Silver clear nylon dressing is effective in preventing radiation-induced dermatitis in patients with lower gastrointestinal cancer: results from a phase III study.
OBJECTIVE
For patients with anal canal and advanced rectal cancer, chemoradiation therapy is a curative modality or an important adjunct to surgery. Nearly all patients treated with chemoradiation experience some degree of radiation-induced dermatitis (RID). Prevention and effective treatment of RID, therefore, is of considerable clinical relevance. The present phase III randomized trial compared the efficacy of silver clear nylon dressing (SCND) with that of standard skin care for these patients.


METHODS
A total of 42 rectal or anal canal cancer patients were randomized to either a SCND or standard skin care group. SCND was applied from Day 1 of radiation therapy (RT) until 2 weeks after treatment completion. In the control arm, sulfadiazine cream was applied at the time of skin dermatitis. Printed digital photographs taken 2 weeks prior to, on the last day, and two weeks after the treatment completion were scored by 10 blinded readers, who used the common toxicity scoring system for skin dermatitis.


RESULTS
The radiation dose ranged from 50.4 to 59.4 Gy, and there were no differences between the 2 groups. On the last day of RT, when the most severe RID occurs, the mean dermatitis score was 2.53 (standard deviation [SD], 1.17) for the standard and 1.67 (SD, 1.2; P=.01) for the SCND arm. At 2 weeks after RT, the difference was 0.39 points in favor of SCND (P=.39). There was considerable intraclass correlation among the 10 observers.


CONCLUSIONS
Silver clear nylon dressing is effective in reducing RID in patients with lower gastrointestinal cancer treated with combined chemotherapy and radiation treatment.
Segal Cancer Centre, Department of Radiation Oncology, Jewish General Hospital, McGill University, Canada.
Tamim M
TM
Niazi
Te
T
Vuong
Laurant
L
Azoulay
Corrie
C
Marijnen
Kryzstof
K
Bujko
Elie
E
Nasr
Christine
C
Lambert
Marie
M
Duclos
Sergio
S
Faria
Marc
M
David
Bernard
B
Cummings
D000368:Aged; D001005:Anus Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D001458:Bandages; D003879:Dermatologic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009757:Nylons; D010781:Photography; D011446:Prospective Studies; D011481:Protective Clothing; D011855:Radiodermatitis / Q000517:prevention & control*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D012837:Silver Sulfadiazine / Q000008:administration & dosage* / Q000627:therapeutic use; D063465:Skin Cream / Q000008:administration & dosage; D013411:Sulfadiazine / Q000008:administration & dosage
D003879:Dermatologic Agents; D009757:Nylons; D013411:Sulfadiazine; D012837:Silver Sulfadiazine