack of evidence-based treatments for this condition. The aim of this study was to investigate the effect of mometasone furoate cream (MMF) on radiation dermatitis in a prospective, double-blind, randomized study.
The study comprised 49 patients with node-negative breast cancer. They were operated on with sector resection and scheduled for postoperative radiotherapy using photons with identical radiation qualities and dosage to the breast parenchyma. The patients were randomized to receive either MMF or emollient cream. The cream was applied on the irradiated skin twice a week from the start of radiotherapy until the 12th fraction (24 Gy) and thereafter once daily until 3 weeks after completion of radiation. Both groups additionally received non-blinded emollient cream daily. The intensity of the acute radiation dermatitis was evaluated on a weekly basis regarding erythema and pigmentation, using a reflectance spectrophotometer together with visual scoring of the skin reactions.
MMF in combination with emollient cream treatment significantly decreased acute radiation dermatitis (P=0.0033) compared with emollient cream alone. There was no significant difference in pigmentation between the two groups.
Adding MMF, a potent topical corticosteroid, to an emollient cream is statistically significantly more effective than emollient cream alone in reducing acute radiation dermatitis.
放射性皮炎是放射治疗非常常见的副作用,可能需要中断治疗。对于这种情况,目前严重缺乏循证治疗方法。本研究的目的是在一项前瞻性、双盲、随机研究中,探讨糠酸莫米松乳膏(MMF)对放射性皮炎的疗效。
本研究纳入49例淋巴结阴性乳腺癌患者。她们接受了扇形切除术,并计划对乳腺实质进行术后放疗,使用具有相同辐射质量和剂量的光子。患者被随机分为接受MMF或润肤霜组。从放疗开始至第12次分割照射(24 Gy),每周两次将乳膏涂抹于受照射皮肤,之后每天一次,直至放疗结束后3周。两组患者每天还额外使用非盲法润肤霜。每周使用反射分光光度计并结合皮肤反应的视觉评分,评估急性放射性皮炎的红斑和色素沉着强度。
与单独使用润肤霜相比,MMF联合润肤霜治疗显著降低了急性放射性皮炎(P = 0.0033)。两组之间色素沉着无显著差异。
在润肤霜中添加强效外用皮质类固醇MMF,在减轻急性放射性皮炎方面,在统计学上比单独使用润肤霜更有效。