Topical agent therapy for prevention and treatment of radiodermatitis: a meta-analysis.
BACKGROUND
Radiodermatitis (RD) is a common side effect during radiotherapy. Various topical agents have been tried to be applied on RD. However, the efficiency of topical agents applied on radiotherapy is still uncertain.


OBJECTIVE
This study aims to assess the efficiency of the topical agents in the prevention and treatment of RD.


METHODS
The Cochrane Central Register of Controlled Trials, Pubmed, and Medline were searched for relevant reports. Quantitative analysis was carried out to evaluate the efficiency of topical agents in the prevention and treatment of RD.


RESULTS
Twenty reports involving 3,098 patients were included: 2,406 patients for prophylactic trials and 692 for treatment trials, respectively. For prophylactic trials, primary meta-analysis indicated that using topical agents could not reduce the incidence of grade 2 and higher RD (P = 0.128, RR = 0.90, 95 % CI = 0.78-1.03) with a high heterogeneity (P = 0.000, I(2) = 71.5 %). In subgroup analyses, heterogeneity disappeared by excluding reports with low Jadad score (≤3) (P = 0.292, I(2) = 15.2 %), and still no significant difference was found between the topical agent group and control group (P = 0.625, RR = 0.98, 95 % CI = 0.89-1.07). In addition, for treatment trials, topical agents failed to increase the incidence of wound healing (P = 0.784, RR = 1.01, 95 % CI = 0.92-1.12) with a high heterogeneity (P = 0.067, I (2) = 51.5 %).


CONCLUSIONS
Topical agents could not prevent or treat RD effectively. New type of agents should be developed to improve the efficiency based on the pathophysiology of RD.
Department of VIP Ward, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, People's Republic of China. z2zhangyj@126.com
Yuejiao
Y
Zhang
Shoude
S
Zhang
Xiaoling
X
Shao
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D005069:Evaluation Studies as Topic; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000532:radiotherapy; D011855:Radiodermatitis / Q000188:drug therapy* / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic