688 Prevention and management of radiation skin reactions: a randomised controlled trial of skin care approaches in patients with breast, head and neck and anorectal cancer

Colloidal oatmeal emollient as an alternative skincare approach in radiotherapy: a feasibility study

Aim

To assess the feasibility of a randomised controlled trial (RCT) on patients receiving radical radiotherapy for carcinoma of the anus in order to compare the present skincare advice at the time of the study with an alternative product, Aveeno, used primarily for dermatological and chemotherapeutic-induced skin conditions.

Materials and method

Standardised Radiation Therapy Oncology Group (RTOG) grading and skincare assessments were used primarily to inform on physical reactions within a RCT. A pre-existing morbidity/quality-of-life instrument ‘the Head and Neck Radiotherapy Questionnaire’, which was validated for use with radiotherapy patients in preceding studies, was adapted for anus patients and formed the secondary basis for data collection. In all, 24 participants undergoing radical radiotherapy for anal cancer were randomised into two arms, Aveeno cream versus Aqueous Cream BP, and reviewed weekly to collect data and perform analysis and Mann–Whitney U non-parametric statistical tests.

Results

RTOG gradings for skin reactions were comparable week by week across the cohorts, with a baseline 100% of participants exhibiting RTOG 0 at week 1 in all areas, through to week 6 where both cohorts had progressed to higher RTOG grades. The Aveeno cohort, however, indicated ap-value approaching significance in regards to epidermal regeneration at follow-up 1 (p=0·0543). Questionnaires yielded diminishing responses as treatment progressed correlating with advancing RTOG grades, and exhibited increasing negativity in responses in correlation with advancing RTOG grade exhibited.

Conclusion

The study was the first to recognise colloidal oatmeal as a skincare approach in the radiotherapy setting and recognises the potential benefits of Aveeno in radiation-induced skin reactions. The study determined the RTOG grading system to be robust as a method of evaluation of skin reactions and the questionnaires deemed the quality-of-life assessment to be a necessity in order to address patients’ psychological needs in addition to the physical needs.