Evidence map›Paper›PMID 39903309›Full record

SynthesisSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025

A critical review of randomized controlled trials on topical corticosteroids for the prevention of radiation dermatitis in breast cancer.

Olivia Kuszaj, Marley Day, Shirley S W Tse, Shing Fung Lee, Alyssa J Wang, Sarah Bayrakdarian, Danny Vesprini, Kimberly Corbin, Irene Karam, J Isabelle Choi and 8 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. MASCC clinical practice statement: Prevention and management of acute radiation dermatitis using topical corticosteroids.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Guideline
  2. Radiomitigators: Breakthroughs in Post-Radiation Recovery.Antioxidants (Basel, Switzerland) · 2026
    Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Olivia KuszajOdette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Marley DayOdette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Shirley S W TseDepartment of Clinical Oncology, United Christian Hospital, Kowloon East Cluster, Hospital Authority, Hong Kong S.A.R, China.
Shing Fung LeeDepartment of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore, Singapore.
Alyssa J WangOdette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Sarah BayrakdarianOdette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Danny VespriniOdette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Kimberly CorbinDepartment of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
Irene KaramOdette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
J Isabelle ChoiDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Gustavo N MartaDepartment of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, Brazil.
Jeffrey Q CaoDivision of Radiation Oncology, Department of Oncology, University of Calgary, Calgary, AB, Canada.
Tarek HijalDepartment of Oncology, McGill University, Montreal, QC, Canada.
Rosemary HillLions Gate Hospital, North Vancouver, British Columbia, Canada.
Francois GallantOdette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Adrian W ChanOdette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Edward ChowOdette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Henry C Y WongDepartment of Oncology, Princess Margaret Hospital, Kowloon West Cluster, Hospital Authority, 6/F, Block H, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong S.A.R, China. henrywong3011@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTopical steroids have shown effectiveness in preventing radiation dermatitis (RD) in breast cancer patients in randomized controlled trials (RCTs). This review provides an in-depth analysis of the study methodology of these RCTs to review whether topical steroids should be employed in routine clinical practice.

methodsA systematic literature search of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials was conducted from database inception until May 31, 2024. RCTs comparing topical steroids with moisturizers or placebo for the prophylaxis of RD in breast cancer patients were included. The methodology of the RCTs, including how topical steroids were applied, whether crossover in the control arm was allowed, if stratification factors were employed, and the reporting of side effects was evaluated.

resultsTwelve RCTs met inclusion criteria. Four different topical steroids were used, including betamethasone 0.1%, mometasone 0.1%, hydrocortisone 1%, and beclomethasone. Eleven studies (92%) showed that topical steroids were effective in reducing incidence or delaying occurrence of grade 2 or above RD with a relative risk of 0.69 (range, 0.19 to 0.98). In all RCTs, topical steroids were consistently used from the start of radiotherapy (RT) until completion to 3 weeks post-RT. Five RCTs (42%) provided patient education on topical steroid application. Six (50%) reported on subsequent management if moist desquamation occurred. Four studies (33%) stratified potential risk factors of RD during randomization. No studies reported any long-term side effects of topical steroids.

conclusionTopical steroids are effective in reducing the incidence of RD. However, heterogeneity was observed among the RCTs with regard to how and when the topical steroids were applied. The long-term safety profile of topical steroids is not well studied. In the context of modern radiotherapy planning techniques and increased use of hypofractionation radiation schedules, a repeat RCT addressing these methodological concerns may provide more guidance to clinicians.

Indexed as

Adrenal Cortex HormonesBreast NeoplasmsRadiodermatitisAdministration, TopicalFemaleHumansRandomized Controlled Trials as TopicAdrenal Cortex HormonesBreast cancerRadiation dermatitisTopical corticosteroids

Identifiers

PMID39903309

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.