Management of erythema and skin preservation; advice for patients receiving radical radiotherapy to the breast: a systematic literature review

Objective: To systematically review and critically appraise all evidence on skin care advice and products tailored for patients receiving radical radiotherapy for breast cancer and to determine an evidence-based conclusion regarding the most effective products. Data Resources and Review Methods: Major healthcare databases were searched with additional efforts made to hand-search current journals. All relevant literature fulfilling the inclusion and exclusion criteria was subjected to quality assurance checks. Those that passed underwent a more rigorous appraisal and were included in the review. Results: Ten studies were identified as fulfilling the review criteria with regards to aims and quality. All were randomised controlled trials; three were double-blinded, three were single-blinded, the remaining were not blinded. Two addressed washing regimes, two addressed deodorant use, whilst the six remaining studies investigated creams, gels or dressings. Conclusions: The results suggest that there is a place for creams in the management and delay of radiation-induced skin toxicities; however, research fails to highlight one product which has a demonstrable benefit over others whilst still being cost effective and free from adverse effects. Patients should not be discouraged from washing with water or mild soaps and results suggest that the restriction of aluminiumfree deodorant during treatment is unnecessary; however, more research in this area is needed with larger sample sizes.