Moist skin care can diminish acute radiation-induced skin toxicity.
BACKGROUND
Radiation treatment may induce acute skin reactions. There are several methods of managing them. Validity of these methods, however, is not sufficiently studied. We therefore investigated, whether moist skin care with 3% urea lotion will reduce acute radiation skin toxicity.


METHODS
88 patients with carcinomas of the head and neck undergoing radiotherapy with curative intent (mean total dose 60 Gy, range: 50-74 Gy) were evaluated weekly for acute skin reactions according to the RTOG-CTC score. In 63 patients, moist skin care with 3% urea lotion was performed. The control group consisted of 25 patients receiving conventional dry skin care. The incidence of grade I, II, and III reactions and the radiation dose at occurrence of a particular reaction were determined and statistically analyzed using the log-rank test. The dose-time relations of individual skin reactions are described.


RESULTS
At some point of time during radiotherapy, all patients suffered from acute skin reactions grade I, > 90% from grade II reactions. 50% of patients receiving moist skin care experienced grade I reactions at 26 Gy as compared to 22 Gy in control patients (p = 0.03). Grade II reactions occurred at 51 Gy versus 34 Gy (p = 0.006). Further, 22% of the patients treated with moist skin care suffered from acute skin toxicity grade III as compared to 56% of the controls (p = 0.0007).


CONCLUSIONS
Moist skin care with 3% urea lotion delays the occurrence and reduces the grade of acute skin reactions in percutaneously irradiated patients with head and neck tumors.
Momm
Felix
F
Department of Radiation Therapy, Radiologic University Hospital, Freiburg i. Br., Germany. momm@mst1.ukl.uni-freiburg.de
Weissenberger
Christian
C
Bartelt
Susanne
S
Henke
Michael
M
D004999:Amifostine / Q000008:administration & dosage*; D052176:Azulenes; D002986:Clinical Trials as Topic; D003627:Data Interpretation, Statistical; D019583:Dose Fractionation, Radiation; D004311:Double-Blind Method; D004921:Erythropoietin / Q000008:administration & dosage; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008055:Lipids; D008297:Male; D015337:Multicenter Studies as Topic; D009823:Ointment Bases / Q000008:administration & dosage; D009824:Ointments; D010315:Particle Accelerators; D010919:Placebos; D011832:Radiation Injuries / Q000517:prevention & control*; D011837:Radiation-Protective Agents / Q000008:administration & dosage*; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D011994:Recombinant Proteins; D012717:Sesquiterpenes / Q000008:administration & dosage; D045789:Sesquiterpenes, Guaiane; D012867:Skin / Q000528:radiation effects*; D017592:Skin Care / Q000379:methods*; D013997:Time Factors; D014508:Urea / Q000008:administration & dosage*
D052176:Azulenes; D008055:Lipids; D009823:Ointment Bases; D009824:Ointments; D010919:Placebos; D011837:Radiation-Protective Agents; D011994:Recombinant Proteins; D012717:Sesquiterpenes; D045789:Sesquiterpenes, Guaiane; C103998:epoetin beta; D004921:Erythropoietin; C004451:guaiazulene; C039909:eucerin; D014508:Urea; D004999:Amifostine