Eficacia de los protectores de la piel y Calendula officinalis para la prevención y tratamiento de la radiodermatitis: revisión integrativa

Simões, Fabiana Verdan; Santos, Valdete Oliveira; Silva, Rodrigo Nogueira da; Silva, Rafael Celestino da

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Revista Brasileira de Enfermagem

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Sumário

REVIEW • Rev. Bras. Enferm. 73 (suppl 5) • 2020 • https://doi.org/10.1590/0034-7167-2019-0815 copiar

Eficacia de los protectores de la piel y Calendula officinalis para la prevención y tratamiento de la radiodermatitis: revisión integrativa

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

analizar la eficacia de los protectores cutáneos y Calendula officinalis para la prevención y el tratamiento de la radiodermatitis.

Método:

revisión integradora, en las bases de datos CINAHL, Cochrane Library, Embase, MEDLINE/PubMed, IBECS, LILACS y Web of Science. La muestra final consistió en cinco estudios, cuatro estudios clínicos y uno preclínico. Se llevó a cabo una apreciación crítica y síntesis narrativa de los hallazgos del estudio.

Resultados:

el protector de piel Cavilon™ fue más efectivo que S butterflyene (crema con 10% de glicerina) y menos efectivo que la crema de Furoato de Mometasona. Calendula officinalis fue más eficaz que la trolamina y los ácidos grasos esenciales y menos eficaz que Ching Wan Hung^® para la prevención y el tratamiento de la radiodermatitis.

Conclusión:

los datos confirman el potencial de Calendula officinalis en la prevención y el tratamiento de la radiodermatitis y apuntan a resultados prometedores en cuanto al uso de protectores cutáneos, sin embargo, existe la necesidad de nuevas pruebas sobre la efectividad de dichos productos.

Descriptores:
Neoplasias; Radiodermatitis; Calendula; Enfermería Oncológica; Revisión

Problem/Outcome	Intervention	Alternative Intervention
Radiation injuries Radiodermatitis Radiation-induced skin toxicity	Barrier film Skin film Barrier film Protective film Skin protector	Calendula officinalis

Database

Search strategy

Embase

('radiation dermatitis'/of OR 'radiation injury'/of OR 'radiation dermatitis':ti,ab,kw OR 'radiodermatitis':ti,ab,kw OR 'radioepithelitis':ti,ab,kw OR 'radiation injuries':ti,ab,kw OR 'radiation injury':ti,ab,kw OR 'radiation-induced dermatitis':ti,ab,kw OR 'radiation-induced skin toxicity':ti,ab,kw) AND ('barrier film':ti,ab,kw OR 'barrier films':ti,ab,kw OR nsbf OR 'film barrier':ti,ab,kw OR 'film barriers':ti,ab,kw OR 'barrier product':ti,ab,kw OR 'barrier products':ti,ab,kw OR 'moisture barrier':ti,ab,kw OR 'moisture barriers':ti,ab,kw OR 'liquid-film':ti,ab,kw OR 'liquid-films':ti,ab,kw OR 'cutaneous protector':ti,ab,kw OR 'cutaneous protectors':ti,ab,kw OR 'skin protector':ti,ab,kw OR 'skin protectors':ti,ab,kw OR 'skin protectant':ti,ab,kw OR 'skin protectants':ti,ab,kw OR 'skin film':ti,ab,kw OR 'skin films':ti,ab,kw OR spray*:ti,ab,kw OR 'calendula'/exp OR 'calendula extract'/de OR 'calendula officinalis extract'/de OR 'calendula':ti,ab,kw) AND ([English]/lim OR [Portuguese]/lim OR [Spanish]/lim) AND [Embase]/lim

Article identification Year/Country	Outlining/number of participants	Interventions	Outcome
A1⁽¹⁵15 Shaw S-Z, Nien H-H, Wu C-J, Lui LT, Su J-F, Lang C-H. 3M Cavilon No-Sting Barrier Film or topical corticosteroid (mometasone furoate) for protection against radiation dermatitis: a clinical trial. J Formos Med Assoc. 2015;114(5):407-14. doi: 10.1016/j.jfma.2013.04.003 https://doi.org/10.1016/j.jfma.2013.04.0... ⁾ 2015 Taiwan	Randomized Clinical Trial 39 human beings with breast cancer Skin assessment scale: CTCAE, version 3.0	Intraindividual comparisons: Cavilon^™ x without treatment (13); Elomet^® x without treatment (9); Elomet^® x Cavilon^™ (17)	Days for radiodermatitis: Cavilon^™=44.2 x without treatment=46.6 (p=0.196); Elomet^® =52 x without treatment=43 (p=0.092); Elomet^® =53.4 x Cavilon^™=44.5 (p=0.002).
A2⁽²³23 Graham P, Browne L, Capp A, Fox C, Graham J, Hollis J, et al. Randomized, paired comparison of No-Sting Barrier Film versus sorbolene cream (10% glycerine) skin care during postmastectomy irradiation. Int J Radiat Oncol. 2004;58(1): 241-6. doi: 10.1016/S0360-3016(03)01431-7 https://doi.org/10.1016/S0360-3016(03)01... ⁾ 2004 Australia	Randomized Clinical Trial 61 human beings with breast cancer Skin rating scale: RTOG acute skin score	Intraindividual comparisons: Cavilon^™ x Sorbolene cream (61)	Skin reaction score >2: Sorbolene=46% x Cavilon^™=33% (p=0.096).
A3⁽²⁴24 Hu JJ, Cui T, Rodriguez-Gil JL, Allen GO, Li J, Takita C, et al. Complementary and alternative medicine in reducing radiation-induced skin toxicity. Radiat Environ Biophys. 2014;53(3):621-6. doi: 10.1007/s00411-014-0540-y https://doi.org/10.1007/s00411-014-0540-... ⁾ 2014 USA	Pre-Clinical Trial 40 mice Skin rating scale: -------------	Control (10) x Ionizing Radiation: 10 Gy/day for 4 days (10) x Ionizing Radiation + Calendula officinalis (10) x Ionizing Radiation + CWH ointment (10)	On the 14^th day, for erythema: Control=10 without injury; Ionizing radiation=7 without injury, 3 moderate injuries; Ionizing Radiation + Calendula officinalis=8 without injury, 2 moderate injuries; Ionizing Radiation + CWH=10 without injury (p=0.033)
A4⁽⁹9 Pommier P, Gomez F, Sunyach MP, D’Hombres A, Carrie C, Montbarbon X. Phase III randomized trial of calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol. 2004;22(8):1447-53. doi: 10.1200/JCO.2004.07.063 https://doi.org/10.1200/JCO.2004.07.063... ⁾ 2004 France	Randomized Clinical Trial 254 human beings with breast cancer Skin rating scale: RTOG acute skin score	Calendula officinalis (126) x Trolamine (128)	Overall skin toxicity (p=<0.001): Calendula officinalis - score 0-1=74, score 2-3=52; Trolamine - score 0-1=47, score 2-3=81
A5⁽²⁵25 Schneider F, Danski MTR, Vayego SA. Usage of Calendula officinalis in the prevention and treatment of radiodermatitis: a randomized double-blind controlled clinical trial. Rev Esc Enferm USP. 2015;49(2):221-8. doi: 10.1590/S0080-623420150000200006 https://doi.org/10.1590/S0080-6234201500... ⁾ 2015 Brazil	Randomized Clinical Trial 51 human beings with head and neck cancer Skin rating scale: RTOG acute skin score	EFA (27) x Calendula officinalis (24)	In the last radiotherapy session, skin toxicity (p => 0.05): EFA - score 0=1, 1=6, 2=3, 3=3; Calendula officinalis - score 0=3, 1=8, 2=1, 3=2

Article identification	1	2	3	4	5	6	7	8	9	10	11	12	13
A1⁽¹⁵15 Shaw S-Z, Nien H-H, Wu C-J, Lui LT, Su J-F, Lang C-H. 3M Cavilon No-Sting Barrier Film or topical corticosteroid (mometasone furoate) for protection against radiation dermatitis: a clinical trial. J Formos Med Assoc. 2015;114(5):407-14. doi: 10.1016/j.jfma.2013.04.003 https://doi.org/10.1016/j.jfma.2013.04.0... ⁾	N	N	N	N	N	N	N	Y	Y	Y	N	Y	Y
A2⁽²³23 Graham P, Browne L, Capp A, Fox C, Graham J, Hollis J, et al. Randomized, paired comparison of No-Sting Barrier Film versus sorbolene cream (10% glycerine) skin care during postmastectomy irradiation. Int J Radiat Oncol. 2004;58(1): 241-6. doi: 10.1016/S0360-3016(03)01431-7 https://doi.org/10.1016/S0360-3016(03)01... ⁾	U	Y	Y	N	N	N	N	N	Y	Y	N	Y	Y
A4⁽⁹9 Pommier P, Gomez F, Sunyach MP, D’Hombres A, Carrie C, Montbarbon X. Phase III randomized trial of calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol. 2004;22(8):1447-53. doi: 10.1200/JCO.2004.07.063 https://doi.org/10.1200/JCO.2004.07.063... ⁾	Y	N	N	N	N	Y	N	N	Y	Y	Y	Y	N/A
A5⁽²⁵25 Schneider F, Danski MTR, Vayego SA. Usage of Calendula officinalis in the prevention and treatment of radiodermatitis: a randomized double-blind controlled clinical trial. Rev Esc Enferm USP. 2015;49(2):221-8. doi: 10.1590/S0080-623420150000200006 https://doi.org/10.1590/S0080-6234201500... ⁾	Y	Y	Y	Y	Y	Y	Y	N	N	Y	Y	Y	N/A

Article identification	1	2	3	4	5	6	7	8	9	10
A3⁽²⁴24 Hu JJ, Cui T, Rodriguez-Gil JL, Allen GO, Li J, Takita C, et al. Complementary and alternative medicine in reducing radiation-induced skin toxicity. Radiat Environ Biophys. 2014;53(3):621-6. doi: 10.1007/s00411-014-0540-y https://doi.org/10.1007/s00411-014-0540-... ⁾	N	U	U	U	U	N	U	Y	Y	Y

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[1] Corresponding author: Rafael Celestino da Silva. Email: rafaenfer@yahoo.com.br