Scientific evidence on factors associated with the quality of life of radiodermatitis patients

Rocha, Daniel de Macêdo; Pedrosa, Aliny de Oliveira; Oliveira, Aline Costa de; Bezerra, Sandra Marina Gonçalves; Benício, Claudia Daniella Avelino Vasconcelos; Nogueira, Lídya Tolstenko

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Sumário

Integrative Review • Rev. Gaúcha Enferm. 39 • 2018 • https://doi.org/10.1590/1983-1447.2018.2017-0224 copy

Scientific evidence on factors associated with the quality of life of radiodermatitis patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

OBJECTIVE

To analyze in the literature the factors associated with the quality of life of patients with radiodermatitis.

METHOD

Integrative literature review of the MEDLINE, CINAHL, Web of Science and IBECS databases between 2007 and 2016.

RESULTS

Fourteen studies that met the established inclusion criteria, with a predominance of

randomized clinical trials, level of evidence II 1 were analyzed. Among the factors that compromised the quality of life were pain, pruritus, alteration of the body image and emotional reactions such as anxiety and depression symptoms stand out. The laser therapy, the emu oil and intensity-modulated radiotherapy represented the interventions that favored the improvement of the quality of life.

CONCLUSION

Radiodermatitis causes significant impairments to the quality of life of cancer patients, requiring multiprofessional interventions and new studies aimed at the prevention and treatment of the lesion.

Keywords:
Neoplasms; Radiodermatitis; Quality of life

MeSH and CINAHL List
P	DC	Neoplasms
P	DNC	Neoplasias; Tumors; Cancers
I	DC	Radiodermatitis
I	DNC	Radiation induced dermatitis; Radiation recall dermatitis; Radiation recall reactions
Co	DC	Quality of Life
Co	DNC	Life quality; Health related quality of life
Search expression MEDLINE via PubMed		((((Neoplasms[Mesh]) OR ((((neoplasias) OR tumors) OR cancers)))) AND ((Radiodermatitis[Mesh]) OR ((((radiodermatitides) OR radiation induced dermatitis) OR radiation recall dermatitis) OR radiation recall reactions))) AND ((Quality of Life[Mesh]) OR ((life quality) OR health related quality of life))
Search expression Web of Science		(TS=(Neoplasms) OR TS=(Neoplasias) OR TS=(Tumors) OR TS=(Cancers)) AND ( TS=(Radiodermatitis) OR TS=(Radiation induced dermatitis) OR TS=(Radiation recall dermatitis) OR TS=(Radiation recall reactions)) AND ( TS=(Quality of Life) OR TS=(Life quality) OR TS=(Health related quality of life))
Search expression CINAHL		((MH "Neoplasms+") OR "Neoplasms" OR "Neoplasias" OR "Tumors" OR "Cancers") AND ((MH "Radiodermatitis") OR "Radiodermatitis" OR "Radiation induced dermatitis" OR "Radiation recall dermatitis" OR "Radiation recall reactions") AND ((MH "Quality of Life+") OR "Quality of Life" OR "Life quality" OR "Health related quality of life")
DeCS
P	DC	Neoplasias
P	DNC	Cancer; Neoplasms; Tumor; Tumors; Malignant tumors; Neoplasia; Benign neoplasm; Malignant neoplasm; Malignancy
I	DC	Radiodermatitis
I	DNC	Radiation-Induced Dermatitis; Radiation Dermatitis; Recall Radiation Dermatitis; Reaction due to Regress Radiation
Co	DC	Quality of Life
Co	DNC	Quality of Life Related to Health
Search expressionIBECS via BVS		(mh:(Neoplasias)) OR (tw:(Cancer)) OR (tw:(Neoplasmas)) OR (tw:(Tumor)) OR (tw:(Tumors)) OR (tw:(Malignant tumors)) OR (tw:(Neoplasia)) OR (tw:(Benign Neoplasia)) OR (tw:(Malignant Neoplasia)) OR (tw:(Malignancy)) AND (tw:(Radiodermatitis)) OR (mh:(Radiation-Induced Dermatitis)) OR (tw:(Regress Radiation Dermatitis)) OR (tw:(Recall Radiation Dermatitis)) OR (tw:(Reaction due to Regress Radiation)) AND (tw:(Quality of Life)) OR (tw:(Quality of Life Related to Health))

Category 1 - Factors that compromise the QL of radiodermatitis patients
Main author, periodical and year	Design, sample (n)	Instrument and main results	NE
Younus J²⁴24 Younus J, Lock M, Vujovic O, Yu E, Malec J, D’Souza D, et al. A case-control, mono-center, open-label, pilot study to evaluate the feasibility of therapeutic touch in preventing radiation dermatitis in women with breast cancer receiving adjuvant radiation therapy. Complement Ther Med. 2015;23(4):612-6.http://dx.doi.org/10.1016/j.ctim.2014.11.003 http://dx.doi.org/10.1016/j.ctim.2014.11... Complement Ther Med. 2015	Control case study (49)	EORTC (QLQ-C30) Pain, itching and fatigue.	III 2
Bazire L¹⁵15 Bazire L, Fromantin I, Diallo A, De la Lande B, Pernin V, Dendale R, et al. Hydrosorb(R) versus control (water based spray) in the management of radio-induced skin toxicity: results of multicentre controlled randomized trial. Radiother Oncol. 2015;117(2):229-33.https://doi.org/10.1016/j.radonc.2015.08.028 https://doi.org/10.1016/j.radonc.2015.08... ⁾ Radiother Oncol. 2015	Randomized clinical trial (278)	Dermatology Life Quality Index (DLQI) Pain and high levels of cutaneous toxicity.	II 1
Hindley A¹⁶16 Hindley A, Zain Z, Wood L, Whitehead A, Sanneh A, Barber D, et al. Mometasone furoate cream reduces acute radiation dermatitis in patients receiving breast radiation therapy: results of a randomized trial. Int J Radiat Oncol Biol Phys. 2014;90(4):748-55.https://doi.org/10.1016/j.ijrobp.2014.06.033 https://doi.org/10.1016/j.ijrobp.2014.06... Int J Radiat Oncol Biol Phys. 2014	Randomized clinical trial (120)	DLQI Symptoms of anxiety and depression.	II 1
Chan RJ¹⁷17 Chan RJ, Mann J, Tripcony L, Keller J, Cheuk R, Blades R, et al. Natural oil-based emulsion containing allantoin versus aqueous cream for managing radiationinduced skin reactions in patients with cancer: a phase 3, double-blind, randomized, controlled trial. Int J Radiat Oncol Biol Phys. 2014;90(4):756-64.https://doi.org/10.1016/j.ijrobp.2014.06.034 https://doi.org/10.1016/j.ijrobp.2014.06... Int J Radiat Oncol Biol Phys. 2014	Randomized clinical trial (174)	Skindex-16 Pain, pruritus and high levels of cutaneous toxicity.	II 1
Sharp L¹⁸18 Sharp L, Johansson H, Hatschek T, Bergenmar M. Smoking as an independent risk factor for severe skin reactions due to adjuvant radiotherapy for breast cancer. Breast. 2013;22(5):634-8https://doi.org/10.1016/j.breast.2013.07.047 https://doi.org/10.1016/j.breast.2013.07... Eur J Oncol Nurs. 2013	Randomized clinical trial (411)	EORTC (QLQ-C30) Pain and sensitivity change.	II 1
Sharp L²⁵25 Sharp L, Finnila K, Johansson H, Abrahamsson M, Hatschek T, Bergenmar M. No differences between Calendula cream and aqueous cream in the prevention of acute radiation skin reactions-results from a randomised blinded trial. Eur J Oncol Nurs. 2013;17(4):429-35.http://dx.doi.org/10.1016/j.ejon.2012.11.003 http://dx.doi.org/10.1016/j.ejon.2012.11... Breast 2013	Control case study (390)	EORTC (QLQ-C30) Severe skin reactions, elevated levels of pain, and altered sleep patterns.	III 2
Dragun AE²³23 Dragun AE, Quillo AR, Riley EC, Roberts TL, Hunter AM, Rai SN, et al. A Phase 2 trial of once-weekly hypofractionated breast irradiation: first report of acute toxicity, feasibility, and patient satisfaction. Int J Rad Oncol Biol Physics. 2013;85(3):E123-8.http://dx.doi.org/10.1016/j.ijrobp.2012.10.021 http://dx.doi.org/10.1016/j.ijrobp.2012.... Int J Radiat Oncol Biol Phys. 2013	Cohort Study (42)	Breast Cancer-Specific Quality of Life Questionnaire (QLQ-BR23) Pain, fatigue, edema, local infection and presence of comorbidities.	III 2
Kirova YM²⁶26 Kirova YM, Fromantin I, De Rycke Y, Fourquet A, Morvan E, Padiglione S, et al. Can we decrease the skin reaction in breast cancer patients using hyaluronic acid during radiation therapy? results of phase III randomised trial. Radiother Oncol. 2011;100(2):205-9.http://dx.doi.org/10.1016/j.radonc.2011.05.014 http://dx.doi.org/10.1016/j.radonc.2011.... Radiotherapy and Oncology. 2011	Prospective Study (93)	EORTC (QLQ-C30) Pain, pruritus, irregular sleep and impaired cognitive functioning. High incidence of injury.	III 2
Schnur JB²⁷27 Schnur JB, Ouellette SC, Dilorenzo TA, Green S, Montgomery GH. A qualitative analysis of acute skin toxicity among breast cancer radiotherapy patients. Psychooncology. 2011;20(3):260-8. http://dx.doi.org/10.1002/pon.1734 http://dx.doi.org/10.1002/pon.1734... Psycho-Oncology 2010	Qualitative study (20)	Interview Pain, discomfort, alteration of body image and emotional reactions.	III 2
Theberge V²¹21 Theberge V, Harel F, Dagnault A. Use of axillary deodorant and effect on acute skin toxicity during radiotherapy for breast cancer: a prospective randomized noninferiority trial. Int J Radiat Oncol Biol Phys. 2009;75(4):1048-52.http://dx.doi.org/10.1016/j.ijrobp.2008.12.046 http://dx.doi.org/10.1016/j.ijrobp.2008.... Int J Radiat Oncol Biol Phys. 2009	Randomized clinical trial (84)	EORTC (QLQ-C30) Edema, pain, discomfort and location of cancer (breast).	II 1
Category 2 - Interventions promoting QL for patients with radiodermatitis			II 1
Censabella S²⁸28 Censabella S, Claes S, Robijns J, Bulens P, Mebis J. Photobiomodulation for the management of radiation dermatitis: the DERMIS trial, a pilot study of MLS® laser therapy in breast cancer patients. Support Care Cancer. 2016;24(9):3925-33.http://dx.doi.org/10.1007/s00520-016-3232-0 http://dx.doi.org/10.1007/s00520-016-323... Suppor Care Cancer. 2016	Cohort study (79)	Skindex-16 Laser therapy that reduced complications such as cutaneous toxicity and promoted greater satisfaction with treatment.	III 2
Rollmann DC¹⁹19 Rollmann DC, Novotny PJ, Petersen IA, Garces YI, Bauer HJ, Yan ES, et al. Double-blind, placebo-controlled pilot study of processed ultra emu oil versus placebo in the prevention of radiation dermatitis. Int J Radiat Oncol Biol Phys. 2015;92(3):650-8.http://dx.doi.org/10.1016/j.ijrobp.2015.02.028 http://dx.doi.org/10.1016/j.ijrobp.2015.... Int J Radiat Oncol Biol Phys. 2014	Randomized clinical trial (42)	Skindex-16 EMU oil reduced skin toxicity, presenting viability and safety in the treatment of radiation-related dermatitis.	II 1
Sharp L²⁰20 Sharp L, Johansson H, Landin Y, Moegelin IM, Bergenmar M. Frequency and severity of skin reactions in patients with breast cancer undergoing adjuvant radiotherapy, the usefulness of two assessment instruments - a pilot study. Eur J Cancer. 2011;47(18):2665-72.http://dx.doi.org/10.1016/j.ejca.2011.06.039 http://dx.doi.org/10.1016/j.ejca.2011.06... Eur J Cancer. 2011	Randomized clinical trial (200)	EORTC (QLQ-C30) The application of QL measurement instruments to provide care planning and care routine.	II 1
Pignol P²²22 Pignol JP, Olivotto I, Rakovitch E, Gardner S, Sixel K, Beckham W, et al. A multicenter randomized trial of breast intensity-modulated radiation therapy to reduce acute radiation dermatitis. J Clin Oncol. 2008;26(13):2085-92.http://dx.doi.org/10.1200/JCO.2007.15.2488 http://dx.doi.org/10.1200/JCO.2007.15.24... ⁾ J Clin Oncol. 2008	Randomized clinical trial (331)	EORTC (QLQ-C30); (QLQ-BR23) Radiation therapy modulated by intensity favored the distribution of the radiation dose and reduced the incidence of moist desquamation.	II 1

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[1] Corresponding author:
Daniel de Macêdo Rocha. daniel_m.rocha@live.com