Prophylactic treatment with a potent corticosteroid cream ameliorates radiodermatitis, independent of radiation schedule: A randomized double blinded study

BACKGROUND AND PURPOSE: The study will test the hypothesis that preventive topical steroid treatment instituted from start of radiotherapy can ameliorate acute radiation dermatitis. Subgroups of increased risk of dermatitis are included.

MATERIAL AND METHODS: A double blinded randomized trial in patients with breast cancer receiving adjuvant radiotherapy (RT) after surgery. In total, 202 patients were randomized to betamethasone-17-valerate cream or Essex® cream, a moisturizer. Treatment was assessed by RTOG clinical scoring. Patients' symptoms were recorded. The analyses were stratified for RT schedules as well as for anatomical sites, skin type, breast size and BMI. Patients treated the irradiated area during the radiation period and two weeks following cessation of radiation.

RESULTS: Patients receiving hypofraction RT developed less skin reactions than those treated with conventional RT. Treatment with a potent steroid resulted in clinically and statistically significantly less skin reactions (p<0.001) regardless of RT schedule. The effect of the steroid was prominent in all subgroups.

CONCLUSION: Prophylactic treatment with a strong local steroid is efficient for the prevention and control of acute radiation dermatitis in breast cancer patients treated with adjuvant RT, independent of RT schedule. Preventive application of a potent corticosteroid cream should be used in the routine and instituted at the start of RT.