Support care cancer: cleaning the irradiated skin of patients with nasopharyngeal carcinoma can reduce the occurrence and severity of acute radiation dermatitis

Recently, a randomized trial published on support care cancer explored the effects of various cleaning methods on the skin of patients with nasopharyngeal carcinoma (NPC) with acute radiation dermatitis (RD).

A total of 168 hospitalized patients with nasopharyngeal carcinoma were randomly selected, and 152 patients completed the whole trial and analyzed the data. The patients were randomly divided into non washing group (group 1), washing with water only group (group 2) and washing with water and soap group (Group 3). All three groups received intensity modulated radiotherapy (IMRT) and other treatments. Follow up was conducted from recruitment or initial radiotherapy dose to 1 month after the final radiotherapy dose. A range of endpoints were assessed, including incidence rate, duration, severity of acute Rd, and quality of life (QOL).
As a result, there was no allergic reaction or aggravation in both cleaning groups during the whole treatment process. The incidence of acute Rd was 100% in all three groups, while the incidence of severe Rd (grade 2-3) was different among groups (group 1 vs. group 2 vs. group 3: 51% vs. 23.5% vs. 18%; P = 0.001). Compared with patients without washing, washing could moderately reduce the severity. Washing also delayed the onset of acute Rd; During the first 20 treatments, the incidence rate of acute Rd was significantly lower than that without washing (P < 0.001). More importantly, cleaning reduced the incidence of wet desquamation (25.5% vs. 5.9% vs. 6%; P = 0.003) and helped alleviate itching (6.49 ± 2.09 vs. 4.90 ± 1.90 vs. 4.00 ± 1.58; P < 0.001). There was no significant difference in pain or burning sensation between the groups. At the end of radiotherapy, cleaning improved QOL of the body (64.37 ± 4.08 vs. 67.41 ± 4.05 vs. 71.30 ± 4.87; P < 0.001), mood (61.47 ± 4.75 vs. 65.75 ± 3.46 vs. 70.80 ± 3.27; P < 0.001) and social function dimension (62.64 ± 3.57 vs. 64.87 ± 3.88 vs. 68.04 ± 4.89; P < 0.001). The results were similar one month after radiotherapy (P < 0.05). Washing with water and soap was the most effective way to reduce itching and improve QOL in the three groups (P < 0.05).

In conclusion, the results of this study show that cleaning the irradiated skin can reduce the occurrence and severity of acute radiation dermatitis.
Original source:
Qingfen Zhang, et al., What is the appropriate skin cleaning method for nasopharyngeal cancer radiotherapy patients? A randomized controlled trial. Support Care Cancer. 2022 May; 30(5):3875-3883. doi: 10.1007/s00520-022-06835-8.
Original link:
https://www.medsci.cn/article/show_article.do?id=463de2962623