Mometasone furoate cream reduces acute radiation dermatitis in patients receiving breast radiation therapy:results of a randomized trial

Hindley, Andrew and Zain, Zakiyah and Wood, Lisa and Whitehead, Anne and Sanneh, Alison and Barber, David and Hornsby, Ruth (2014) Mometasone furoate cream reduces acute radiation dermatitis in patients receiving breast radiation therapy:results of a randomized trial. International Journal of Radiation Oncology - Biology - Physics, 90 (4). pp. 748-755. ISSN 0360-3016

Abstract

Purpose We wanted to confirm the benefit of mometasone furoate (MF) in preventing acute radiation reactions, as shown in a previous study (Boström et al, Radiother Oncol 2001;59:257-265). Methods and Materials The study was a double-blind comparison of MF with D (Diprobase), administered daily from the start of radiation therapy for 5 weeks in patients receiving breast radiation therapy, 40 Gy in 2.67-Gy fractions daily over 3 weeks. The primary endpoint was mean modified Radiation Therapy Oncology Group (RTOG) score. Results Mean RTOG scores were significantly less for MF than for D (P=.046). Maximum RTOG and mean erythema scores were significantly less for MF than for D (P=.018 and P=.012, respectively). The Dermatology Life Quality Index (DLQI) score was significantly less for MF than for D at weeks 4 and 5 when corrected for Hospital Anxiety and Depression (HAD) questionnaire scores. Conclusions MF cream significantly reduces radiation dermatitis when applied to the breast during and after radiation therapy. For the first time, we have shown a significantly beneficial effect on quality of life using a validated instrument (DLQI), for a topical steroid cream. We believe that application of this cream should be the standard of care where radiation dermatitis is expected. Summary In a randomized trial of patients receiving radiation therapy to the breast or chest wall, mometasone furoate cream, when applied from the start of radiation therapy for 5 weeks, was shown to significantly reduce mean Radiation Therapy Oncology Group skin toxicity scores and objective erythema measurements and to significantly reduce impairment of quality of life, using the Dermatology Life Quality Index.