Vavassis P, Gelinas M, Chabot Tr J, Nguyen-Tân PF, et al.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de.... Date of publication 2008 Feb 1;volume 37(1):124-9.
1. J Otolaryngol Head Neck Surg. 2008 Feb;37(1):124-9.
Phase 2 study of silver leaf dressing for treatment of radiation-induced
dermatitis in patients receiving radiotherapy to the head and neck.
Vavassis P(1), Gelinas M, Chabot Tr J, Nguyen-Tân PF.
Author information:
(1)Department of Radiation Oncology, Centre Hospitalier de l'Université de
Montréal, Montreal, Quebec. pvavassis.hmr@ssss.gouv.qc.ca
OBJECTIVE: The use of silver leaf dressing is common in the treatment of burn
victims owing to its capacity to improve healing and inherent antimicrobial
properties. The goal of this study was to investigate its effectiveness in the
treatment of radiation-induced dermatitis in a patient population receiving
radiotherapy with or without concurrent chemotherapy for various carcinomas of
the head and neck compared with our current standard of care, silver sulfadiazine
(Flamazine).
METHODS: Twelve patients presenting with cancers of the head and neck region with
Radiation Therapy Oncology Group (RTOG) grade 2 or more skin toxicity were
offered topical treatment of silver sulfadiazine and silver leaf dressing. Each
patient applied silver-leaf dressing on one side of the neck and silver
sulfadiazine on the other. Three independent observers evaluated the patients
based on standardized digital photography and regular follow-up by the treating
physician. The sign test was used to evaluate whether the observed difference was
statistically significant.
RESULTS: There was no improvement in RTOG grade skin toxicity. However, within
the same grade, two of three observers agreed on some degree of improvement in
the dermatitis with silver leaf dressing compared with silver sulfadiazine. As
well, 67% of patients reported improved pain control on the side treated with
silver leaf dressing. Sign test analysis indicated that the use of silver-leaf
dressing gave significantly superior results when compared with silver
sulfadiazine (p = .035).
CONCLUSION: Silver leaf dressing does not appear to be superior to our standard
treatment for radiation-induced dermatitis when the RTOG grading system is used.
It does, however, seem to reduce the severity of reaction within the same grade,
accelerate healing, and provide improved pain control over standard treatment. It
shows promise regarding symptom control and merits further investigation.
PMID: 18479639 [Indexed for MEDLINE]
