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Barrier films or dressings for the prevention of acute radiation dermatitis in breast cancer: a systematic review and network meta-analysis

  • 期刊论文

  • 发表日期：

    2024年8月7日

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  • Henry C. Y. Wong,
  • Shing Fung Lee,
  • Saverio Caini,
  • Adrian Wai Chan,
  • Jennifer Y. Y. Kwan,
  • Mark Waddle,
  • Stephen Sonis,
  • Patries Herst,
  • Sara Alcorn,
  • Pierluigi Bonomo,
  • Cindy Wong,
  • Kimberly Corbin,
  • J. Isabelle Choi,
  • Agata Rembielak,
  • Muna AlKhaifi,
  • Gustavo Nader Marta,
  • Dirk Rades,
  • Corina van den Hurk,
  • Julie Ryan Wolf,
  • Raymond J. Chan,
  • Leonard Christopher Schmeel,
  • Michael Lock,
  • Tarek Hijal,
  • Jeffrey Cao,
  • Hayeon Kim,
  • Edward Chow

摘要

Background

Barrier films or dressings were reported to be effective in preventing radiation dermatitis (RD) in breast cancer patients, but their comparative efficacy is unknown.

Methods

A systematic literature search was performed on Embase, MEDLINE and Cochrane CENTRAL Registry of Clinical Trials from inception to October 20, 2023. Randomised controlled trials (RCTs) comparing barrier films or dressings to the standard of care (SOC) or other interventions were included. We estimated summary odds ratios and mean differences using network meta-analysis with random effects. This study was registered with PROSPERO (ID: CRD42023475021).

Results

Fourteen RCTs met inclusion criteria. Six interventions were analysed: 3M™ Moisturizing Double Barrier Cream (MDBC), 3M™ No Sting Barrier Film (BF), Hydrofilm® (HF), Mepitel® Film (MF), Silver Leaf Nylon Dressing and StrataXRT®. HF, MF and StrataXRT® reduced the incidence of moist desquamation compared to SOC (HF: OR = 0.08; p = 0.02; MF: OR = 0.31 p < 0.01; StrataXRT®: OR = 0.22, p = 0.04). The ranking of agents from most to least effective in preventing moist desquamation according to P-scores was HF (92.5%), MF (78.5%), StrataXRT® (70.1%), BF (46.4%), Silver Leaf Nylon Dressing (24.9%), MDBC (22.9%) and SOC (14.7%). Only four RCTs on HF and MF included patient-reported outcome (PRO) assessments that allowed pooling for analysis. HF and MF were more effective in reducing pain, itchiness and burning sensation compared to SOC (p < 0.01 for all symptoms).

Conclusion

HF and MF were effective in preventing RD in breast cancer. Future RCTs should compare these interventions to effective cream preparations, such as topical corticosteroids.