Head-and-neck cancer

12. Oct 2016
Prevention of radiation dermatitis in patients with locally advanced head-and-neck cancer.

Radiation-induced skin reactions
Annually, about 50 of 100 000 inhabitants develop a malignant head-and-neck tumor. Patients most commonly receive radiotherapy or radiochemotherapy (radiotherapy combined with concurrent chemotherapy) either with or without surgery. An acute side effect of radiotherapy is the inflammation of the skin (radiation dermatitis). The skin reactions range from a slight redness via a dry desquamation of through to extensive moist desquamation with blistering and are stressful for the patients. If the skin toxicity becomes severe (grade 3), it may lead to interruptions of the planned therapy, which can be associated with poorer treatment outcomes in patients.
In order to successfully avoid severe skin reactions, it appears mandatory to avoid or at least postpone the development of grade 2 skin toxicity. Despite application of regular standard care procedures, more than 80 percent of patients receiving radiotherapy for treatment of head-and-neck cancer, report grade 2 skin reactions. These figures for side effects need to be improved.

Self-adhesive dressing for reduced skin reaction
The results of a published study investigating the use of a self-adhesive dressing as a new option for the treatment of radiation-related dermatitis of breast cancer patients were promising. Recently, a new dressing has been developed, which is thinner and more comfortable for the affected patients.

Course of the study
The aim for the present study named RAREST (RAdiotherapy RElated Skin Toxicity) is to compare the new dressing with the standard skin care. 168 patients receiving radiotherapy alone or radiochemotherapy for locally advanced head-and-neck cancer will be included. The primary aim is to investigate the rate of patients experiencing severe, stressful radiation dermatitis. The skin status will daily be inspected and assessed by specially trained doctors and nursing staff.

Objectives
It is expected that the new self-adhesive dressing is superior to standard care with respect to prevention of grade 2 radiation dermatitis in patients receiving radiotherapy or radio(chemo)therapy for a head-and-neck tumor. Thus, the dressing would be well qualified to become a new standard procedure at the skin care of patients with a head-neck tumor.

Coordinating Investigator
Prof. Dr. med. Dirk Rades, Department of Radiation Oncology, University of Lübeck / University Medical Center Schleswig-Holstein Campus Lübeck (Germany)