title: A Dermatitis Control Program (DeCoP) for head and neck cancer patients receiving radiotherapy: a prospective phase II study.
abstract: OBJECTIVE
  We speculated that a systematic program to manage radiation dermatitis might decrease the incidence of severe or fatal cases in head and neck cancer patients receiving radiotherapy. Here, we conducted a prospective phase II study to clarify the clinical benefit of a Dermatitis Control Program (DeCoP) that did not use corticosteroids.
  
  
  METHODS
  Head and neck cancer patients scheduled to receive definitive or postoperative radiotherapy were enrolled. Radiation dermatitis was managed with a DeCoP consisting of a three-step ladder: Step 1, gentle washing; Step 2, gentle washing and moistening of the wound-healing environment; Step 3, prevention against infection, gentle washing and moistening of the wound-healing environment. The primary endpoint was the incidence of grade 4 dermatitis.
  
  
  RESULTS
  A total of 113 patients were registered between January 2009 and February 2010. Eighty patients received radiotherapy as an initial approach, while the remaining 33 received radiotherapy postoperatively. Grade 3 and 4 dermatitis events occurred in 11 (9.7%) and 0 (0%, 95% confidence interval 0-3.2%) patients, respectively. Median radiation dose at the onset of grade 2 dermatitis was 61.5 Gy (range 36-70 Gy) and median period between onset and recovery was 14 days (range 1-46 days).
  
  
  CONCLUSIONS
  The Dermatitis Control Program has promising clinical potential. Radiation dermatitis might be manageable if gentle washing and moistening of the wound-healing environment is done.
authors.affiliation: Division of Radiation Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. szenda@east.ncc.go.jp
authors.forename: Sadamoto
authors.initials: S
authors.lastname: Zenda
authors.forename: Shinobu
authors.initials: S
authors.lastname: Ishi
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Kawashima
authors.forename: Satoko
authors.initials: S
authors.lastname: Arahira
authors.forename: Makoto
authors.initials: M
authors.lastname: Tahara
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
authors.forename: Seiji
authors.initials: S
authors.lastname: Kishimoto
authors.forename: Tomiko
authors.initials: T
authors.lastname: Ichihashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000473:pathology* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011829:Radiation Dosage; D011855:Radiodermatitis / Q000188:drug therapy* / Q000473:pathology; D014945:Wound Healing