Laffin Nadine, Smyth Wendy, Heyer Elizabeth, Fasugba Oyebola, Abernethy Gail, Gardner Anne
Author Affiliations: Radiation Therapy Unit (Ms Laffin) and Cancer Clinical Trials (Ms Heyer), Townsville Cancer Centre, The Townsville Hospital; Tropical Health Research Unit for Nursing and Midwifery Practice, Townsville Hospital and Health Service and James Cook University (Dr Smyth and Mss Laffin, Heyer, and Abernethy); and School of Nursing, Midwifery and Nutrition, James Cook University, Townsville, Queensland Australia (Dr Smyth); and School of Nursing, Midwifery and Paramedicine (Signadou Campus), Australian Catholic University, Australian Capital Territory (Dr Gardner and Ms Fasugba).
Cancer Nurs. 2015 May-Jun;38(3):205-14. doi: 10.1097/NCC.0000000000000161.
Inconsistent evidence about product effectiveness to prevent moist desquamation during radiation treatment and minimal research about the acceptability to patients of recommended products prompted this study.
This randomized controlled trial compared the effectiveness of 2 creams at minimizing the incidence of moist desquamation in a tropical setting and explored which product was most acceptable to patients receiving radiation treatment.
Participants (n = 255) were stratified according to breast or chest wall radiation treatment and randomly allocated to use a moisturizing or barrier cream. Nurses assessed radiation skin reactions weekly with a standardized grading system, and patients were telephoned 1 month after completing treatment for a final skin assessment. Participants completed an Acceptability Survey at similar times.
At treatment completion, 15% of participants had moist desquamation. An additional 26% self-reported this at follow-up. Risk factors for moist desquamation included increased breast cup size and body mass index. The barrier cream significantly reduced the incidence of moist desquamation during treatment in patients receiving radiation to the chest wall (χ = 3.93, P = .047). Participants preferred the barrier cream over the moisturizer (χ = 5.81, P = .02) during treatment.
This study identified a relatively high incidence of moist desquamation in patients receiving radiation therapy for breast cancer. Future patients will have information about product effectiveness in minimizing moist desquamation when choosing skin care products.
Structured discharge planning and patient education need to include information about factors that contribute to the likelihood of developing moist desquamation.
关于预防放疗期间湿性脱皮的产品有效性的证据不一致,且对推荐产品在患者中的可接受性研究极少,因此开展了本研究。
本随机对照试验比较了两种乳膏在热带环境中减少湿性脱皮发生率的有效性,并探讨了哪种产品对接受放疗的患者最可接受。
参与者(n = 255)根据乳房或胸壁放疗进行分层,并随机分配使用保湿乳膏或屏障乳膏。护士每周使用标准化分级系统评估放射性皮肤反应,治疗完成1个月后给患者打电话进行最终皮肤评估。参与者在相似时间完成可接受性调查。
治疗结束时,15%的参与者出现湿性脱皮。另外26%在随访时自述有此情况。湿性脱皮的危险因素包括胸罩罩杯尺寸增加和体重指数升高。屏障乳膏显著降低了胸壁放疗患者治疗期间湿性脱皮的发生率(χ = 3.93,P = .047)。治疗期间,参与者更喜欢屏障乳膏而非保湿乳膏(χ = 5.81,P = .02)。
本研究发现乳腺癌放疗患者中湿性脱皮的发生率相对较高。未来患者在选择护肤品时将了解产品在减少湿性脱皮方面的有效性。
结构化出院计划和患者教育需要包括导致发生湿性脱皮可能性的因素的信息。