Ravo, V., Calvanese, M.G., Di Franco, R., Crisci, V., Murino, P., Manzo, R., . . . Muto, P. (2011). Prevention of cutaneous damages induced by radiotherapy in breast cancer: an institutional experience. Tumori, 97(6), 732–736.

To evaluate the most efficient topical hydrating treatment in the prevention of cutaneous radio-induced effects in breast cancer

Topical treatments used in comparison were Pure Vitamin E; Omega 3, 6, and 9; Betaglucan; sodium hyaluronate; Ixoderm; and Xderit. Patients started using the skin emollients at the start of therapy until three months after completion of therapy. They were not allowed to use any other ointments during the course of therapy.  Any patient who developed a grade 2 or higher skin toxicity stopped the topical treatment and were treated with cortisone creams.

• The study sample (N = 100) was comprised of feamle patients with breast cancer.
• In the study sample, 53% had prior chemotherapy and 75% were receiving hormonal agents during and after radiation therapy.

The study took place in across multiple outpatient sites in Italy.

Patients were undergoing active antitumor treatment.

The study used an observational design.

The Radiation Therapy Oncology Group and European Organisation for the Research and Treatment of Cancer skin toxicity grading scale was used.

There were no grade 2 or 3 toxicities. No differences in toxicities associated with individual agents used could be determined because of the number of different agents used and the small number of patients observed.

 No conclusions can be drawn from this report regarding any comparisons of topical agents used.

• The sample size was small, with less than 100 patients.
• The groups had important differences.
• The study had a risk of bias due to no control group, no blinding, and no random assignment.
• Measurement methods were not described.
• Variation in patients regarding the combination of chemotherapy and radiation therapy could influence results.
• No description of total radiation therapy dosages. 
• No patient demographics provided.

 The study does not add much to evidence regarding prevention or management of radiodermatitis.