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Decrease of radiation-induced skin reactions in breast cancer patients by preventive application of film dressings—a systematic review

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Abstract

Purpose

Radiation-induced skin reactions remain one of the most frequent side effects of adjuvant radiotherapy for breast cancer, which is the most common global malignancy. In individual cases, we observed a decrease in radiation dermatitis under film dressings used for skin marking purposes. Therefore, we decided to revise the available evidence regarding the prophylactic use of film dressings to reduce radiation dermatitis in breast cancer patients.

Methods

On 20 March 2023, we conducted a systematic review of literature for randomized controlled trials published in the English, German, French, or Spanish language, available in the PubMed database.

Results

Of 82 publications, 9 full texts were assessed and 6 randomized controlled trials were included in the final synthesis. Two trials analyzed the application of polyurethane film (Hydrofilm, Paul Hartmann AG, Heidenheim, Germany), the other four of silicone-based polyurethane film (Mepitel film, Molnlycke Health Care Limited, Milton Keynes, United Kingdom). The evaluation scales Common Terminology Criteria for Adverse Events (CTCAE), Radiation Therapy Oncology Group (RTOG), and the Radiation-Induced Skin Reaction Assessment Scale (RISRAS) were used for assessment. All six trials, with a total of 788 patients yielding data for analysis, demonstrate a significant decrease in radiation-induced skin reactions by use of the film (mainly p < 0.001).

Conclusion

Our analysis demonstrates a significant decrease in radiation-induced skin reactions by prophylactically applied film dressings in breast cancer patients. Consequent preventive use of film dressings might systematically reduce acute radiation-induced skin reactions in these patients.

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Abbreviations

CTCAE:

Common Terminology Criteria for Adverse Events

ITT:

Intention-to-treat

mITT:

Modified intention-to-treat

RCT:

Randomized controlled trial

RISRAS:

Radiation-Induced Skin Reaction Assessment Scale

RTOG:

Radiation Therapy Oncology Group

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Funding

This systematic review was supported by the Department of Radiation Oncology, Ortenau Klinikum Offenburg-Kehl, Offenburg (Germany).

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Authors and Affiliations

  1. Department of Radiation Oncology, Ortenau Klinikum Offenburg-Kehl, Academic Teaching Hospital of the Albert Ludwig University of Freiburg, Weingartenstraße 70, 77654, Offenburg, Germany

    Judith Kraemer M.D. & Felix Momm

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  1. Judith Kraemer M.D.
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Correspondence to Judith Kraemer M.D..

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Conflict of interest

J. Kraemer and F. Momm declare that they have no competing interests.

Ethical standards

This review did not undergo assessment by the Ethical Committee as it is based on literature search. With respect to the case report, we obtained written informed consent from the patient for anonymous publication of the photographs and corresponding information.

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Kraemer, J., Momm, F. Decrease of radiation-induced skin reactions in breast cancer patients by preventive application of film dressings—a systematic review. Strahlenther Onkol 200, 109–122 (2024). https://doi.org/10.1007/s00066-023-02151-0

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