Bacterial Decolonization for Prevention of Radiation Dermatitis: A Randomized Clinical Trial

Area of Science:

• Oncology
• Dermatology
• Infectious Disease

Background:

• Acute radiation dermatitis (ARD) is a common and debilitating side effect of radiation therapy (RT).
• Current evidence-based strategies for ARD prevention are limited, necessitating novel approaches to improve patient care.
• Bacterial decolonization (BD) has emerged as a potential strategy to mitigate ARD severity.

Purpose of the Study:

• To evaluate the efficacy of bacterial decolonization (BD) in reducing the severity of acute radiation dermatitis (ARD) compared to the standard of care.
• To assess the impact of BD on ARD development in patients receiving RT for breast cancer or head and neck cancer.

Main Methods:

• A phase 2/3 randomized clinical trial was conducted with investigator blinding.
• Patients received either intranasal mupirocin and chlorhexidine body cleanser (BD) or standard of care.
• The primary outcome was the development of grade 2 acute radiation dermatitis with moist desquamation (ARD grade 2-MD).

Main Results:

• None of the 39 patients treated with BD developed ARD grade 2-MD or higher, compared to 9 of 38 patients (23.7%) receiving standard of care (P=.001).
• The mean ARD grade was significantly lower in the BD group (1.2) versus the standard of care group (1.6) (P=.02).
• Regimen adherence was high (69.2%), with only one patient experiencing a mild adverse event (itch).

Conclusions:

• Bacterial decolonization is an effective strategy for the prophylaxis of acute radiation dermatitis, particularly in patients with breast cancer.
• BD represents a safe and effective intervention to reduce ARD severity and improve patient outcomes during RT.
• Further research may explore BD in broader patient populations receiving RT.