Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Support Care Cancer. 2023 Aug 16;31(9):524. doi: 10.1007/s00520-023-07982-2.
This systematic review and meta-analysis aimed to evaluate the efficacy of Mepitel film in preventing or treating acute radiation dermatitis (RD) in patients with breast cancer in randomized controlled trials (RCTs).
Embase, APA PsychInfo, Journals@Ovid Full Text, Ovid MEDLINE, PubMed, and Cochrane Trials were searched until December 12, 2022, to identify RCTs on the use of Mepitel film for preventing or treating acute RD from breast cancer radiotherapy. Per-protocol analysis was used to compare outcomes, calculate pooled effect sizes, odds ratio (OR), and 95% confidence intervals (CI), and to create forest plots using random effects analysis in RevMan 5.4.
Three RCTs were included in this review. Mepitel film significantly reduced the incidence of grade 3 RD (OR 0.15 95% CI 0.06, 0.37, p<0.0001) and grade 2 or 3 RD (OR 0.16 95% CI 0.04, 0.65, p=0.01) as scored on either the CTCAE or the RTOG scale. Additionally, Mepitel film significantly reduced RISRAS mean scores assessed by patients and combined researcher and patient (standardized mean difference (SMD) -7.59, 95% CI -14.42, -0.76, p=0.03; SMD -15.36, 95% CI -30.01, -0.71 p=0.04) but not the researcher component of the assessment tool (SMD -17.55, 95% CI -36.94, 1.84, p=0.08).
Mepitel film reduced the incidence of acute RD and improved patient-reported outcomes with minimal side effects, the main one being itchiness. Future research should assess the feasibility of Mepitel film with respect to specific patient-reported outcomes such as health-related quality of life issues associated with its use.
本系统评价和荟萃分析旨在评估 Mepitel 膜在随机对照试验(RCT)中预防或治疗乳腺癌患者急性放射性皮炎(RD)的疗效。
检索 Embase、APA PsychInfo、Journals@Ovid Full Text、Ovid MEDLINE、PubMed 和 Cochrane Trials,截至 2022 年 12 月 12 日,以确定使用 Mepitel 膜预防或治疗乳腺癌放疗后急性 RD 的 RCT。采用意向治疗分析比较结局,计算合并效应量、比值比(OR)和 95%置信区间(CI),并使用 RevMan 5.4 中的随机效应分析创建森林图。
本综述纳入了 3 项 RCT。Mepitel 膜显著降低了 3 级 RD(OR 0.15,95%CI 0.06,0.37,p<0.0001)和 2 级或 3 级 RD(OR 0.16,95%CI 0.04,0.65,p=0.01)的发生率,评分标准为 CTCAE 或 RTOG 量表。此外,Mepitel 膜显著降低了患者和研究者联合评估的放射性皮肤损伤严重程度评分(RISRAS)的平均得分(患者评估的标准化均数差(SMD)-7.59,95%CI -14.42,-0.76,p=0.03;研究者和患者联合评估的 SMD -15.36,95%CI -30.01,-0.71,p=0.04),但未降低评估工具的研究者评估部分的得分(SMD -17.55,95%CI -36.94,1.84,p=0.08)。
Mepitel 膜降低了急性 RD 的发生率,并改善了患者报告的结局,副作用极小,主要是瘙痒。未来的研究应评估 Mepitel 膜在特定患者报告结局方面的可行性,例如与使用相关的健康相关生活质量问题。