Meghrajani, C.F., Co, H.S., Arcillas, J.G., Maano, C.C., & Cupino, N.A. (2015). A randomized, double-blind trial on the use of 1% hydrocortisone cream for the prevention of acute radiation dermatitis. Expert Review of Clinical Pharmacology, 9, 483–491.
To evaluate the efficacy of 1% hydrocortisone cream for the prevention of acute radiodermatitis
Patients were randomized to receive either 1% hydrocortisone or placebo cream. Patients were to apply the cream to the irradiated field twice daily beginning on the first day of radiation therapy until one week after the last radiation session. The cream was to be applied at least two hours prior to therapy. Patients were instructed not to use any other topical medications or deodorants during the study. In case of severe radiodermatitis, additional treatment was determined by the dermatologist. These patients were considered treatment failures and were included in the analysis. Patients were evaluated at one, two, three, four, and five weeks.
PHASE OF CARE: Active antitumor treatment
Four patients from each group developed moist desquamation by week 5. No difference existed between groups in preventing moist desquamation. At week 1, a higher incidence of grade 1 dermatitis was observed in the placebo group (p = 0.038), and at week 4, a higher occurrence of grade 2 dermatitis was observed in the placebo group (p = 0.017). Groups were comparable at weeks 3–5. The incidence of pruritus was less in the steroid group in weeks 4 and 5 (p < 0.04).
The findings suggest that the use of topical 1% hydrocortisone cream reduced pruritus and delayed the onset of radiation dermatitis. However, it did not prevent moist desquamation compared to the placebo.
Topical steroid cream was associated with less pruritus from radiodermatitis and may delay the onset of skin problems; however, it was not effective in preventing severe skin toxicity. Whether stronger formulations would be more beneficial is unclear. Patients can benefit from the use of topical steroids to reduce itching.