Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Department of Supportive Care in Cancer, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
Support Care Cancer. 2023 Mar 17;31(4):217. doi: 10.1007/s00520-023-07677-8.
Radiation dermatitis (RD) is a common side effect of radiation therapy, affecting a majority of breast and head and neck cancer patients with a negative impact on quality of life. Currently, no consensus exists regarding the prevention of RD.
PubMed, Embase and Cochrane databases (1946 to December 2022) were searched using PRISMA guidelines to identify randomized controlled trials (RCTs) that investigated the use of topical non-steroidal agents in the prevention of RD in patients undergoing radiotherapy.
A total of six RCTs were included, comprising 627 patients. Among the topical non-steroidal agents analyzed, only the use of Biafine® in breast cancer patients was significant in preventing grade 4 and 3 + RD as classified by the Radiation Therapy Oncology group (RTOG) scale (OR = 0.07, 95% CI 0.01-0.63, p = 0.02, and OR 0.11, 95% CI 0.03-0.41, p < 0.01, respectively). The remaining agents (trolamine alone and hyaluronic acid/hyaluronan) did not significantly prevent the occurrence of RD.
The results of this systematic review and meta-analysis indicate that Biafine® can prevent grade 3 + RD in breast cancer patients. The use of trolamine and hyaluronic acid does not significantly affect the incidence of RD.
放射性皮炎(RD)是放射治疗的常见副作用,影响大多数乳腺癌和头颈部癌症患者,对生活质量产生负面影响。目前,对于 RD 的预防尚无共识。
根据 PRISMA 指南,检索 PubMed、Embase 和 Cochrane 数据库(1946 年至 2022 年 12 月),以确定调查放疗中使用局部非甾体药物预防 RD 的随机对照试验(RCT)。
共纳入 6 项 RCT,包括 627 名患者。在所分析的局部非甾体药物中,只有比亚芬®在乳腺癌患者中预防 RTOG 分级 4 级和 3+级 RD 具有统计学意义(OR=0.07,95%CI 0.01-0.63,p=0.02,OR=0.11,95%CI 0.03-0.41,p<0.01)。其余药物(单独使用三乙醇胺和透明质酸/透明质酸钠)不能显著预防 RD 的发生。
本系统评价和荟萃分析的结果表明,比亚芬®可预防乳腺癌患者的 3+级 RD。三乙醇胺和透明质酸的使用对 RD 的发生率无显著影响。