Bazire Louis, Fromantin Isabelle, Diallo Alhassane, de la Lande Brigitte, Pernin Victor, Dendale Remi, Fourquet Alain, Savignoni Alexia, Kirova Youlia M
Institut Curie, Paris, France.
Institut Curie, Paris, France.
Radiother Oncol. 2015 Nov;117(2):229-33. doi: 10.1016/j.radonc.2015.08.028. Epub 2015 Aug 29.
To report the efficacy of Hydrosorb® versus control (water based spray) as topical treatment of grade 1-2 radiodermatitis in patients (pts) treated for early stage breast cancer (BC) with normo fractionated radiotherapy (RT).
BC pts were randomized to receive either Hydrosorb® (A) or water based spray (B). The primary endpoint was local treatment failure defined as interruption of RT because of skin radiotoxicity or change of local care because of skin alteration. Secondary endpoints were: evaluation of skin colorimetry, pain, quality of life.
Two-hundred seventy-eight pts were enrolled. There were 186 successfully treated pts. There were 60 "failures" in the Hydrosorb® arm, and 62 in the control arm (p=0.72), but mostly without interruption of the RT. Twenty-four pts stopped RT for local care. The average absolute reduction of colorimetric levels between day 28 and day 0 was 4 in the Hydrosorb®, and 4.2 in the water spray groups, respectively (p=0.36). Forty-eight patients in the Hydrosorb® arm had a VAS >2 versus 51 pts in the placebo arm, i.e. 34% and 38%, respectively (p=0.45). A significant reduction of pain was observed on D7 and D21 in the Hydrosorb® arm.
The present study showed no significant difference between Hydrosorb® and simple water spray in the treatment of acute radio-induced dermatitis even if there was a trend to an improvement in pain at the first weeks after the treatment. Systematic prevention measures and modern breast cancer radiotherapy techniques now allow excellent tolerability, but the place of topical treatment to optimize this tolerability has yet to be defined. It seems that the most important part of the skin care is the prevention of skin reactions using new adapted techniques, as well as strict hygiene.
报告水凝胶敷料(Hydrosorb®)与对照(水性喷雾剂)相比,作为局部治疗早期乳腺癌(BC)患者接受常规分割放疗(RT)时1-2级放射性皮炎的疗效。
BC患者被随机分为接受水凝胶敷料(A组)或水性喷雾剂(B组)。主要终点是局部治疗失败,定义为因皮肤放射毒性而中断放疗或因皮肤改变而改变局部护理。次要终点包括:皮肤比色法评估、疼痛、生活质量。
共纳入278例患者。186例患者得到成功治疗。水凝胶敷料组有60例“治疗失败”,对照组有62例(p = 0.72),但大多数患者放疗未中断。24例患者因局部护理而停止放疗。水凝胶敷料组在第28天和第0天之间比色水平的平均绝对降低值为4,水性喷雾剂组为4.2(p = 0.36)。水凝胶敷料组48例患者视觉模拟评分(VAS)>2,安慰剂组为51例,即分别为34%和38%(p = 0.45)。水凝胶敷料组在第7天和第21天观察到疼痛显著减轻。
本研究表明,水凝胶敷料与单纯水性喷雾剂在治疗急性放射性皮炎方面无显著差异,即使在治疗后的头几周疼痛有改善趋势。系统的预防措施和现代乳腺癌放疗技术现在可实现良好的耐受性,但局部治疗在优化这种耐受性方面的作用尚待确定。似乎皮肤护理最重要的部分是使用新的适用技术预防皮肤反应以及保持严格的卫生。