-
Clinical and Experimental Dermatology Jul 2021Curcuma and its derivatives are associated with anti-inflammatory and antioxidant activities in the skin. They exhibit beneficial effects in wound healing and prevention... (Meta-Analysis)
Meta-Analysis
Curcuma and its derivatives are associated with anti-inflammatory and antioxidant activities in the skin. They exhibit beneficial effects in wound healing and prevention of chronic ultraviolet B damage and may prevent facial redness such as rosacea and flushing. This review aims to provide an up-to-date and rigorous synthesis of studies that demonstrated the clinical efficacy of curcuminoids in the skin. We evaluated studies published in the MEDLINE-PubMed/PMC (National Library of Medicine) databases, and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for this review. This search included papers published in the past 10 years in controlled clinical trials, double-blind and randomized controlled studies, and case studies. The search resulted in 12 studies published in the past 10 years. Curcuma species (Curcuma longa and Curcuma aeruginosa) and curcumin were found to produce various dermatological effects, including influencing antioxidant and anti-inflammatory processes in the production of hyaluronan, increasing skin moisture, and reducing axillary hair growth. Curcuma was also found to reduce thickness, erythema, pruritus, burning and pain in psoriasis lesions and to improve radiodermatitis lesions. Our review results show that Curcuma species may play a role in skin health management and may exhibit various dermatological effects, thus it could be a new therapeutic arsenal for dermatology professionals. Nevertheless, more clinical trials should be conducted with humans to establish the optimum delivery method and dosages for different dermatological conditions.
Topics: Anti-Inflammatory Agents; Antioxidants; Curcuma; Curcumin; Double-Blind Method; Female; Humans; Hyaluronic Acid; Male; Plant Extracts; Psoriasis; Radiodermatitis; Randomized Controlled Trials as Topic; Rosacea; Skin; Treatment Outcome; Wound Healing
PubMed: 33522006
DOI: 10.1111/ced.14584 -
Supportive Care in Cancer : Official... May 2021This review aimed to assess the quality and efficacy of tools currently used in breast cancer patients to score radiation dermatitis (RD), a common debilitating side...
PURPOSE
This review aimed to assess the quality and efficacy of tools currently used in breast cancer patients to score radiation dermatitis (RD), a common debilitating side effect of radiotherapy (RT).
METHODS
A search was conducted through Ovid Medline, Embase, and Cochrane Central Register of Controlled Trials databases on 14 February 2020. English articles that evaluated an instrument's use in assessing RD among breast cancer patients receiving external beam RT were included. Studies that reported on the reliability, validity, or concordance of items between assessment tools were included in accordance with the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.
RESULTS
Twelve studies were included in this review, with a total of 13 skin toxicity assessment tools discussed. Tools that assessed clinician-reported outcomes (CROs) mostly reported moderate correlation with biophysical parameter (BP) measurements and low correlation with patient-reported outcomes (PROs). Traditionally used CRO scoring tools demonstrated moderate inter-rater reliability between clinicians, likely due to the subjective nature of items on the grading scales. Most commonly used tools were found to be either insufficient or indeterminate in their measurement properties.
CONCLUSIONS
Current standardized tools that measure CROs are subject to clinician interpretation and fail to represent the patient experience. Tools designed to assess PROs are promising in their assessments of the impact of RT on patient quality of life; however, most PRO tools are generic to all skin conditions and require further validation for use in breast cancer. Among tools that measure CROs, PROs, and BPs, there is insufficient evidence on their measurement properties to establish a "gold standard" for the assessment of RD in breast cancer patients.
Topics: Breast Neoplasms; Female; Humans; Middle Aged; Radiodermatitis; Reproducibility of Results
PubMed: 33205325
DOI: 10.1007/s00520-020-05889-w -
Journal of the American Academy of... Mar 2021
Meta-Analysis
Incidence of dermatologic adverse events in patients with cancer treated with concurrent immune checkpoint inhibitors and radiation therapy: A systematic review and meta-analysis.
Topics: Chemoradiotherapy; Clinical Trials as Topic; Drug Eruptions; Humans; Immune Checkpoint Inhibitors; Incidence; Neoplasms; Radiodermatitis
PubMed: 33137440
DOI: 10.1016/j.jaad.2020.10.071 -
Oncology Nursing Forum Nov 2020A systematic review and meta-analysis was conducted to inform the development of guidelines on the management of radiodermatitis among patients with cancer. (Meta-Analysis)
Meta-Analysis
PROBLEM IDENTIFICATION
A systematic review and meta-analysis was conducted to inform the development of guidelines on the management of radiodermatitis among patients with cancer.
LITERATURE SEARCH
The authors updated a systematic review to include available literature published through September 30, 2019.
DATA EVALUATION
Two investigators assessed risk of bias using the Cochrane Collaboration risk-of-bias tool and certainty of the evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.
SYNTHESIS
The use of deodorant/antiperspirant had no effect on development of radiodermatitis. Aloe vera and emu oil were equivalent or less effective than standard care. Oral curcumin had a minimal beneficial effect. Nonsteroidal topical interventions had a minimal beneficial effect on the development of moist desquamation and relief of itching while causing a small increase for grade 2 radiodermatitis. Topical calendula increased risk for the development of radiodermatitis. Topical steroids and dressings each showed benefits to minimize the development of radiodermatitis and moist desquamation while lowering rates of patient-reported symptoms, such as pain and pruritus.
IMPLICATIONS FOR RESEARCH
Symptom management strategies for radiodermatitis among patients with cancer that are likely to be effective include topical nonsteroidals, topical steroids, and dressings.
SUPPLEMENTAL MATERIAL CAN BE FOUND AT HTTPS
//bit.ly/2FWj3Kp.
Topics: Bandages; Humans; Neoplasms; Radiodermatitis
PubMed: 33063778
DOI: 10.1188/20.ONF.E225-E236 -
Oncology Nursing Forum Jan 2020Radiation dermatitis (RD) is an expected side effect of radiation to the breast and chest wall. Healthcare providers routinely grade the severity of RD without assessing...
PROBLEM IDENTIFICATION
Radiation dermatitis (RD) is an expected side effect of radiation to the breast and chest wall. Healthcare providers routinely grade the severity of RD without assessing its impact on quality of life for patients with breast cancer. Instruments are needed to identify a patient's ability and confidence to self-manage RD.
LITERATURE SEARCH
A search was conducted of published literature from 2001 to 2018 that included patients who had received radiation therapy for breast cancer. A validated instrument was used to assess RD.
DATA EVALUATION
Eleven instruments were identified and evaluated for assessing self-management.
SYNTHESIS
One instrument was identified that measured a patient's ability to self-manage symptoms. The Patient-Reported Outcomes Measurement Information System Self-Efficacy for Managing Chronic Conditions-Manage Symptoms should be considered for clinical integration.
IMPLICATIONS FOR PRACTICE
Using a validated instrument to assess patients' needs and ability to self-manage RD will promote personalized care plans tailored to each patient. Findings can be used to implement a patient-reported outcome measure into clinical practice, develop educational programs for RD management, and create personalized care plans.
Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Female; Humans; Middle Aged; Patient Reported Outcome Measures; Quality of Life; Radiodermatitis; Radiotherapy; Self-Management
PubMed: 31845919
DOI: 10.1188/20.ONF.101-111 -
Breast (Edinburgh, Scotland) Apr 2020Radiation dermatitis is a common adverse effect of radiotherapy (RT) in breast cancer patients. Although radiation dermatitis is reported by either the clinician or the... (Meta-Analysis)
Meta-Analysis
Radiation dermatitis is a common adverse effect of radiotherapy (RT) in breast cancer patients. Although radiation dermatitis is reported by either the clinician or the patient, previous studies have shown disagreement between clinician-reported outcomes (CROs) and patient-reported outcomes (PROs). This review evaluated the extent of discordance between CROs and PROs for radiation dermatitis. Studies reporting both clinician and patient-reported outcomes for external beam RT were eligible. Nine studies met the inclusion criteria for the systematic review, while 8 of these studies were eligible for inclusion in a meta-analysis of acute and late skin toxicities. We found an overall agreement between CROs and PROs of acute skin colour change, fibrosis and/or retraction, and moist desquamation (p > 0.005). Reporting of late breast pain, breast edema, skin colour change, telangiectasia, fibrosis and/or retraction and induration/fibrosis alone (p > 0.005) were also in agreement between clinicians and patients. Our meta-analysis revealed a greater reporting of acute breast pain by patients (RR = 0.89, 95% CI 0.87-0.92, p < 0.001), greater reporting of acute breast edema by physicians (RR = 1.80, 95% CI 1.65-1.97, p < 0.001) and a greater reporting of late breast shrinkage by patients (RR = 0.61, 95% CI 0.44-0.86, p = 0.005). However, our review was limited by the discrepancies between PRO and CRO measurement tools as well as the absence of standard time points for evaluation of radiation dermatitis. Given potential discrepancies between CROs and PROs, both measures should be reported in future studies. Ultimately, we advocate for the development of a single tool to assess symptoms from both perspectives.
Topics: Breast; Breast Neoplasms; Edema; Fibrosis; Humans; Outcome Assessment, Health Care; Pain; Patient Reported Outcome Measures; Physicians; Radiodermatitis
PubMed: 31563429
DOI: 10.1016/j.breast.2019.09.009 -
Supportive Care in Cancer : Official... Nov 2019Photobiomodulation therapy (PBMT) has been considered an effective method for preventing and managing certain cancer-related toxicities in head and neck cancer (HNC)...
Photobiomodulation therapy (PBMT) has been considered an effective method for preventing and managing certain cancer-related toxicities in head and neck cancer (HNC) patients treated with radiotherapy and chemotherapy. However, the potential effects of PBMT on pain control and analgesia resulting from these toxicities is still controversial. The aim of this systematic review was to compile available evidence of the effects of PMBT on pain control and reduced use of analgesics in HNC patients. We searched three indexed databases: MEDLINE/PubMed, Embase, and Scopus. The databases were reviewed up to and including December 2018. Only human clinical studies in English language were selected. Information was only available for mucositis and radiodermatitis. Fifteen out of 1112 studies met the inclusion criteria (14 for oral mucositis (OM) and 1 for radiodermatitis). From the 14 studies involving the prevention and treatment of OM, 10 had the study subjects compared to a placebo group. Of these 10 studies, all but 1 showed statistically significant difference related to pain control favoring the PBMT group. The study that compared PBMT with other treatment modality showed better results in pain control with PBMT. It appears that PBMT application frequency and potency impact on pain control. The only study involving the prevention and treatment of radiodermatitis was compared to placebo arm and showed statistically significant difference related to pain control favoring the PBMT group. Seven studies compared the need of analgesic medication between PBMT and placebo groups. Of these, five studies showed that the use of analgesic medication was significantly higher in the placebo group. The current evidence supports that PBMT is effective in pain control resulting from OM and radiodermatitis and may also reduce the need for analgesics. The evidence is not yet available of the effects of PBMT in other HNC treatment-related toxicities.
Topics: Female; Head and Neck Neoplasms; Humans; Low-Level Light Therapy; Male; Pain; Stomatitis
PubMed: 31264186
DOI: 10.1007/s00520-019-04939-2 -
Oral Oncology Jun 2019Photobiomodulation therapy (PBMT), also known as low-level laser therapy (LLLT), has been increasingly used for the treatment of toxicities related to cancer treatment.... (Review)
Review
Photobiomodulation therapy (PBMT), also known as low-level laser therapy (LLLT), has been increasingly used for the treatment of toxicities related to cancer treatment. One of the challenges for the universal acceptance of PBMT use in cancer patients is whether or not there is a potential for the light to stimulate the growth of residual malignant cells that evaded oncologic treatment, increasing the risk for tumor recurrences and development of a second primary tumor. Current science suggests promising effects of PBMT in the prevention and treatment of breast cancer-related lymphedema and oral mucositis, among other cancer treatment toxicities. Nevertheless, this seems to be the first systematic review to analyze the safety of the use of PBMT for the management of cancer-related toxicities. Scopus, MEDLINE/PubMed, and Embase were searched electronically. A total of 27 articles met the search criteria. Selected studies included the use of PBMT for prevention and treatment of oral mucositis, lymphedema, radiodermatitis, and peripheral neuropathy. Most studies showed that no side effects were observed with the use of PBMT. The results of this systematic review, based on current literature, suggest that the use of PBMT in the prevention and management of cancer treatment toxicities does not lead to the development of tumor safety issues.
Topics: Humans; Low-Level Light Therapy; Lymphedema; Neoplasms; Randomized Controlled Trials as Topic; Stomatitis; Treatment Outcome
PubMed: 31109692
DOI: 10.1016/j.oraloncology.2019.04.004 -
Radiation-induced Skin Toxicity in Breast Cancer Patients: A Systematic Review of Randomized Trials.Clinical Breast Cancer Oct 2018Radiation dermatitis is a common side effect of radiotherapy. Radiation dermatitis has been investigated for decades, and many approaches have been proposed to limit its...
Radiation dermatitis is a common side effect of radiotherapy. Radiation dermatitis has been investigated for decades, and many approaches have been proposed to limit its incidence and severity. The purpose of the present systematic review was to summarize the approaches and findings of studies testing various methods for management of radiation dermatitis in breast cancer patients. Medline, Cochrane, and Embase were searched for studies pertaining to radiation-induced skin toxicity in breast cancer patients. The search results were limited to randomized trials of external beam radiotherapy conducted in humans and reported in the English language. The primary outcome was the incidence or severity of radiation dermatitis. Descriptive statistical analyses were performed. A total of 96 studies were included in the present review. These evaluated the effect of different radiotherapy techniques, topical treatments, supplements, skin care regimens, and treatments on radiation dermatitis. Few topical agents and oral supplements demonstrated their effectiveness across the randomized trials; however, various radiotherapy techniques, such as intensity-modulated radiotherapy, hypofractionated radiotherapy, accelerated partial breast irradiation, simultaneous integrated boost, and prone positioning consistently demonstrated decreased rates of radiation dermatitis, despite the limited number of studies in which they were evaluated.
Topics: Breast Neoplasms; Dose Fractionation, Radiation; Female; Humans; Incidence; Radiation-Protective Agents; Radiodermatitis; Radiotherapy; Randomized Controlled Trials as Topic; Skin Care
PubMed: 30072193
DOI: 10.1016/j.clbc.2018.06.015 -
Revista Latino-americana de Enfermagem 2018to evaluate the effects of trolamine in the prevention or treatment of radiation dermatitis. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
to evaluate the effects of trolamine in the prevention or treatment of radiation dermatitis.
METHOD
systematic review and meta-analysis. Detailed individual search strategies for Cinahl, Cochrane Library Central, LILACS, PubMed, and Web of Science were developed in January 2016. A manual search was also performed to find additional references. A grey literature search was executed by using Google Scholar. Two researchers independently read the titles and abstracts from every cross-reference. The risk of bias of the included studies was analyzed by the Cochrane Collaboration Risk of Bias Tool. The quality of evidence and grading of strength of recommendations was assessed using Grades of Recommendation, Assessment, Development and Evaluation (GRADE).
RESULTS
seven controlled clinical trials were identified. The controls used were calendula, placebo, institutional preference / usual care, Aquaphor®, RadiaCare™, and Lipiderm™. The studies were pooled using frequency of events and risk ratio with 95% confidence intervals, in subgroups according to radiation dermatitis graduation.
CONCLUSION
based on the studies included in this review, trolamine cannot be considered as a standardized product to prevent or treat radiation dermatitis in patients with breast and head and neck cancer.
Topics: Acute Disease; Ethanolamines; Humans; Radiodermatitis
PubMed: 29742271
DOI: 10.1590/1518-8345.2035.2929