Efficacy of Topical Honey, Topical Hydrocortisone 1% and Simple Washing on Healing of Radiation-induced Dermatitis in Breast Cancer Patients

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Resident, Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Assistant Professor, Department of Radiation Oncology, Golestan Hospital, Ahwaz University of Medical Sciences, Ahwaz, Iran.

4 Assistant Professor, Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

5 Professor, Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

6 Assistant Professor of Medical Physics, Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Sci-ences, Shiraz, Iran.

Abstract

Background: Although acute radiation dermatitis is a common complication of radiotherapy, there is currently no general consensus regarding the prevention or treatment of choice for this adverse effect. The present study aimed to investigate the efficacy and safety use of topical honey in the treatment of radiation-induced dermatitis.Methods: Ninety breast cancer patients undergone modified radical mastectomy, chemotherapy and chest wall telecobalt radiotherapy (48-50 Gy) and developed grade II-III radiation-induced dermatitis, were randomly assigned to received only daily washing (arm 1), topical honey plus daily washing (arm 2) or topical hydrocortisone 1% plus daily washing (arm 3). The area of wet dermatitis and the severity of subjective symptoms such as itching, pain, oozing and burning were recorded at the end of each week of follow-up for three weeks. The efficacy and safety of topical honey were the primary and the second study endpoints.Finding: The mean age of the patients in treatment arms 1, 2 and 3, were 41.8, 44.5 and 46.1 years respectively. The mean dermatitis areas were 84.3, 84.6 and 84.8 cm2 in treatment arms 1, 2 and 3, respectively. In addition, the mean total radiation doses were 49.5, 49.6 and 49.3 Gy in treatment arms 1, 2 and 3, respectively. There was no significant statistical difference between three treatment arms regarding the rate of subjective symptoms and dermatitis severity. However, topical hydrocortisone 1% significantly improved subjective symptoms (such as itching and burning) compared to topical honey application.Conclusion: The present study suggests that the topical honey cannot reduce subjective symptoms or improve radiation-induced dermatitis severity compared to topical hydrocortisone 1% or daily washing in breast cancer patients receiving radiotherapy.

Keywords

References

  1. Mendelsohn FA, Divino CM, Reis ED, Kerstein MD. Wound care after radiation therapy. Adv Skin Wound Care 2002; 15(5): 216-24.
  2. Bolderston A, Lloyd NS, Wong RK, Holden L, Robb-Blenderman L. The prevention and man-agement of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer 2006; 14(8): 802-17.
  3. Maddocks-Jennings W, Wilkinson JM, Shillington D. Novel approaches to radiotherapy-induced skin reactions: a literature review. Complement Ther Clin Pract 2005; 11(4): 224-31.
  4. Deng G, Cassileth BR. Supportive care and quality of life. In: Perez CA, Brady LW. Principles and practice of radiation oncology. 5th ed. Lippincott-Raven, Philadelphia; 2008: 2016-7
  5. Graham P, Browne L, Capp A, Fox C, Graham J, Hollis J, et al. Randomized, paired com-parison of No-Sting Barrier Film versus sorbolene cream (10% glycerine) skin care during postmastectomy irradiation. Int J Radiat Oncol Biol Phys 2004; 58(1): 241-6.
  6. Miko ET, Johnson T, Peterson N, Homer L, Walts D, Johnson N. Combination glutathione and anthocyanins as an alternative for skin care during external-beam radiation. Am J Surg 2005; 189(5): 627-30.
  7. Hymes SR, Strom EA, Fife C. Radiation dermatitis: clinical presentation, pathophysiology, and treatment 2006. J Am Acad Dermatol 2006; 54(1): 28-46.
  8. Fisher J, Scott C, Stevens R, Marconi B, Cham-pion L, Freedman GM, et al. Randomized phase III study comparing Best Supportive Care to Biafine as a prophylactic agent for radiation-induced skin toxicity for women undergoing breast irradiation: Radiation Therapy Oncology Group (RTOG) 97-13. Int J Radiat Oncol Biol Phys 2000; 48(5): 1307-10.
  9. Bostrom A, Lindman H, Swartling C, Berne B, Bergh J. Potent corticosteroid cream (mometa-sone furoate) significantly reduces acute radiation dermatitis: results from a double-blind, randomized study. Radiother Oncol 2001; 59(3): 257-65.
  10. Zimmermann JS, Wilhelm R, Niehoff P, Schneider R, Kovacs G, Kimmig B. [Prevention and therapy of acute radiation injuries of the skin and mucosa. I. Results of a German multicenter questionnaire]. Strahlenther Onkol 1998; 174(3): 142-8.
  11. Al Waili NS. Topical honey application vs. acyclovir for the treatment of recurrent herpes simplex lesions. Med Sci Monit 2004; 10(8): 94-8.
  12. Moolenaar M, Poorter RL, van der Toorn PP, Lenderink AW, Poortmans P, Egberts AC. The effect of honey compared to conventional treatment on healing of radiotherapy-induced skin toxicity in breast cancer patients. Acta Oncol 2006; 45(5): 623-4.
  13. Potera ME, Lookingbill DP, Stryker JA. Prophylaxis of radiation dermatitis with a topical cortisone cream. Radiology 1982; 143(3): 775-7.
  14. Glees JP, Mameghan-Zadeh H, Sparkes CG. Effectiveness of topical steroids in the control of radiation dermatitis: a randomised trial using 1% hydrocortisone cream and 0.05% clobetasone butyrate (Eumovate). Clin Radiol 1979; 30(4): 397-403.
  15. Williams MS, Burk M, Loprinzi CL, Hill M, Schomberg PJ, Nearhood K et al. Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Int J Radiat Oncol Biol Phys 1996; 36(2): 345-9.
Journal of Isfahan Medical School
Volume 28, Issue 114 - Serial Number 114
September and October 2011
Pages 828-836

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History

  • Receive Date: 07 January 2011
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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