Momm, F., Weibenberger, C., Bartelt, S., & Henke M. (2003). Moist skin care can diminish acute radiation-induced skin toxicity. Strahlentherapie und Onkologie, 179, 708–712.

To investigate whether moist skin care with 3% urea lotion will reduce acute radiation (RT) skin toxicity.

Irradiated skin of inpatients was treated with 3% urea lotion (Eucerin^® 3%, Beiersdorf).

Outpatients were treated with either urea lotion or powder, depending randomly on the date when they started RT (Azulon^®, Baxter Oncology GmbH, formerly ASTA Medical AWD).

They were instructed to avoid mechanical, chemical, or thermal irritations of the skin, to wear light clothes, and to omit jewelry. Men were told to use an electric shaver.

Starting with the first day of irradiation, irradiated skin was treated with lotion or powder twice daily. At the occurrence of a skin reaction grade I or II, the lotion or powder was given at least five times per day. If skin lesions grade III or IV occurred, treatment with lotion or powder was stopped and the patient received appropriate wound care programs (povidone-iodine and zinc ointments). Findings were compared to those of historical controls.

• The sample was comprised of 88 patients (63 urea lotion, 25 historical controls).
• Age was not reported.
• Of the patients, 85% were male and 15% were female.
• Patients had carcinomas of the head and neck and were undergoing RT with curative intent.
• Mean total dose was 60 Gy (range 50–74 Gy).

Multiple sites in Germany

The study was a single-arm clinical trial with a historical control comparison.

Patients were evaluated weekly for acute skin reactions according to the Radiation Therapy Oncology Group (RTOG) score.

To exclude sampling errors and scoring differences between different observers, all skin evaluations were performed by the same physician.

Results showed that controls had a higher prevalence of skin toxicities at all grades, at lower radiation doses (p < 0.05).

Moist skin care with 3% urea lotion may delay the occurrence of acute RT-induced skin reactions.

• The sample of patients with head and neck cancers was very diverse, and treatment plans varied substantially. A 6-mev machine tends to have more skin toxicity than an accelerator with the ability to perform multienergy.
• A larger proportion of controls were also receiving chemotherapy, which may have skewed the results.
• The study had a relatively small sample and was not randomized.