Department of Radiation Oncology, Dr. B Borooah Cancer Institute, Gopinath Nagar, Guwahati, Assam, India.
Indian J Cancer. 2021 Jan-Mar;58(1):69-75. doi: 10.4103/ijc.IJC_790_18.
Almost all the patients receiving curative radiotherapy for head and neck cancer develop radiation dermatitis, which many a times leads to treatment interruption and reduce patient compliance. In this study, we evaluated the effect of potent topical steroid (Betamethasone Valerate 0.1%) cream on acute radiation dermatitis in head and neck cancer patients receiving curative radiotherapy.
A total 106 patients of head and neck cancers were randomly divided into arm A (52 patients) and arm B (54 patients). The patient in study arm A were treated with topical betamethasone 0.1% twice daily during radiotherapy/chemo-radiotherapy and arm B was kept as control. The radiation reaction in both the groups was monitored weekly according to Radiation Therapy Oncology Group (RTOG) acute radiation dermatitis grading.
Out of 106 patients, 85 (80.2%) patients completed treatment. Patient in control arm had earlier onset of grade 1 reaction (5.7% in arm A vs 16.7 % in arm B at 2 week, P value 0.157 and 28.8% in arm A vs 50% in arm B at 3 week, P value 0.028) and progression of radiation dermatitis. In 7 week patient in arm A had higher grade 1 reaction (17.3% in arm A vs 0% in arm B), while arm B had higher grade 2 reaction (66.7% arm B vs 55.8% in arm A). There was no difference in incidence of grade 3 and 4 reaction. No difference was observed in time taken for reaction to heal.
Topical Betamethasone can delay the onset and progression of radiation dermatitis in head and neck cancer, without significant delay in wound healing.
几乎所有接受头颈部癌症根治性放疗的患者都会出现放射性皮炎，这往往会导致治疗中断和降低患者的依从性。在这项研究中，我们评估了强效外用皮质类固醇（倍他米松戊酸酯 0.1%）乳膏对头颈部癌症患者接受根治性放疗时急性放射性皮炎的影响。
将 106 例头颈部癌症患者随机分为 A 组（52 例）和 B 组（54 例）。研究组 A 的患者在放疗/放化疗期间每天接受两次外用倍他米松 0.1%治疗，B 组作为对照组。根据放射治疗肿瘤学组（RTOG）急性放射性皮炎分级每周监测两组的放射反应。
106 例患者中，85 例（80.2%）完成治疗。对照组患者 1 级反应的发病时间更早（A 组 2 周时为 5.7%，B 组为 16.7%，P 值为 0.157；A 组 3 周时为 28.8%，B 组为 50%，P 值为 0.028），放射性皮炎进展更快。第 7 周时，A 组患者 1 级反应发生率更高（A 组 17.3%，B 组 0%），而 B 组 2 级反应发生率更高（B 组 66.7%，A 组 55.8%）。3 级和 4 级反应的发生率无差异。反应愈合所需时间无差异。
外用倍他米松可延迟头颈部癌症放射性皮炎的发生和进展，而不会显著延迟伤口愈合。
