title: Treatment of acute radiodermatitis with an oil-in-water emulsion following radiation therapy for breast cancer: a controlled, randomized trial.
abstract: BACKGROUND
  A side effect of radiotherapy for breast cancer is acute radiodermatitis. It is a common practice to keep irradiated skin dry on account of data from the 1950s that suggested this regimen limits dermatitis. However, severe dryness of the skin induced by irradiation results in itching and discomfort. Dry skin is characterized by scaliness, epidermal barrier dysfunction, and reduced stratum corneum hydration, and these signs and symptoms are reduced by treatment with an emulsion.
  
  
  METHODS
  We performed a randomized, controlled, open-label study with 66 patients (ITT population), treating the irradiated skin in one group (n = 34) with an oil-in-water emulsion (WO1932), while leaving the other group untreated (n = 32). Clinical scoring (ONS radiation skin reaction scoring, pruritus) and biophysical measurements (stratum corneum hydration and transepidermal water loss (TEWL), as a marker of skin barrier function) were determined at day 1 (directly after termination of the radiation therapy), day 8, and day 47 (± 7).
  
  
  RESULTS
  Irradiation increased the ONS score and pruritus, whereas skin hydration and TEWL were reduced. The primary hypothesis that the increase in skin hydration was significantly greater in the emulsion-treated compared to the untreated group as early as after 8 days of treatment could not be confirmed. At the end of the study (day 47 ± 7), however, normalization of stratum corneum hydration was more advanced in the treatment group compared to the untreated group and nearly reached the values of the contralateral healthy breast skin. ONS score and pruritus also revealed an advantage for the emulsion-treated group. TEWL did not show significant changes during emulsion treatment. No adverse events were caused by the treatment regimens
  
  
  CONCLUSIONS
  Treatment of radiodermatitis with an oil-in-water emulsion was well tolerated, enhanced stratum corneum hydration, improved clinical indicators, and provided relief from itching.
authors: Department of Dermatology, University Hospitals of Schleswig-Holstein, University of Kiel, Germany. mjensen@dermatology.uni-kiel.de
authors: Jens-Michael
authors: JM
authors: Jensen
authors: Tanja
authors: T
authors: Gau
authors: Jürgen
authors: J
authors: Schultze
authors: Gunter
authors: G
authors: Lemmnitz
authors: Regina
authors: R
authors: Fölster-Holst
authors: Theodor
authors: T
authors: May
authors: Christoph
authors: C
authors: Abels
authors: Ehrhardt
authors: E
authors: Proksch
references: Strahlenther Onkol. 2010 Nov;186(11):621-9
references: 21072624
references: Strahlenther Onkol. 1998 Nov;174 Suppl 3:30-6
references: 9830453
references: J Am Acad Dermatol. 2006 Jan;54(1):28-46
references: 16384753
references: Strahlenther Onkol. 2009 Sep;185(9):582-7
references: 19756424
references: J Invest Dermatol. 2004 Jun;122(6):1423-31
references: 15175033
references: J Wound Ostomy Continence Nurs. 2005 Sep-Oct;32(5):337-9; discussion 339-40
references: 16234729
references: Cancer Radiother. 2010 Jun;14(3):213-6
references: 20427219
references: Skin Pharmacol Physiol. 2008;21(2):75-80
references: 18187966
references: Strahlenther Onkol. 2007 Aug;183(8):426-31
references: 17680222
references: Cutan Ocul Toxicol. 2006;25(3):165-71
references: 16980242
references: J Dtsch Dermatol Ges. 2009 Oct;7(10):899-910
references: 19682176
references: Br J Dermatol. 1997 Aug;137(2):219-25
references: 9292070
references: Contact Dermatitis. 2009 Mar;60(3):123-30
references: 19260908
references: Arch Dermatol. 2001 Aug;137(8):1019-23
references: 11493094
references: Lancet Oncol. 2009 Jul;10(7):736
references: 19573803
references: Strahlenther Onkol. 2002 Jun;178(6):321-9
references: 12122788
references: Acta Derm Venereol. 1993 Oct;73(5):335-9
references: 7904396
references: Oncologist. 2009 Feb;14(2):197-8
references: 19251909
references: Strahlenther Onkol. 2004 May;180(5):315-22
references: 15127162
references: Strahlenther Onkol. 2010 Jan;186(1):36-39
references: 20082186
references: J Allergy Clin Immunol. 2009 May;123(5):1124-33
references: 19410693
references: Strahlenther Onkol. 2009 Apr;185(4):254-9
references: 19370429
references: J Investig Dermatol Symp Proc. 2001 Nov;6(1):87-94
references: 11764293
references: Eur J Dermatol. 2008 May-Jun;18(3):317-21
references: 18474463
references: Contact Dermatitis. 1990 Mar;22(3):164-78
references: 2335090
references: Strahlentherapie. 1963 Jul;121:349-64
references: 14044548
references: Int Arch Occup Environ Health. 2002 Sep;75(7):491-9
references: 12172896
references: Strahlenther Onkol. 1998 Mar;174(3):142-8
references: 9524623
references: Br J Dermatol. 2002 Jun;146(6):983-91
references: 12072066
references: Jpn J Clin Oncol. 2008 May;38(5):334-8
references: 18417501
references: Eur J Cancer Care (Engl). 1999 Sep;8(3):143-53
references: 10763645
references: Curr Probl Dermatol. 2007;34:138-150
references: 17312364
references: Semin Oncol Nurs. 2006 Aug;22(3):163-73
references: 16893745
references: Clin Transl Oncol. 2010 Jan;12(1):43-8
references: 20080470