Ulff, E., Maroti, M., Serup, J., Nilsson, M., & Falkmer, U. (2016). Prophylactic treatment with a potent corticosteroid cream ameliorates radiodermatitis, independent of radiation schedule: A randomized double blinded study. Radiotherapy and Oncology, 122, 50–53. 

DOI Link

Study Purpose

To evaluate the preventive effect of topical corticosteroids on radiodermatitis

Intervention Characteristics/Basic Study Process

Patients were randomized to use betamethasone or  a moisturizer (Essex) as a control. Patients in the steroid group applied the betamethasone once daily and the moisturizer once daily. Those in the control group applied the moisturizer twice daily. Creams were applied to the irradiated area four hours before or directly after radiation therapy and again in the evening. Creams were applied every day during radiation therapy and for two weeks after the completion of radiation therapy. Symptoms were reported weekly by patients. Radiation Therapy Oncology Group (RTOG) assessment was conducted at the end of radiation treatment.

Sample Characteristics

  • N = 202   
  • MEDIAN AGE = 63 years
  • FEMALES: 100%
  • CURRENT TREATMENT: Radiation, combination radiation and chemotherapy
  • KEY DISEASE CHARACTERISTICS: All had breast cancer. Sixty-seven percent also received chemotherapy.
  • OTHER KEY SAMPLE CHARACTERISTICS: Two percent in each group were smokers.

Setting

  • SITE: Single site   
  • SETTING TYPE: Outpatient    
  • LOCATION: Sweden

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Study Design

Double-blind, randomized, controlled trial with active control

Measurement Instruments/Methods

  • Visual analog scale (VAS) for symptoms of burning and itching
  • RTOG grading

Results

For all patients receiving either conventional or hypofractional radiation therapy, those in the corticosteroid group had a significantly lower incidence of radiodermatitis above grade 1 (p < 0.0001). Symptoms of burning and itching were also less prevalent in patients receiving the steroid at the end of treatment and one week later. There were no differences in outcomes based upon skin type. Compliance with the intervention was greater than 95%.

Conclusions

A potent topical steroid was effective in reducing radiodermatitis severity and symptoms among women treated with radiation therapy for breast cancer.

Nursing Implications

A topical steroid was effective in reducing radiodermatitis. Long-term effects of extended use of strong topical steroids are unknown. Nurses can suggest topical steroid use to reduce symptoms and severity of radiodermatitis.