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Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials

PURPOSE: Radiation dermatitis (RD) is the most common side effect of adjuvant whole-breast or chest wall irradiation, majorly impacting quality of life in numerous patients. The use of barrier films (polyurethane dressings such as Hydrofilm® and Mepitel® film remaining on the skin for the duration o...

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Autores principales: Dejonckheere, Cas Stefaan, Dejonckheere, Egon, Layer, Julian Philipp, Layer, Katharina, Sarria, Gustavo Renato, Koch, David, Abramian, Alina, Kaiser, Christina, Lindner, Kira, Bachmann, Anne, Anzböck, Teresa, Röhner, Fred, Schmeel, Frederic Carsten, Schmeel, Leonard Christopher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10404536/
https://www.ncbi.nlm.nih.gov/pubmed/37473629
http://dx.doi.org/10.1016/j.breast.2023.07.001
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author Dejonckheere, Cas Stefaan
Dejonckheere, Egon
Layer, Julian Philipp
Layer, Katharina
Sarria, Gustavo Renato
Koch, David
Abramian, Alina
Kaiser, Christina
Lindner, Kira
Bachmann, Anne
Anzböck, Teresa
Röhner, Fred
Schmeel, Frederic Carsten
Schmeel, Leonard Christopher
author_facet Dejonckheere, Cas Stefaan
Dejonckheere, Egon
Layer, Julian Philipp
Layer, Katharina
Sarria, Gustavo Renato
Koch, David
Abramian, Alina
Kaiser, Christina
Lindner, Kira
Bachmann, Anne
Anzböck, Teresa
Röhner, Fred
Schmeel, Frederic Carsten
Schmeel, Leonard Christopher
author_sort Dejonckheere, Cas Stefaan
collection PubMed
description PURPOSE: Radiation dermatitis (RD) is the most common side effect of adjuvant whole-breast or chest wall irradiation, majorly impacting quality of life in numerous patients. The use of barrier films (polyurethane dressings such as Hydrofilm® and Mepitel® film remaining on the skin for the duration of the radiation treatment) has been investigated as a prophylactic measure in several prospective trials. Here, we critically appraise the available evidence behind preventive barrier film application in the context of breast cancer treatment. METHODS: International literature was reviewed and high-quality randomised controlled trials (RCTs) were included in this meta-analysis. RESULTS: The results of 5 RCTs (663 patients; >90% Caucasian) were analysed. Overall, barrier films lead to improved clinician- and patient-reported outcomes: fewer grade ≥2 RD (11% vs. 42%; OR = 0.16; p < 0.001) and moist desquamation (2% vs. 16%; OR = 0.12; p = 0.006), as well as less patient-reported pain (standardised mean difference [SMD] −0.51; p < 0.001), itching (SMD −0.52; p = 0.001), burning (SMD −0.41; p = 0.011), and limitations in daily activities (SMD −0.20; p = 0.007). Furthermore, barrier films have a high acceptance rate among patients, as well as a favourable cost-benefit ratio. Possible side effects due to its application are mild and mostly self-limiting. Overall, there was a lack of information on the radiation treatment techniques used. CONCLUSION: The evidence presented in this meta-analysis suggests that barrier films are an excellent tool in the prevention of RD among Caucasian patients receiving whole-breast or chest wall irradiation. Its use should therefore be considered routinely in these patients.
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spelling pubmed-104045362023-08-08 Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials Dejonckheere, Cas Stefaan Dejonckheere, Egon Layer, Julian Philipp Layer, Katharina Sarria, Gustavo Renato Koch, David Abramian, Alina Kaiser, Christina Lindner, Kira Bachmann, Anne Anzböck, Teresa Röhner, Fred Schmeel, Frederic Carsten Schmeel, Leonard Christopher Breast Review PURPOSE: Radiation dermatitis (RD) is the most common side effect of adjuvant whole-breast or chest wall irradiation, majorly impacting quality of life in numerous patients. The use of barrier films (polyurethane dressings such as Hydrofilm® and Mepitel® film remaining on the skin for the duration of the radiation treatment) has been investigated as a prophylactic measure in several prospective trials. Here, we critically appraise the available evidence behind preventive barrier film application in the context of breast cancer treatment. METHODS: International literature was reviewed and high-quality randomised controlled trials (RCTs) were included in this meta-analysis. RESULTS: The results of 5 RCTs (663 patients; >90% Caucasian) were analysed. Overall, barrier films lead to improved clinician- and patient-reported outcomes: fewer grade ≥2 RD (11% vs. 42%; OR = 0.16; p < 0.001) and moist desquamation (2% vs. 16%; OR = 0.12; p = 0.006), as well as less patient-reported pain (standardised mean difference [SMD] −0.51; p < 0.001), itching (SMD −0.52; p = 0.001), burning (SMD −0.41; p = 0.011), and limitations in daily activities (SMD −0.20; p = 0.007). Furthermore, barrier films have a high acceptance rate among patients, as well as a favourable cost-benefit ratio. Possible side effects due to its application are mild and mostly self-limiting. Overall, there was a lack of information on the radiation treatment techniques used. CONCLUSION: The evidence presented in this meta-analysis suggests that barrier films are an excellent tool in the prevention of RD among Caucasian patients receiving whole-breast or chest wall irradiation. Its use should therefore be considered routinely in these patients. Elsevier 2023-07-05 /pmc/articles/PMC10404536/ /pubmed/37473629 http://dx.doi.org/10.1016/j.breast.2023.07.001 Text en © 2023 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Dejonckheere, Cas Stefaan
Dejonckheere, Egon
Layer, Julian Philipp
Layer, Katharina
Sarria, Gustavo Renato
Koch, David
Abramian, Alina
Kaiser, Christina
Lindner, Kira
Bachmann, Anne
Anzböck, Teresa
Röhner, Fred
Schmeel, Frederic Carsten
Schmeel, Leonard Christopher
Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials
title Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials
title_full Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials
title_fullStr Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials
title_full_unstemmed Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials
title_short Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials
title_sort barrier films for the prevention of acute radiation dermatitis in breast cancer: a systematic review and meta-analysis of randomised controlled trials
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10404536/
https://www.ncbi.nlm.nih.gov/pubmed/37473629
http://dx.doi.org/10.1016/j.breast.2023.07.001
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