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Barrier films for the prevention of acute radiation dermatitis in breast cancer: A systematic review and meta-analysis of randomised controlled trials
Dejonckheere,C.S. Dejonckheere,E. Layer,J.P. Layer,K. Sarria,G.R. Koch,D. Abramian,A. Kaiser,C. Lindner,K. Bachmann,N.
Dejonckheere,C.S.
Dejonckheere,E.
Layer,J.P.
Layer,K.
Sarria,G.R.
Koch,D.
Abramian,A.
Kaiser,C.
Lindner,K.
Bachmann,N.
Abstract
Purpose Radiation dermatitis (RD) is the most common side effect of adjuvant whole-breast or chest wall irradiation, majorly impacting quality of life in numerous patients. The use of barrier films (polyurethane dressings such as Hydrofilm® and Mepitel® film remaining on the skin for the duration of the radiation treatment) has been investigated as a prophylactic measure in several prospective trials. Here, we critically appraise the available evidence behind preventive barrier film application in the context of breast cancer treatment. Methods International literature was reviewed and high-quality randomised controlled trials (RCTs) were included in this meta-analysis. Results The results of 5 RCTs (663 patients; >90% Caucasian) were analysed. Overall, barrier films lead to improved clinician- and patient-reported outcomes: fewer grade ≥2 RD (11% vs. 42%; OR = 0.16; p < 0.001) and moist desquamation (2% vs. 16%; OR = 0.12; p = 0.006), as well as less patient-reported pain (standardised mean difference [SMD] −0.51; p < 0.001), itching (SMD −0.52; p = 0.001), burning (SMD −0.41; p = 0.011), and limitations in daily activities (SMD −0.20; p = 0.007). Furthermore, barrier films have a high acceptance rate among patients, as well as a favourable cost-benefit ratio. Possible side effects due to its application are mild and mostly self-limiting. Overall, there was a lack of information on the radiation treatment techniques used. Conclusion The evidence presented in this meta-analysis suggests that barrier films are an excellent tool in the prevention of RD among Caucasian patients receiving whole-breast or chest wall irradiation. Its use should therefore be considered routinely in these patients.
Description
The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. There are no relevant financial or non-financial interests to disclose, nor are there any proprietary interests in the material discussed in this article.
Date
2023
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Publisher
Research Projects
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Keywords
Acute radiation dermatitis, Barrier film, Breast cancer, Hydrofilm, Mepitel film, Meta-analysis, Prevention, Radiotherapy, Systematic review, SDG 3 - Good Health and Well-being
Citation
Dejonckheere, C S, Dejonckheere, E, Layer, J P, Layer, K, Sarria, G R, Koch, D, Abramian, A, Kaiser, C, Lindner, K, Bachmann, N, Anzbock, T, Rohner, F, Schmeel, F C & Schmeel, L C 2023, 'Barrier films for the prevention of acute radiation dermatitis in breast cancer : A systematic review and meta-analysis of randomised controlled trials', The Breast, vol. 71, pp. 31-41. https://doi.org/10.1016/j.breast.2023.07.001