mupirocin and Breast-Neoplasms

Evidence-based approaches for the prevention of acute radiation dermatitis (ARD) are limited, and additional strategies are necessary to optimize care.. To determine the efficacy of bacterial decolonization (BD) to reduce ARD severity compared with standard of care.. This phase 2/3 randomized clinical trial was conducted from June 2019 to August 2021 with investigator blinding at an urban academic cancer center and enrolled patients with breast cancer or head and neck cancer receiving radiation therapy (RT) with curative intent. Analysis was performed on January 7, 2022.. Intranasal mupirocin ointment twice daily and chlorhexidine body cleanser once daily for 5 days prior to RT and repeated for 5 days every 2 weeks through RT.. The primary outcome as planned prior to data collection was the development of grade 2 or higher ARD. Based on wide clinical variability of grade 2 ARD, this was refined to grade 2 ARD with moist desquamation (grade 2-MD).. Of 123 patients assessed for eligibility via convenience sampling, 3 were excluded, and 40 refused to participate, with 80 patients in our final volunteer sample. Of 77 patients with cancer (75 patients with breast cancer [97.4%] and 2 patients with head and neck cancer [2.6%]) who completed RT, 39 were randomly assigned BC, and 38 were randomly assigned standard of care; the mean (SD) age of the patients was 59.9 (11.9) years, and 75 (97.4%) were female. Most patients were Black (33.7% [n = 26]) or Hispanic (32.5% [n = 25]). Among patients with breast cancer and patients with head and neck cancer (N = 77), none of the 39 patients treated with BD and 9 of the 38 patients (23.7%) treated with standard of care developed ARD grade 2-MD or higher (P = .001). Similar results were observed among the 75 patients with breast cancer (ie, none treated with BD and 8 [21.6%] receiving standard of care developed ARD grade ≥2-MD; P = .002). The mean (SD) ARD grade was significantly lower for patients treated with BD (1.2 [0.7]) compared with patients receiving standard of care (1.6 [0.8]) (P = .02). Of the 39 patients randomly assigned to BD, 27 (69.2%) reported regimen adherence, and only 1 patient (2.5%) experienced an adverse event related to BD (ie, itch).. The results of this randomized clinical trial suggest that BD is effective for ARD prophylaxis, specifically for patients with breast cancer.. ClinicalTrials.gov Identifier: NCT03883828.

Topics: Breast Neoplasms; Chlorhexidine; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Mupirocin; Radiodermatitis

A 39-year-old female patient who consulted due to onycholysis, subungual hyperkeratosis and presence of exudate in the big toe of the right foot. The lesions appeared during oncology treatment of bilateral breast cancer with lymphatic metastases with paclitaxel every three weeks and capecitabine daily. Clinical manifestations are due to the involvement of the nail bed caused by the chemotherapy. These should be known and taken into account due to the increased use of this type of cytotoxic agents.

Topics: Adult; Anti-Bacterial Agents; Antimetabolites, Antineoplastic; Antineoplastic Agents, Phytogenic; Astringents; Breast Neoplasms; Capecitabine; Deoxycytidine; Exudates and Transudates; Female; Fluorouracil; Hallux; Humans; Keratosis; Mupirocin; Nail Diseases; Ointments; Paclitaxel; Time Factors; Treatment Outcome; Zinc Sulfate