Topical agent therapy for prevention and treatment of radiodermatitis: a meta-analysis

Radiodermatitis (RD) is a common side effect during radiotherapy. Various topical agents have been tried to be applied on RD. However, the efficiency of topical agents applied on radiotherapy is still uncertain. This study aims to assess the efficiency of the topical agents in the prevention and treatment of RD. The Cochrane Central Register of Controlled Trials, Pubmed, and Medline were searched for relevant reports. Quantitative analysis was carried out to evaluate the efficiency of topical agents in the prevention and treatment of RD. Twenty reports involving 3,098 patients were included: 2,406 patients for prophylactic trials and 692 for treatment trials, respectively. For prophylactic trials, primary meta-analysis indicated that using topical agents could not reduce the incidence of grade 2 and higher RD (P = 0.128, RR = 0.90, 95 % CI = 0.78-1.03) with a high heterogeneity (P = 0.000, I (2) = 71.5 %). In subgroup analyses, heterogeneity disappeared by excluding reports with low Jadad score (a parts per thousand currency sign3) (P = 0.292, I (2) = 15.2 %), and still no significant difference was found between the topical agent group and control group (P = 0.625, RR = 0.98, 95 % CI = 0.89-1.07). In addition, for treatment trials, topical agents failed to increase the incidence of wound healing (P = 0.784, RR = 1.01, 95 % CI = 0.92-1.12) with a high heterogeneity (P = 0.067, I (2) = 51.5 %). Topical agents could not prevent or treat RD effectively. New type of agents should be developed to improve the efficiency based on the pathophysiology of RD.