Topical silver sulfadiazine for the prevention of acute dermatitis during irradiation for breast cancer.

PURPOSE: This study aimed to evaluate the effectiveness of topical silver sulfadiazine (SSD) in preventing acute radiation dermatitis in women receiving radiotherapy for breast cancer. METHODS: A randomized controlled clinical trial was conducted on patients with breast cancer referred for radiotherapy after treatment with mastectomy and chemotherapy. The patients were randomized into the intervention (n = 51) and control (n = 51) groups and were instructed on general skin care during radiotherapy. The intervention group received SSD cream 1%, three times a day, 3 days a week, for 5 weeks during radiotherapy and one week thereafter. A blinded observer assessed the severity of dermatitis weekly (for 6 weeks) and graded it from 0 to 4 according to the Radiation Therapy Oncology Group criteria. RESULTS: The two groups were similar in baseline characteristics. Two patients in the control group discontinued the radiotherapy course because of severe skin injuries (grades 3 and 4). The intervention group encountered significantly less severe dermatitis during radiotherapy compared to the controls. The total score of skin injury was also lower in the intervention group compared with controls (5.49 ± 1.02 vs. 7.21 ± 1.76, p < 0.001). A multivariate analysis found that the use of SSD cream (p < 0.001) and flat chest wall anatomy (p = 0.008) were significantly associated with a decreased skin injury. CONCLUSIONS: SSD cream reduced the severity of radiation-induced skin injury compared with general skin care alone. Further studies in patients with other types of cancer and also comparing SSD cream with other topical agents are warranted.

Evaluation of relationship between breast cancer and migraine.

BACKGROUND: Frequency of migraine changes at different times of a woman's reproductive cycle because of fluctuation of estrogen levels. Breast cancer has also a link with hormonal changes. Given this fact that both migraine and breast cancer are affected by estrogen, the prevalence of migraine may be different in breast cancer patients compared to the normal population. MATERIALS AND METHODS: In this case-control study, two groups of women with and without breast cancer were compared regarding the prevalence of migraine. Each group consisted of 400 women. The diagnosis of different types of headache was made based on The International Headache Society (IHS) guidelines. Type of headache, type and receptor status of breast cancer, as well as history of taking hormonal medications was recorded. Independent t-test and Chi-square tests were used for data analysis. RESULTS: Relative frequency of migraine headache in the normal woman was 38% compared to 19% in the breast cancer group (P < 0.0001). Tension headache was also significantly more prevalent in the normal group (P < 0.001). The frequency of migraine was significantly lower in estrogen receptor (ER)+/progesterone receptor (PR)- women compared to ER-/PR+ (26 and 43 women, respectively; P = 0.04); however, this difference was not significant for tension headache (P = 0.68). CONCLUSION: This study confirmed the lower frequency of migraine, as well as tension headache, in breast cancer sufferers. This could be contributed to several non-hormonal factors, such as a history of long term use of nonsteroidal anti-inflammatory drugs (NSAIDs), and hormonal factors, although only migraine showed a strong link with hormone status.

Clinical evaluation of BIOXTRA in relieving signs and symptoms of dry mouth after head and neck radiotherapy of cancer patients at Seyed-al-Shohada Hospital, Isfahan, Iran.

BACKGROUND: Radiotherapy of head and neck cancers causes acute and chronic xerostomia and acute mucositis. Xerostomia increases risk of radiation caries and affects on oral comfort, fit of prostheses, speech, swallowing, and the growth of caries-producing organisms. Salivary flow rate can be measured by asking patients some questions. There are different types of commercial synthetic saliva such as BIOXTRA, but until now, no one can effectively relieve xerostomia. We tried to design a clinical research on BIOXTRA efficacy for treating xerostomia. MATERIALS AND METHODS: In this research, 58 patients with head and neck cancer (except salivary gland cancers) treated in Seyed-al-Shohada Hospital. The patients received at least 40-50 GY; and after 2 months of compilation treatment, they were evaluated by asking about having xerostomia. Before and after treatment with the BIOXTRA, the PH of the oral cavity, candida albicans, and lactobacillus counts measured and documented in laboratory. We used BIOXTRA for 2 weeks, 3 times daily, and then re-evaluated patients with some questions. RESULTS: The counts of candida albicans and lactobacilli statistically significant decreased. CONCLUSION: Xerostomia for most patients improved clinically during the day and night while PH of the oral cavity increased.