Department of Radiation Oncology, Seyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Shiri Bridge, Isfahan, Iran.
Support Care Cancer. 2012 Aug;20(8):1613-8. doi: 10.1007/s00520-011-1250-5. Epub 2011 Oct 19.
This study aimed to evaluate the effectiveness of topical silver sulfadiazine (SSD) in preventing acute radiation dermatitis in women receiving radiotherapy for breast cancer.
A randomized controlled clinical trial was conducted on patients with breast cancer referred for radiotherapy after treatment with mastectomy and chemotherapy. The patients were randomized into the intervention (n = 51) and control (n = 51) groups and were instructed on general skin care during radiotherapy. The intervention group received SSD cream 1%, three times a day, 3 days a week, for 5 weeks during radiotherapy and one week thereafter. A blinded observer assessed the severity of dermatitis weekly (for 6 weeks) and graded it from 0 to 4 according to the Radiation Therapy Oncology Group criteria.
The two groups were similar in baseline characteristics. Two patients in the control group discontinued the radiotherapy course because of severe skin injuries (grades 3 and 4). The intervention group encountered significantly less severe dermatitis during radiotherapy compared to the controls. The total score of skin injury was also lower in the intervention group compared with controls (5.49 ± 1.02 vs. 7.21 ± 1.76, p < 0.001). A multivariate analysis found that the use of SSD cream (p < 0.001) and flat chest wall anatomy (p = 0.008) were significantly associated with a decreased skin injury.
SSD cream reduced the severity of radiation-induced skin injury compared with general skin care alone. Further studies in patients with other types of cancer and also comparing SSD cream with other topical agents are warranted.
本研究旨在评估局部磺胺嘧啶银（SSD）在预防接受乳腺癌放疗的女性急性放射性皮炎方面的有效性。
对接受乳腺癌根治术和化疗后行放疗的乳腺癌患者进行了一项随机对照临床试验。患者随机分为干预组（n = 51）和对照组（n = 51），并在放疗期间接受一般皮肤护理指导。干预组在放疗期间每周 3 天、每天 3 次使用 1% SSD 乳膏，共 5 周，之后再使用 1 周。由盲法观察者每周（共 6 周）评估皮炎严重程度，并根据放射治疗肿瘤学组（RTOG）标准将其分为 0 至 4 级。
两组患者在基线特征方面相似。对照组中有 2 例患者因皮肤损伤严重（3 级和 4 级）而中断放疗。与对照组相比，干预组在放疗期间的皮炎严重程度明显较轻。干预组的皮肤损伤总评分也低于对照组（5.49 ± 1.02 对 7.21 ± 1.76，p < 0.001）。多变量分析发现，SSD 乳膏的使用（p < 0.001）和平坦胸壁解剖结构（p = 0.008）与皮肤损伤减少显著相关。
与单纯使用一般皮肤护理相比，SSD 乳膏可降低放射性皮肤损伤的严重程度。有必要在其他类型的癌症患者中开展进一步研究，并比较 SSD 乳膏与其他局部制剂。
