Dermatitis during radiation for vulvar carcinoma: prevention and treatment with granulocyte-macrophage colony-stimulating factor impregnated gauze.
The aim of this study was to determine the effectiveness of granulocyte-macrophage colony-stimulating factor (GM-CSF) impregnated gauze in preventing or healing radiation-induced dermatitis. Sixty-one patients were irradiated for vulvar carcinoma. Thirty-seven applied steroid cream at irradiated areas throughout radiotherapy (Group A) and 24 patients applied additionally GM-CSF impregnated gauze (40 micrcog/cm2 of skin-irradiated area, twice per day) in addition to the steroid cream, after 20 Gy of irradiation (Group B). The score of skin reactions (P=0.008, chi2 test) and the time interval of radiotherapy interruption (P=0.037, Mann-Whitney U test) were statistically significantly reduced in Group B patients. Multivariate analysis of variance showed for this group not only a significant reduction in the Sum of Gross Dermatitis Scoring (P<0.001, adjusted for Duration of Dermatitis) but also a significant reduction of the healing time (P=0.02, adjusted for Sum of Gross Dermatitis Scoring). The pain grading was less (P=0.014, chi2 test) and pain reduction was noticed sooner after the application of GM-CSF impregnated gauze (P=0.0017, Mann-Whitney U test). Multivariate logistic regression analysis showed that the only significant effect on dermatitis score is due to Body Mass Index (P=0.034) and the application of GM-CSF (P=0.008). GM-CSF impregnated gauze can be effective in preventing and healing radiation-induced dermatitis and in reducing the interruption intervals of radiotherapy for vulvar carcinomas.
Kouvaris
J R
JR
Aretaieion Hospital, Department of Radiotherapy, University of Athens, Greece. jrkouv@otenet.gr
Kouloulias
V E
VE
Plataniotis
G A
GA
Balafouta
E J
EJ
Vlahos
L J
LJ
D000208:Acute Disease; D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D001623:Betamethasone / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D015400:Clinical Nursing Research; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D011322:Primary Prevention / Q000379:methods; D011855:Radiodermatitis / Q000145:classification / Q000209:etiology / Q000451:nursing* / Q000517:prevention & control*; D012720:Severity of Illness Index; D017592:Skin Care / Q000379:methods* / Q000451:nursing*; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000532:radiotherapy*; D014945:Wound Healing
D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D001623:Betamethasone