title: Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study.
abstract: BACKGROUND
  Radiation dermatitis is a common side-effect of radiation therapy, but there is no current consensus about its appropriate therapy.
  
  
  OBJECTIVE
  To compare treatment with topical 0.1% methylprednisolone vs. 0.5% dexpanthenol in a cohort of patients undergoing fractionated radiation therapy for breast cancer.
  
  
  METHODS
  In a randomized, double-blind design, treatment was initiated at the beginning of radiation therapy and continued for 2 weeks after termination of radiation. Outcomes were compared by three different measures: clinical (symptom score), functional (transepidermal water loss, TEWL) and subjective (quality of life, QOL).
  
  
  RESULTS
  In a preliminary cohort of untreated patients undergoing radiation therapy, clinical signs and TEWL levels increased progressively during radiation therapy, reaching highest values at 5 and 4 weeks, respectively. Although neither topical treatment reduced the incidence of radiation dermatitis, both delayed the emergence of greatest clinical and TEWL scores until approximately 6 and 5 weeks, respectively. With topical corticosteroids, clinical symptoms and TEWL were less pronounced than with dexpanthenol. Whereas general QOL improved after completion of radiation therapy, skin-related QOL declined. However, the skin-related QOL decline could be at least in part reversed by use of topical corticosteroid vs. dexpanthenol-containing emollient.
  
  
  CONCLUSIONS
  We provide evidence that prophylactic and ongoing use of topical therapy with either topical corticosteroid or a dexpanthenol-containing emollient ameliorates, but does not prevent radiation dermatitis. Our data suggest, but do not prove, a benefit of a topical corticosteroid vs. a dexpanthenol-containing emollient. Further controlled studies with larger cohorts will be needed to determine optimal forms of topical therapy for radiation dermatitis.
authors.affiliation: Department of Dermatology, University of Innsbruck, Austria. matthias.schmuth@uibk.ac.at
authors.forename: M
authors.initials: M
authors.lastname: Schmuth
authors.forename: M A
authors.initials: MA
authors.lastname: Wimmer
authors.forename: S
authors.initials: S
authors.lastname: Hofer
authors.forename: A
authors.initials: A
authors.lastname: Sztankay
authors.forename: G
authors.initials: G
authors.lastname: Weinlich
authors.forename: D M
authors.initials: DM
authors.lastname: Linder
authors.forename: P M
authors.initials: PM
authors.lastname: Elias
authors.forename: P O
authors.initials: PO
authors.lastname: Fritsch
authors.forename: E
authors.initials: E
authors.lastname: Fritsch
mesh_terms: D000208:Acute Disease; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000532:radiotherapy; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D008875:Middle Aged; D009824:Ointments; D010205:Pantothenic Acid / Q000008:administration & dosage* / Q000031:analogs & derivatives; D011446:Prospective Studies; D011855:Radiodermatitis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D009824:Ointments; D010205:Pantothenic Acid; C007288:dexpanthenol; C078007:methylprednisolone aceponate; D008775:Methylprednisolone