calendula and Radiodermatitis

to analyze the effectiveness of skin protectors and Calendula officinalis for prevention and treatment of radiodermatitis.. an integrative review conducted at CINAHL, Cochrane Library, Embase, MEDLINE/PubMed, IBECS, LILACS, and Web of Science. The final sample consisted of five studies, four clinical studies and one preclinical. Critical appreciation and narrative synthesis of the findings were carried out.. the Cavilon™ skin protector was more effective than Sorbolene (cream with 10% glycerin) and less effective than Mometasone Furoate cream. Calendula officinalis was more effective than Trolamine and essential fatty acids and less effective than Ching Wan Hung® for prevention and treatment of radiodermatitis.. data confirm the potential of Calendula officinalis for prevention and treatment of radiodermatitis and point to promising results regarding skin protector use; however, there is a need for further testing as to the effectiveness of such products.

Topics: Calendula; Humans; Phytotherapy; Plant Extracts; Radiodermatitis

Acute radiation dermatitis is a common side-effect of radiotherapy which often necessitates interruption of the therapy. Currently, there is no general consensus about its prevention or about the treatment of choice. The goal of this work was to focus on optimal methods to prevent and manage acute skin reactions related to radiation therapy and to determine if there are specific topical or oral agents for the prevention of this acute skin reaction. The prevention and the early treatment are the two focus points of the management of the acute radiation dermatitis.

Topics: Acute Disease; Administration, Cutaneous; Anti-Infective Agents, Local; Baths; Calendula; Combined Modality Therapy; Debridement; Dermatologic Agents; ErbB Receptors; Ethanolamines; Humans; Hyaluronic Acid; Multicenter Studies as Topic; Phytotherapy; Plant Extracts; Radiodermatitis; Radiotherapy; Randomized Controlled Trials as Topic

Homeopathic medicines are used by patients with cancer, often alongside conventional treatment. Cancer treatments can cause considerable morbidity and one of the reasons patients use homeopathic medicines is to help with adverse effects.. Evaluate effectiveness and safety of homeopathic medicines used to prevent or treat adverse effects of cancer treatments.. The following were searched up to November 2008: Cochrane PaPaS Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; CINAHL; BNI; CancerLIT; AMED; CISCOM; Hom-Inform; SIGLE; National Research Register; Zetoc; www.controlled-trials.com; http://clinicaltrials.gov; Liga Medicorum Homeopathica Internationalis (LMHI, Liga) conference proceedings; reference lists of relevant studies were checked; and homeopathic manufacturers, leading researchers and practitioners were contacted.. Randomised controlled trials (RCTs) of homeopathic medicines in participants with a clinical or histological diagnosis of cancer where the intervention was aimed at preventing or treating symptoms associated with cancer treatments. All age groups, and all stages of disease were included.. Two review authors independently assessed studies for inclusion and two review authors extracted data. Three review authors independently assessed trial quality using the Delphi List and the Cochrane Collaboration's tool for assessing risk of bias. Disagreements were resolved by consensus. Where available, data were extracted for analysis.. Eight controlled trials (seven placebo controlled and one trial against an active treatment) with a total of 664 participants met the inclusion criteria. Three studied adverse effects of radiotherapy, three studied adverse effects of chemotherapy and two studied menopausal symptoms associated with breast cancer treatment.Two studies with low risk of bias demonstrated benefit: one with 254 participants demonstrated superiority of topical calendula over trolamine (a topical agent not containing corticosteroids) for prevention of radiotherapy-induced dermatitis, and another with 32 participants demonstrated superiority of Traumeel S (a proprietary complex homeopathic medicine) over placebo as a mouthwash for chemotherapy-induced stomatitis. Two other studies reported positive results, although the risk of bias was unclear, and four further studies reported negative results.No serious adverse effects or interactions were reported attributable to the homeopathic medicines used.. This review found preliminary data in support of the efficacy of topical calendula for prophylaxis of acute dermatitis during radiotherapy and Traumeel S mouthwash in the treatment of chemotherapy-induced stomatitis. These trials need replicating. There is no convincing evidence for the efficacy of homeopathic medicines for other adverse effects of cancer treatments. Further research is required.

Topics: Antineoplastic Agents; Breast Neoplasms; Calendula; Female; Homeopathy; Humans; Menopause; Minerals; Neoplasms; Phytotherapy; Plant Extracts; Radiation Injuries; Radiodermatitis; Randomized Controlled Trials as Topic; Stomatitis

Radio-epithelitis represents a common problem, for which treatments are characterized by a great heterogeneity. The present review of literature focuses on data referenced in Pubmed((c))/Medline((c)) and published in French/English. Despite a real preclinical rationale, aloe vera and trolamine failed to demonstrate any benefit in the prophylactic settings. In a prospective assessment phase III assessment, Calendula Officinalis was shown to be superior to trolamine for the prevention of radio-epithelitis. In the curative settings, sucrafalte failed to demonstrate any benefit. The benefit of dermocorticoids was suggested in terms of erythema and itching. Promising clinical results are available with hyaluronic acid (MA S065D and Ialugen) and silver leaf may reduce the intensity of cutaneous radio-induced side effects. Data from the literature are conflicting, making real the difficulty to adopt from clinical trials any proof-of-principle strategy. Considering these uncertainties, several strategies are allowed. New topics are under investigation. Present data from the literature highlight the need for further trials, in order to propose evidence-based treatments and to harmonize clinical practice.

Topics: Administration, Topical; Adrenal Cortex Hormones; Aloe; Calendula; Dermatologic Agents; Emulsions; Eosine Yellowish-(YS); Fatty Acids; Humans; Hyaluronic Acid; Lipids; Phytotherapy; Plant Preparations; Radiodermatitis; Radiotherapy; Salicylates; Sesquiterpenes; Sucralfate

To review published studies evaluating interventions for the prevention and management of radiation skin reactions/dermatitis.. Research studies, review articles, and clinical practice guidelines.. There is insufficient evidence in the literature to recommend specific topical or oral agents in the prevention or management of skin reactions. Recent limited evidence suggests that the use of calendula cream may reduce the incidence of grade 2 and 3 reactions in women with breast cancer. Additionally, early studies evaluating the use of barrier films or creams may improve moist desquamation.. Oncology nurses need to increase their awareness of the evidence or lack of evidence when recommending interventions to their patients. Further research is required to evaluate interventions in the prevention and management of radiation dermatitis.

Topics: Acute Disease; Adjuvants, Immunologic; Administration, Cutaneous; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Bandages; Calendula; Dermatologic Agents; Emollients; Emulsions; Evidence-Based Medicine; Humans; Hyaluronic Acid; Lipids; Neoplasms; Nursing Assessment; Ointments; Oncology Nursing; Phytotherapy; Radiation Oncology; Radiodermatitis; Severity of Illness Index; Skin; Skin Care; Skin Physiological Phenomena; Sucralfate

A randomised controlled trial was undertaken to compare the efficacy of topical Calendula officinalis (Calendula) versus standard of care (Sorbolene: 10% glycerine in cetomacragol cream) in reducing the prevalence of radiation-induced dermatitis in women undergoing breast cancer radiotherapy.. A total of 271 women were screened and 82 were randomised. The primary outcome was prevalence of acute radiation-induced dermatitis (RTOG grade 2+) assessed at multiple skin sites. A chi-squared test was conducted for the primary outcome with a worst-case scenario imputation.. The recruitment target (n = 178) was not achieved. A total of n = 81 participants were analysed (n = 40 Calendula; n = 41 Sorbolene). There was no detectable difference in prevalence of radiation-induced dermatitis grade 2+ between the Calendula (53%) and Sorbolene (62%) groups (primary analysis OR = 0.87, 95% CI: [0.36, 2.09], P = 0.92; covariate adjusted complete case analysis OR 0.40, 95% CI: [0.13, 1.20], P = 0.10).. This randomised controlled trial showed no difference between Calendula and standard of care (Sorbolene) for the prevention of radiation-induced dermatitis. However, the study was underpowered (limited recruitment) for the primary comparison.

Topics: Administration, Topical; Adult; Aged; Breast Neoplasms; Calendula; Female; Humans; Middle Aged; Ointments; Phytotherapy; Plant Extracts; Radiodermatitis; Single-Blind Method

To evaluate the efficacy of Calendula officinalis in relation to Essential Fatty Acids for the prevention and treatment of radiodermatitis.. This is a randomized double-blind controlled clinical trial with 51 patients with head and neck cancer in radiotherapy treatment divided into two groups: control (27) and experimental (24).. There is statistically significant evidence (p-value = 0.0120) that the proportion of radiodermatitis grade 2 in Essential Fatty Acids group is higher than Calendula group. Through the Kaplan-Meier survival curve we observed that Essential Fatty Acids group has always remained below the Calendula group survival curve, due to the lower risk of developing radiodermatitis grade 1, which makes the usage of Calendula more effective, with statistical significance (p-value = 0.00402).. Calendula showed better therapeutic response than the Essential Fatty Acids in the prevention and treatment of radiodermatitis. Brazilian Registry of Clinical Trials: RBR-237v4b.

Topics: Calendula; Double-Blind Method; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Phytotherapy; Radiodermatitis

The purpose of this blinded, randomized clinical trial was to compare two topical agents (Calendula Weleda cream vs. Essex cream) in reducing the risk of severe acute radiation skin reactions (ARSR) in relation to adjuvant radiotherapy (RT) for breast cancer.. The primary endpoint was the difference in proportion of patients with ARSR, assessed with the Radiation Therapy Oncology Group/The Organization for Research and Treatment of Cancer Acute Radiation Morbidity Scoring Criteria (RTOG/EORTC scale) at follow-up. The secondary endpoints included patient reported outcome measures; Quality of Life Questionnaire (QLQ-C30), Sleep disturbances (MOS-sleep questionnaire) and symptoms from the irradiated area (visual analogue scale). Patients' experiences and adherence to the topical agents were also evaluated.. A total of 420 patients were randomised and 411 were analysed. With the exception of previous chemotherapy, the treatment groups were well balanced, both regarding treatment- and patient-related factors. The incidence of severe ARSR (RTOG/EORTC grade ≤2) at the follow-up visit was 23% (n = 45) in the Calendula group and 19% (n = 38) in the Essex group. We found no difference in severe ARSR between the groups at any point of assessment. The patients reported low levels of skin related symptoms and no statistically significant differences between the groups were found.. No differences in ARSR between patients randomised to Calendula or Essex cream was found. ARSR seem to be a relatively limited problem, probably more influenced by treatment related factors than by choice of skin care products in this patient group.

Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Calendula; Female; Humans; Medication Adherence; Middle Aged; Phytotherapy; Plant Extracts; Quality of Life; Radiodermatitis; Radiotherapy, Adjuvant; Regression Analysis; Single-Blind Method; Skin Cream; Surveys and Questionnaires; Treatment Outcome

The effectiveness of nonsteroid topical agents for the prevention of acute dermatitis during adjuvant radiotherapy for breast carcinoma has not been demonstrated. The goal of this study was to compare the effectiveness of calendula (Pommade au Calendula par Digestion; Boiron Ltd, Levallois-Perret, France) with that of trolamine (Biafine; Genmedix Ltd, France), which is considered in many institutions to be the reference topical agent.. Between July 1999 and June 2001, 254 patients who had been operated on for breast cancer and who were to receive postoperative radiation therapy were randomly allocated to application of either trolamine (128 patients) or calendula (126 patients) on the irradiated fields after each session. The primary end point was the occurrence of acute dermatitis of grade 2 or higher. Prognostic factors, including treatment modalities and patient characteristics, were also investigated. Secondary end points were the occurrence of pain, the quantity of topical agent used, and patient satisfaction.. The occurrence of acute dermatitis of grade 2 or higher was significantly lower (41% v 63%; P <.001) with the use of calendula than with trolamine. Moreover, patients receiving calendula had less frequent interruption of radiotherapy and significantly reduced radiation-induced pain. Calendula was considered to be more difficult to apply, but self-assessed satisfaction was greater. Body mass index and adjuvant chemotherapy before radiotherapy after lumpectomy were significant prognostic factors for acute dermatitis.. Calendula is highly effective for the prevention of acute dermatitis of grade 2 or higher and should be proposed for patients undergoing postoperative irradiation for breast cancer.

Topics: Acute Disease; Administration, Topical; Adolescent; Adult; Aged; Breast Neoplasms; Calendula; Combined Modality Therapy; Ethanolamines; Female; Humans; Middle Aged; Ointments; Plant Extracts; Radiation Injuries; Radiodermatitis; Radiotherapy, Adjuvant

Acute radiation dermatitis remains one of the most commonly observed side effect during radiation therapy leading to complication such as superinfection or treatment disruption. Its management is characterized by a great heterogeneity. Few strategies have demonstrated a benefit in preventing radiation dermatitis, which relies mostly on decreasing dose delivered to the skin and skin care practices. Simple emollients and use of topical steroids can be useful in early stages. The singularity of the skin toxicity seen with cetuximab and radiotherapy warrants a specific grading system and distinctive clinical treatment with use of antibiotics.

Topics: Adjuvants, Immunologic; Analgesics; Anti-Infective Agents, Local; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Bandages, Hydrocolloid; Calendula; Cetuximab; Dermatologic Agents; Eosine Yellowish-(YS); Ethanolamines; Glucocorticoids; Humans; Hyaluronic Acid; Methylprednisolone; Phytotherapy; Radiodermatitis; Radiotherapy; Radiotherapy Dosage; Severity of Illness Index; Skin Care