title: The safety and efficacy of EGF-based cream for the prevention of radiotherapy-induced skin injury: results from a multicenter observational study.
abstract: OBJECTIVE
  This study was designed to evaluate the efficacy and safety of topically applied recombinant human epidermal growth factor (rhEGF) for the prevention of radiation-induced dermatitis in cancer patients.
  
  
  METHODS
  From December 2010 to April 2012, a total of 1,172 cancer patients who received radiotherapy (RT) of more than 50 Gy were prospectively enrolled and treated with EGF-based cream. An acute skin reaction classified according to the Radiation Therapy Oncology Group 6-point rating scale was the primary end point and we also assessed the occurrence of edema, dry skin, or pruritus.
  
  
  RESULTS
  The percentage of radiation dermatitis with maximum grade 0 and grade 1 was 19% and 58% at the time of 50 Gy, and it became 29% and 47% after completion of planned RT. This increment was observed only in breast cancer patients (from 18%/62% to 32%/49%). Adverse events related to the EGF-based cream developed in 49 patients (4%) with mild erythema the most common. Skin toxicity grade >2 was observed in 5% of the patients. Edema, dry skin, and pruritus grade ≥3 developed in 9%, 9%, and 1% of the patients, respectively.
  
  
  CONCLUSIONS
  Prophylactic use of an EGF-based cream is effective in preventing radiation dermatitis with tolerable toxicity. Further studies comparing EGF cream with other topical agents may be necessary.
authors.affiliation: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. ; Department of Radiation Oncology, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea.
authors.forename: Hyun-Cheol
authors.initials: HC
authors.lastname: Kang
authors.affiliation: Department of Radiation Oncology, Asan Medical Center, Seoul, Korea.
authors.forename: Seung-Do
authors.initials: SD
authors.lastname: Ahn
authors.affiliation: Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea.
authors.forename: Doo-Ho
authors.initials: DH
authors.lastname: Choi
authors.affiliation: Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Min Kyu
authors.initials: MK
authors.lastname: Kang
authors.affiliation: Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Huasun, Korea.
authors.forename: Woong-Ki
authors.initials: WK
authors.lastname: Chung
authors.affiliation: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hong-Gyun
authors.initials: HG
authors.lastname: Wu
keywords: Cancer; Dermatitis; Epidermal growth factor; Radiation induced dermatitis; Radiotherapy