Roy I, Fortin A, Larochelle M, et al.
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncol.... Date of publication 2001 Mar 1;volume 58(3):333-9.
1. Radiother Oncol. 2001 Mar;58(3):333-9.
The impact of skin washing with water and soap during breast irradiation: a
randomized study.
Roy I(1), Fortin A, Larochelle M.
Author information:
(1)Department of Radiation Oncology, Centre Hospitalier Universitaire de Québec,
Pavillon L'Hôtel-Dieu de Québec, 11, Côte-du-Palais, Quebec City, Quebec, Canada.
BACKGROUND: The effect of washing the irradiated skin during radiotherapy for
breast cancer is uncertain. The purpose of this study was to evaluate the impact
of washing the breast skin with water and soap during radiotherapy on the
intensity of acute skin toxicity.
MATERIALS AND METHODS: Ninety-nine patients treated for breast cancer were
prospectively randomized prior to receiving radiotherapy to the breast into two
groups: (1), no washing was allowed during radiotherapy (49 patients); and (2),
washing was allowed with water and soap (50 patients). Acute toxicity was
recorded according to the Radiation Therapy Oncology Group (RTOG) acute skin
toxicity scale for each patient every week during radiotherapy and 1 month after
the end of radiotherapy. Symptoms related to skin toxicity were scored by visual
analogue scales at the same time intervals. Other data collected included
sociodemographic data, characteristics related to the tumor and previous
treatments, radiation technique, necessity for a second simulation due to loss of
skin marks and treatment interruptions.
RESULTS: In the non-washing group, the following maximum acute toxicity scores
were observed: grade 0, 2%; grade 1, 41%; grade 2, 57%; grades 3 and 4, 0%. For
the washing group, the scores were: grade 0, 0%; grade 1, 64%; grade 2, 34%;
grade 3, 2%; and grade 4, 0%. Moist desquamation was seen in 33% of non-washing
patients, but in only 14% of washing patients. The median scores of pain, itching
and burning of the treated skin were higher in the non-washing group, although
this was not statistically significant. In a multivariate analysis using logistic
regression, acute skin toxicity was associated with the patient's weight,
concomitant radiochemotherapy and hot spots on dosimetry, and there was a trend
toward more acute skin toxicity in the non-washing group.
CONCLUSION: Washing the irradiated skin during the course of radiotherapy for
breast cancer is not associated with increased skin toxicity and should not be
discouraged.
PMID: 11230896 [Indexed for MEDLINE]
