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Critical Reviews in Oncology/hematology Dec 2017Radiotherapy plus cetuximab is an effective combination therapy for locally advanced head and neck squamous cell carcinoma. The aim of our study was to determine the... (Review)
Review
PURPOSE
Radiotherapy plus cetuximab is an effective combination therapy for locally advanced head and neck squamous cell carcinoma. The aim of our study was to determine the frequency of skin toxicity in patients receiving the combined treatment.
RESULTS
Forty-eight studies were included in our analysis, for a total of 2152 patients. The mean rates of G3/G4 radiation dermatitis and acneiform rash were 32.5% (SD: 20.4; 95% CI: 28.5-36.5) and 13.4% (SD: 11.5; 95% CI: 11.2-15.6), respectively. The majority of studies referred to CTCAE scales for reporting both side effects (85.7% and 92.1%, respectively). Data on the management of skin toxicity were available in only 35.4% of the reviewed literature.
CONCLUSIONS
severe radiation dermatitis is a frequent side effect induced by the combination of radiotherapy and cetuximab in head and neck cancer. The lack of predictive biomarkers of toxicity hampers the possibilty to design preventive measures on a personalized basis.
Topics: Acneiform Eruptions; Antineoplastic Agents, Immunological; Carcinoma, Squamous Cell; Cetuximab; Chemoradiotherapy; Head and Neck Neoplasms; Humans; Incidence; Radiodermatitis; Skin; Squamous Cell Carcinoma of Head and Neck
PubMed: 29198343
DOI: 10.1016/j.critrevonc.2017.10.011 -
Anticancer Research Oct 2017To evaluate the efficacy of topical corticosteroids in managing acute radiation dermatitis (RD) in female breast cancer patients. (Meta-Analysis)
Meta-Analysis Review
AIM
To evaluate the efficacy of topical corticosteroids in managing acute radiation dermatitis (RD) in female breast cancer patients.
MATERIALS AND METHODS
MEDLINE, EMBASE, CINAHL, CENTRAL, ScienceDirect, Google Scholar and Clinicaltrials.gov were searched up to and including March 2017 to identify Randomised Controlled Trials (RCTs) assessing topical corticosteroids for the management and prevention of acute RD.
RESULTS
Ten RCTs (919 participants) were identified. Meta-analysis, including results for 845 participants, demonstrated significant benefits of topical corticosteroids in preventing the incidence of wet desquamation (OR: 0.29; 95%CI: 0.19-0.45; p<0.0001) and reducing the mean RD score (SMD: -0.47, 95%CI: -0.61 - -0.33, p<0.00001).
CONCLUSION
Topical corticosteroids impacted on the incidence of wet desquamation and the average RD score observed in female breast cancer patients. The use of topical corticosteroids can reduce pruritus in participants and improve quality of life.
Topics: Administration, Cutaneous; Adrenal Cortex Hormones; Breast Neoplasms; Chi-Square Distribution; Dermatologic Agents; Female; Humans; Odds Ratio; Quality of Life; Radiodermatitis; Radiotherapy, Adjuvant; Risk Factors; Treatment Outcome
PubMed: 28982842
DOI: 10.21873/anticanres.11960 -
Journal of B.U.ON. : Official Journal... 2017We conducted a network meta-analysis to evaluate the efficacy and toxicity of cetuximab and nimotuzumab in the treatment of advanced nasopharyngeal carcinoma (NPC).
PURPOSE
We conducted a network meta-analysis to evaluate the efficacy and toxicity of cetuximab and nimotuzumab in the treatment of advanced nasopharyngeal carcinoma (NPC).
METHODS
A systematic literature search was performed though Pubmed, Embase, Cochran Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical (CBM) and Wanfang databases. Totally, 19 randomized controlled trials (RCTs) (n=1201) met the study selection criteria and were incorporated in this network meta-analysis.
RESULTS
Compared with cetuximab, the results of network meta-analysis indicated that nimotuzumab may achieve higher complete remission rate (CRR) or overall remission rate (ORR) of the primary tumor, but no difference was noticed in 1- and 2-year overall survival (OS) rate and certain toxicities such as myelosuppression, radiodermatitis, mucositis and gastrointestinal reactions. Although nimotuzumab increased the 3-year OS rate, compared with cetuximab, this result needs to be interpreted cautiously because of the studies' heterogeneity.
CONCLUSION
Even though we didn't find significant difference between cetuximab and nimotuzumab in terms of survival outcomes, nimotuzumab is more advantageous in short-term efficacy.
Topics: Antibodies, Monoclonal, Humanized; Antineoplastic Agents, Immunological; Cetuximab; China; Humans; Nasopharyngeal Carcinoma; Network Meta-Analysis; Randomized Controlled Trials as Topic; Survival Rate
PubMed: 28952220
DOI: No ID Found -
European Journal of Cancer Care Nov 2017The aim of this systematic review is to assess the available evidence concerning the effectiveness of semi-permeable dressings, on the full range of skin reactions,... (Review)
Review
The aim of this systematic review is to assess the available evidence concerning the effectiveness of semi-permeable dressings, on the full range of skin reactions, related to radiation therapy in cancer patients, from local erythema to moist desquamation, including subjective symptoms such as pain, discomfort, itchiness, burning and the effect on daily life activities. The bibliographic search was carried out looking for Randomised Clinical Trials (RCTs) indexed in PubMed, Cinhal, Cochrane plus and Biblioteca Nacional de Salud, published in the English and Spanish language, between 2010 and 2015. Data extraction and evaluation of study quality was undertaken by peer reviewers using the Critical Appraisal Skills Programme (CASP). Of 181 studies, nine full texts were assessed. Finally, six RCT were included in the final synthesis: three analysed the application of Mepilex Lite in breast cancer and head & neck cancer; one evaluated the application of Mepitel Film in breast cancer; and two assessed the use of silver nylon dressings in breast cancer and in patients with lower gastrointestinal cancer. The results show that semi-permeable dressings are beneficial in the management of skin toxicity related to radiation therapy. However, rigorous trials showing stronger evidence are needed.
Topics: Bandages; Breast Neoplasms; Gastrointestinal Neoplasms; Head and Neck Neoplasms; Humans; Radiodermatitis; Silicones; Treatment Outcome
PubMed: 28417508
DOI: 10.1111/ecc.12685 -
Supportive Care in Cancer : Official... Mar 2017The purpose of the study is to evaluate the effects of pharmacological and non-pharmacological topical controls in the prevention of radiation dermatitis. (Review)
Review
PURPOSE
The purpose of the study is to evaluate the effects of pharmacological and non-pharmacological topical controls in the prevention of radiation dermatitis.
METHODS
Relevant clinical trials were identified through electronic searching databases CINAHL, CENTRAL, LILACS, PubMed, Scopus, and Web of Science. Handsearching and gray literature searches were also performed to find additional references. Primary outcomes of interest were the development of radiation dermatitis and the time of occurrence of radiation dermatitis.
RESULTS
Thirteen randomized clinical trials were included in this review. The trials were published in Chinese, English, or French, from 1980 to 2015. Pharmacological interventions used in the trials were trolamine, aloe vera, allantoin, Lianbai liquid, sucralfate, Na-sucrose octasulfate, olive oil, hialuronic acid, and dexpanthenol. Non-pharmacological topical controls were usual care/institution routine, aqueous cream, mild soap, water thermal gel, placebo, and no intervention.
CONCLUSIONS
There was no strong evidence that indicates differences between topical pharmacological interventions or non-pharmacological topical controls in the prevention of acute radiation dermatitis among patients with head and neck cancer undergoing radiotherapy.
Topics: Administration, Topical; Dermatologic Agents; Head and Neck Neoplasms; Humans; Radiodermatitis; Randomized Controlled Trials as Topic; Skin Care
PubMed: 27957620
DOI: 10.1007/s00520-016-3521-7 -
European Journal of Dermatology : EJD Oct 2016Taxanes (docetaxel and paclitaxel) are among the most commonly prescribed anticancer drugs approved for the treatment of metastatic or locally advanced breast, non-small... (Review)
Review
Taxanes (docetaxel and paclitaxel) are among the most commonly prescribed anticancer drugs approved for the treatment of metastatic or locally advanced breast, non-small cell lung, prostate, gastric, head and neck, and ovarian cancers, as well as in the adjuvant setting for operable node-positive breast cancers. Although the true incidence of dermatological adverse events (AEs) in patients receiving taxanes is not known, and has never been prospectively analysed, they clearly represent one of the major AEs associated with these agents. With an increase in the occurrence of cutaneous AEs during treatment with novel targeted and immunological therapies when used in combination with taxanes, a thorough understanding of reactions attributable to this class is imperative. Moreover, identification and management of dermatological AEs is critical for maintaining the quality of life in cancer patients and for minimizing dose modifications of their antineoplastic regimen. This analysis represents a systematic review of the dermatological conditions reported with the use of these drugs, complemented by experience at comprehensive cancer centres. The conditions reported herein include skin, hair, and nail toxicities. Lastly, we describe the dermatological data available for the new, recently FDA-and EMA- approved, solvent-free nab-paclitaxel.
Topics: Alopecia; Antineoplastic Agents; Docetaxel; Drug Eruptions; Edema; Humans; Lupus Erythematosus, Cutaneous; Nail Diseases; Paclitaxel; Pigmentation Disorders; Radiodermatitis; Taxoids
PubMed: 27550571
DOI: 10.1684/ejd.2016.2833 -
Phytotherapy Research : PTR Aug 2016Turmeric (Curcuma longa), a commonly used spice throughout the world, has been shown to exhibit antiinflammatory, antimicrobial, antioxidant, and anti-neoplastic... (Review)
Review
Turmeric (Curcuma longa), a commonly used spice throughout the world, has been shown to exhibit antiinflammatory, antimicrobial, antioxidant, and anti-neoplastic properties. Growing evidence shows that an active component of turmeric, curcumin, may be used medically to treat a variety of dermatologic diseases. This systematic review was conducted to examine the evidence for the use of both topical and ingested turmeric/curcumin to modulate skin health and function. The PubMed and Embase databases were systematically searched for clinical studies involving humans that examined the relationship between products containing turmeric, curcumin, and skin health. A total of 234 articles were uncovered, and a total of 18 studies met inclusion criteria. Nine studies evaluated the effects of ingestion, eight studies evaluated the effects of topical, and one study evaluated the effects of both ingested and topical application of turmeric/curcumin. Skin conditions examined include acne, alopecia, atopic dermatitis, facial photoaging, oral lichen planus, pruritus, psoriasis, radiodermatitis, and vitiligo. Ten studies noted statistically significant improvement in skin disease severity in the turmeric/curcumin treatment groups compared with control groups. Overall, there is early evidence that turmeric/curcumin products and supplements, both oral and topical, may provide therapeutic benefits for skin health. However, currently published studies are limited and further studies will be essential to better evaluate efficacy and the mechanisms involved. Copyright © 2016 John Wiley & Sons, Ltd.
Topics: Anti-Inflammatory Agents; Curcuma; Humans; Skin
PubMed: 27213821
DOI: 10.1002/ptr.5640 -
Enfermeria Clinica 2015After radiation therapy most patients experience acute skin toxicity to some degree. The purpose of this systematic review is to assess the available evidence concerning... (Review)
Review
BACKGROUND
After radiation therapy most patients experience acute skin toxicity to some degree. The purpose of this systematic review is to assess the available evidence concerning the effectivity of topical therapies on patients with breast cancer that experience radiodermatitis after radiotherapy.
METHOD
The review included clinical trials aimed to evaluate topical therapies for prevention or treatment of acute radiodermatitis in women with breast cancer, which were published between 2009 and 2014. The bibliographic search was carried out in the following databases: PubMed, Cinahl, Cochrane Plus, IBECS and LILACS. The studies were selected independently by peer reviewers using the Critical Appraisal Skills Programme in its Spanish version.
RESULTS
86 bibliographical references were identified. Twenty full-text articles of clinical trials were assessed and two were excluded because they were not completed; 12 of clinical trials evaluated topical treatment with creams and ointments, three with corticosteroid creams and other three with dressings. The effectivity of human epidermal growth factor cream, linoleic acid emulsion, topical silver sulfadiazine, corticosteroids creams and polyurethane dressings has been shown in these clinical trials.
CONCLUSIONS
Given that radiodermatitis is a dynamic process, these topical agents were effective in different stages of skin toxicity. Some of them delayed the onset, others decreased the development and severity of acute skin toxicity degree and others improved the subjective symptoms (itching, pain, burning). Only polyurethane dressings suggest effectiveness in all stages of skin toxicity, in prevention, management of the different skin toxicity degrees and improvement of wellbeing.
Topics: Administration, Topical; Breast Neoplasms; Clinical Trials as Topic; Dermatologic Agents; Female; Humans; Radiodermatitis
PubMed: 26475084
DOI: 10.1016/j.enfcli.2015.06.003