International Journal of Clinical Oncology

, Volume 18, Issue 2, pp 350–355 | Cite as

A Dermatitis Control Program (DeCoP) for head and neck cancer patients receiving radiotherapy: a prospective phase II study

  • Sadamoto Zenda
  • Shinobu Ishi
  • Mitsuhiko Kawashima
  • Satoko Arahira
  • Makoto Tahara
  • Ryuichi Hayashi
  • Seiji Kishimoto
  • Tomiko Ichihashi
Original Article



We speculated that a systematic program to manage radiation dermatitis might decrease the incidence of severe or fatal cases in head and neck cancer patients receiving radiotherapy. Here, we conducted a prospective phase II study to clarify the clinical benefit of a Dermatitis Control Program (DeCoP) that did not use corticosteroids.

Patients and methods

Head and neck cancer patients scheduled to receive definitive or postoperative radiotherapy were enrolled. Radiation dermatitis was managed with a DeCoP consisting of a three-step ladder: Step 1, gentle washing; Step 2, gentle washing and moistening of the wound-healing environment; Step 3, prevention against infection, gentle washing and moistening of the wound-healing environment. The primary endpoint was the incidence of grade 4 dermatitis.


A total of 113 patients were registered between January 2009 and February 2010. Eighty patients received radiotherapy as an initial approach, while the remaining 33 received radiotherapy postoperatively. Grade 3 and 4 dermatitis events occurred in 11 (9.7%) and 0 (0%, 95% confidence interval 0–3.2%) patients, respectively. Median radiation dose at the onset of grade 2 dermatitis was 61.5 Gy (range 36–70 Gy) and median period between onset and recovery was 14 days (range 1–46 days).


The Dermatitis Control Program has promising clinical potential. Radiation dermatitis might be manageable if gentle washing and moistening of the wound-healing environment is done.


Head and neck cancer Cancer nursing Dermatitis Radiotherapy 



This study was supported by the Foundation for Promotion of Cancer Research.

Conflict of interest

There is no conflict of interest.


  1. 1.
    Seiwert TY, Cohen EE (2005) State-of-the-art management of locally advanced head and neck cancer. Br J Cancer 92:1341–1348PubMedCrossRefGoogle Scholar
  2. 2.
    Adelstein DJ, Li Y, Adams GL et al (2003) An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol 21:92–98PubMedCrossRefGoogle Scholar
  3. 3.
    Forastiere AA, Goepfert H, Maor M et al (2003) Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 349:2091–2098PubMedCrossRefGoogle Scholar
  4. 4.
    Cooper JS, Pajak TF, Forastiere AA et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944PubMedCrossRefGoogle Scholar
  5. 5.
    Bernier J, Domenge C, Ozsahin M et al (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350:1945–1952PubMedCrossRefGoogle Scholar
  6. 6.
    Bernier J, Cooper JS, Pajak TF et al (2005) Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck 27:843–850PubMedCrossRefGoogle Scholar
  7. 7.
    Posner MR, Hershock DM, Blajman CR et al (2007) Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357:1705–1715PubMedCrossRefGoogle Scholar
  8. 8.
    Vermorken JB, Remenar E, van Herpen C et al (2007) Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 357:1695–1704PubMedCrossRefGoogle Scholar
  9. 9.
    Bolderston A, Lloyd NS, Wong RK et al (2006) The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer 14:802–817PubMedCrossRefGoogle Scholar
  10. 10.
    Evensen JF, Bjordal K, Jacobsen AB et al (2001) Effects of Na-sucrose octasulfate on skin and mucosa reactions during radiotherapy of head and neck cancers—a randomized prospective study. Acta Oncol 40:751–755PubMedCrossRefGoogle Scholar
  11. 11.
    Campbell IR, Illingworth MH (1992) Can patients wash during radiotherapy to the breast or chest wall? A randomized controlled trial. Clin Oncol (R Coll Radiol) 4:78–82CrossRefGoogle Scholar
  12. 12.
    McQuestion M (2006) Evidence-based skin care management in radiation therapy. Semin Oncol Nurs 22:163–173PubMedCrossRefGoogle Scholar
  13. 13.
    Roy I, Fortin A, Larochelle M (2001) The impact of skin washing with water and soap during breast irradiation: a randomized study. Radiother Oncol 58:333–339PubMedCrossRefGoogle Scholar
  14. 14.
    Lokkevik E, Skovlund E, Reitan JB et al (1996) Skin treatment with bepanthen cream versus no cream during radiotherapy—a randomized controlled trial. Acta Oncol 35:1021–1026PubMedCrossRefGoogle Scholar
  15. 15.
    Bostrom A, Lindman H, Swartling C et al (2001) Potent corticosteroid cream (mometasone furoate) significantly reduces acute radiation dermatitis: results from a double-blind, randomized study. Radiother Oncol 59:257–265PubMedCrossRefGoogle Scholar
  16. 16.
    Schmuth M, Wimmer MA, Hofer S et al (2002) Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study. Br J Dermatol 146:983–991PubMedCrossRefGoogle Scholar

Copyright information

© Japan Society of Clinical Oncology 2012

Authors and Affiliations

  • Sadamoto Zenda
    • 1
    • 4
  • Shinobu Ishi
    • 1
  • Mitsuhiko Kawashima
    • 1
  • Satoko Arahira
    • 1
  • Makoto Tahara
    • 2
  • Ryuichi Hayashi
    • 3
  • Seiji Kishimoto
    • 4
  • Tomiko Ichihashi
    • 1
  1. 1.Division of Radiation OncologyNational Cancer Center Hospital EastKashiwaJapan
  2. 2.Gastrointestinal Oncology and EndoscopyNational Cancer Center Hospital EastKashiwaJapan
  3. 3.Head and Neck SurgeryNational Cancer Center Hospital EastKashiwaJapan
  4. 4.Department of Head and Neck SurgeryTokyo Medical and Dental UniversityTokyoJapan

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