Efficacy of a hydroactive colloid gel versus historical controls for the prevention of radiotherapy-induced moist desquamation in breast cancer patients

• Published in: European journal of oncology nursing : the official journal of European Oncology Nursing Society 2017-08, Vol.29, p.1-7
• Main Authors: Censabella, Sandrine, PhD, Claes, Stefan, RN, Orlandini, Marc, MSc, Braekers, Roel, PhD, Bulens, Paul, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Breast cancer; Breast Neoplasms - complications; Breast Neoplasms - radiotherapy; Colloids - therapeutic use; Dexpanthenol; Female; Hematology, Oncology and Palliative Medicine; Humans; Hydroactive colloid gel; Hydrocolloid; Hydrogel; Middle Aged; Moist desquamation; Nursing; Pantothenic Acid - analogs & derivatives; Pantothenic Acid - therapeutic use; Quality of Life; Radiation dermatitis; Radiodermatitis; Radiodermatitis - drug therapy; Radiodermatitis - etiology; Radiotherapy - adverse effects; Radiotherapy-induced skin reactions; Wound healing
• ISSN: 1462-3889; 1532-2122
• DOI: 10.1016/j.ejon.2017.04.003

Abstract Purpose Radiotherapy-induced moist desquamation (RIMD) is a complication that can affect patients’ quality of life and jeopardize radiotherapy outcomes. The curative use of a hydroactive colloid gel has previously been shown effective in the management of RIMD in breast cancer patients. This study aimed at investigating the efficacy of this same gel but in the prevention of RIMD. Methods A group of breast cancer patients who applied the hydroactive gel from start to end of post-lumpectomy radiotherapy (Preventive Hydrogel group) were compared with two groups of matched historical controls: a group applying a dexpanthenol cream throughout their therapy and a group applying first the dexpanthenol cream then, after 11–14 fractions of radiotherapy, the hydroactive gel (Curative Hydrogel group). All patients received identical fractionation regimen. The clinical outcomes were the incidence and time to onset of RIMD. Key results After 25 fractions of radiotherapy (50 Gy), patients in the Preventive Hydrogel group (N = 202) developed RIMD significantly less frequently and later than patients in the Dexpanthenol group (N = 131; incidence = 7% vs 35% respectively, odds ratios = 7.27; probability of RIMD-free survival after 50 Gy = 0.88 vs 0.62). There were no significant differences between the Preventive and the Curative Hydrogel group (N = 87). Conclusions These findings confirm our previous results: applying the hydroactive colloid gel, rather than dexpanthenol, delayed the onset and reduced the incidence of RIMD in breast cancer patients. However, applying the hydrogel preventively offered no statistically significant advantages over applying it curatively.