A randomized, double-blind trial on the use of 1% hydrocortisone cream for the prevention of acute radiation dermatitis

Abstract

Background: To determine whether the application of 1% hydrocortisone cream during radiation therapy can prevent the occurrence of moist desquamation.

Methods: Fifty adult female breast carcinoma patients were randomized after modified radical mastectomy and chemotherapy to receive prophylactic placebo cream (n = 27) or 1% hydrocortisone cream (n = 23) during radiation therapy. The patients, caregiver and assessor were all blinded to the treatment received. Occurrence of moist desquamation, severity of acute radiation dermatitis (ARD) and hyperpigmentation were evaluated weekly until the end of radiotherapy.

Results & conclusion: Five patients in each group developed moist desquamation; however, its extent and severity were milder in the steroid group. Mean ARD scores were also lower in the steroid group (0.713 vs. 0.874, p = 0.024). A lower incidence of Grades 1 and 2 radiation dermatitis was also noted in the steroid group at weeks 2 and 4, respectively, indicating prophylactic use of steroids delayed the onset of radiodermatitis.

Keywords: Radiation dermatitis; moist desquamation; prevention; randomized controlled trial; topical corticosteroid.