Elaine Barros Ferreira

Topical interventions to prevent acute radiation dermatitis in head and neck cancer patients: a systematic review

PurposeThe purpose of the study is to evaluate the effects of pharmacological and non-pharmacological topical controls in the prevention of radiation dermatitis.MethodsRelevant clinical trials were identified through electronic searching databases CINAHL, CENTRAL, LILACS, PubMed, Scopus, and Web of Science. Handsearching and gray literature searches were also performed to find additional references. Primary outcomes of interest were the development of radiation dermatitis and the time of occurrence of radiation dermatitis.ResultsThirteen randomized clinical trials were included in this review. The trials were published in Chinese, English, or French, from 1980 to 2015. Pharmacological interventions used in the trials were trolamine, aloe vera, allantoin, Lianbai liquid, sucralfate, Na-sucrose octasulfate, olive oil, hialuronic acid, and dexpanthenol. Non-pharmacological topical controls were usual care/institution routine, aqueous cream, mild soap, water thermal gel, placebo, and no intervention.ConclusionsThere was no strong evidence that indicates differences between topical pharmacological interventions or non-pharmacological topical controls in the prevention of acute radiation dermatitis among patients with head and neck cancer undergoing radiotherapy.

Use of stereotactic body radiation therapy for oligometastatic recurrent prostate cancer: A systematic review

The purpose of this study is to evaluate the effectiveness and safety of stereotactic body radiation therapy (SBRT) in the management of oligometastatic recurrent prostate cancer (PCa) by means of a systematic review. Six databases were searched (CENTRAL, Embase, LILACS, PubMed, Scopus and Web of Science). Additionally, hand‐searching and grey literature search were performed. The main outcomes were progression‐free survival (PFS) and toxicity rates. Androgen deprivation therapy‐free survival (ADT‐FS), local control, pattern of recurrence, cancer‐specific survival and overall survival were also assessed. Risk of bias and quality of evidence were judged with the aid of specific tools. Fourteen studies were included, involving 661 patients and 899 lesions (561 nodal, 336 bone, 2 liver). Median PFS and ADT‐FS were around 1 to 3 years. Local control rates varied from 82 to 100% among researches with low risk of bias. Acute and late grade 2 toxicity was observed in 2.4% and 1.1% of the patients, respectively. One case of acute and two cases of late grade 3 toxicity were registered. Only one randomized study addresses this topic. Although it does not meet all the eligibility criteria, it is useful for the discussion. A quantitative analysis was not possible, nor were subgroup analyses, due to the significant heterogeneity of the interventions and outcomes reported. Longer follow‐up period is required. SBRT seems to be a safe approach to metastatic lesions that might provide disease control and defer androgen deprivation therapy (ADT). Local control is better when higher radiation doses are employed.

Gel of chamomile vs. urea cream to prevent acute radiation dermatitis in patients with head and neck cancer: a randomized controlled trial

AIM To compare a gel made with chamomile (Chamomilla recutita) with a cream of urea as an intervention to delay the time to occurrence of radiation dermatitis. BACKGROUND Radiation dermatitis is one of the most common adverse effects of radiotherapy in patients with head and neck cancer. It is characterized by erythema, itching, pain, skin breakage and burning sensation, and there is no consensus on how to prevent it. DESIGN The study is a randomized controlled clinical trial. METHODS We will recruit 48 individuals with head and neck cancer who will be starting their radiotherapy and randomize them to receive either gel of chamomile or cream of urea, as an intervention for prevention of radiation dermatitis. Social-demographic data will be collected at baseline, and clinical data will be collected before the initiation of radiotherapy. Participants will be followed weekly to assess development of radiation dermatitis. The protocol is funded by Conselho Nacional de Pesquisa e Desenvolvimento Científico (Brazil). The study was approved by a research ethics committee. DISCUSSION Given the clinical relevance of preventing radiation dermatitis and the lack of evidence supporting specific preventive interventions, it is important to study new products that might be efficacious to prevent this complication. This article presents the protocol of a randomized controlled trial comparing a gel made with chamomile (intervention) with a cream of urea (control) to prevent radiation dermatitis in patients with head and neck cancer undergoing radiotherapy.

Distraction methods for pain relief of cancer children submitted to painful procedures: systematic review

JUSTIFICATIVA E OBJETIVOS: A dor assume papel de destaque dentre os mais persistentes sintomas do câncer. As terapias nao farmacologicas sao fontes potenciais para a assistencia das criancas com câncer e devem ser consideradas como alternativas para o manuseio de sinais e sintomas oncologicos. O objetivo deste estudo foi identificar intervencoes efetivas de distracao para o alivio e controle da dor em crianca com câncer quando submetida a um procedimento invasivo. CONTEUDO: Trata-se de revisao sistematica, cuja busca dos estudos primarios foi realizada nas bases de dados eletronicas LILACS, CINAHL, Biblioteca Cochrane CENTRAL e Pubmed, utilizando-se a combinacao dos descritores controlados e nao controlados: child, pain, cancer, e distraction. Foram identificados 10 estudos, que abordavam a distracao como intervencao para puncoes venosas, musculares, subcutâneas e procedimentos relacionados a aspiracao de medula ossea e puncao lombar. CONCLUSAO: Dentre as intervencoes identificadas esta o uso da realidade virtual, praticas como soprar bolhas de sabao, uso da almofada aquecida, soprador de festa, brinquedo eletronico, dentre outras intervencoes autosselecionadas (musica, jogos, livros). As intervencoes sao, em sua maioria, de facil programacao considerando seu baixo custo e uteis aos profissionais de saude que buscam aprimorar a assistencia ao paciente pediatrico no que se refere ao manuseio da dor.

Use of trolamine to prevent and treat acute radiation dermatitis: a systematic review and meta-analysis

Objetivo: avaliar os efeitos da trolamina na prevencao ou no tratamento da radiodermatite. Metodo: revisao sistematica e meta-analise. Em janeiro de 2016, foram desenvolvidas estrategias detalhadas de busca individual para Cinahl, Cochrane Library Central, LILACS, PubMed e Web of Science. Tambem foram realizadas buscas manuais para encontrar referencias adicionais. Se utilizou Google Scholar para buscar a literatura cinzenta. Dois investigadores leram os titulos e resumos de cada referencia cruzada de forma independente. O risco de vies dos estudos incluidos foi analisado com a ferramenta Cochrane Collaboration Risk of Bias Tool. A qualidade das evidencias e a classificacao da forca das recomendacoes foram avaliadas mediante os Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Resultados: foram identificados sete ensaios clinicos controlados. Os controles utilizados foram calendula, placebo, preferencia institucional / atencao padrao, Aquaphor®, RadiaCare™ e Lipiderm™. Os estudos foram agrupados utilizando a frequencia de eventos e o indice de risco com intervalos de confianca de 95% em subgrupos, de acordo com a graduacao da radiodermatite. Conclusao: com base nos estudos incluidos nesta revisao, a trolamina nao pode ser considerada um produto padronizado para a prevencao ou o tratamento da radiodermatite em pacientes com câncer de mama e cabeca e pescoco.ABSTRACT Objective: to evaluate the effects of trolamine in the prevention or treatment of radiation dermatitis. Method: systematic review and meta-analysis. Detailed individual search strategies for Cinahl, Cochrane Library Central, LILACS, PubMed, and Web of Science were developed in January 2016. A manual search was also performed to find additional references. A grey literature search was executed by using Google Scholar. Two researchers independently read the titles and abstracts from every cross-reference. The risk of bias of the included studies was analyzed by the Cochrane Collaboration Risk of Bias Tool. The quality of evidence and grading of strength of recommendations was assessed using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: seven controlled clinical trials were identified. The controls used were calendula, placebo, institutional preference / usual care, Aquaphor®, RadiaCare™, and Lipiderm™. The studies were pooled using frequency of events and risk ratio with 95% confidence intervals, in subgroups according to radiation dermatitis graduation. Conclusion: based on the studies included in this review, trolamine cannot be considered as a standardized product to prevent or treat radiation dermatitis in patients with breast and head and neck cancer.

Uso de trolamina para prevención y tratamiento de radiodermatitis aguda: revisión sistemática y meta-análisis

Objetivo: avaliar os efeitos da trolamina na prevencao ou no tratamento da radiodermatite. Metodo: revisao sistematica e meta-analise. Em janeiro de 2016, foram desenvolvidas estrategias detalhadas de busca individual para Cinahl, Cochrane Library Central, LILACS, PubMed e Web of Science. Tambem foram realizadas buscas manuais para encontrar referencias adicionais. Se utilizou Google Scholar para buscar a literatura cinzenta. Dois investigadores leram os titulos e resumos de cada referencia cruzada de forma independente. O risco de vies dos estudos incluidos foi analisado com a ferramenta Cochrane Collaboration Risk of Bias Tool. A qualidade das evidencias e a classificacao da forca das recomendacoes foram avaliadas mediante os Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Resultados: foram identificados sete ensaios clinicos controlados. Os controles utilizados foram calendula, placebo, preferencia institucional / atencao padrao, Aquaphor®, RadiaCare™ e Lipiderm™. Os estudos foram agrupados utilizando a frequencia de eventos e o indice de risco com intervalos de confianca de 95% em subgrupos, de acordo com a graduacao da radiodermatite. Conclusao: com base nos estudos incluidos nesta revisao, a trolamina nao pode ser considerada um produto padronizado para a prevencao ou o tratamento da radiodermatite em pacientes com câncer de mama e cabeca e pescoco.ABSTRACT Objective: to evaluate the effects of trolamine in the prevention or treatment of radiation dermatitis. Method: systematic review and meta-analysis. Detailed individual search strategies for Cinahl, Cochrane Library Central, LILACS, PubMed, and Web of Science were developed in January 2016. A manual search was also performed to find additional references. A grey literature search was executed by using Google Scholar. Two researchers independently read the titles and abstracts from every cross-reference. The risk of bias of the included studies was analyzed by the Cochrane Collaboration Risk of Bias Tool. The quality of evidence and grading of strength of recommendations was assessed using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: seven controlled clinical trials were identified. The controls used were calendula, placebo, institutional preference / usual care, Aquaphor®, RadiaCare™, and Lipiderm™. The studies were pooled using frequency of events and risk ratio with 95% confidence intervals, in subgroups according to radiation dermatitis graduation. Conclusion: based on the studies included in this review, trolamine cannot be considered as a standardized product to prevent or treat radiation dermatitis in patients with breast and head and neck cancer.

Uso de trolamina para prevenção e tratamento da radiodermatite aguda: revisão sistemática e meta-análise

Objetivo: avaliar os efeitos da trolamina na prevencao ou no tratamento da radiodermatite. Metodo: revisao sistematica e meta-analise. Em janeiro de 2016, foram desenvolvidas estrategias detalhadas de busca individual para Cinahl, Cochrane Library Central, LILACS, PubMed e Web of Science. Tambem foram realizadas buscas manuais para encontrar referencias adicionais. Se utilizou Google Scholar para buscar a literatura cinzenta. Dois investigadores leram os titulos e resumos de cada referencia cruzada de forma independente. O risco de vies dos estudos incluidos foi analisado com a ferramenta Cochrane Collaboration Risk of Bias Tool. A qualidade das evidencias e a classificacao da forca das recomendacoes foram avaliadas mediante os Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Resultados: foram identificados sete ensaios clinicos controlados. Os controles utilizados foram calendula, placebo, preferencia institucional / atencao padrao, Aquaphor®, RadiaCare™ e Lipiderm™. Os estudos foram agrupados utilizando a frequencia de eventos e o indice de risco com intervalos de confianca de 95% em subgrupos, de acordo com a graduacao da radiodermatite. Conclusao: com base nos estudos incluidos nesta revisao, a trolamina nao pode ser considerada um produto padronizado para a prevencao ou o tratamento da radiodermatite em pacientes com câncer de mama e cabeca e pescoco.ABSTRACT Objective: to evaluate the effects of trolamine in the prevention or treatment of radiation dermatitis. Method: systematic review and meta-analysis. Detailed individual search strategies for Cinahl, Cochrane Library Central, LILACS, PubMed, and Web of Science were developed in January 2016. A manual search was also performed to find additional references. A grey literature search was executed by using Google Scholar. Two researchers independently read the titles and abstracts from every cross-reference. The risk of bias of the included studies was analyzed by the Cochrane Collaboration Risk of Bias Tool. The quality of evidence and grading of strength of recommendations was assessed using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: seven controlled clinical trials were identified. The controls used were calendula, placebo, institutional preference / usual care, Aquaphor®, RadiaCare™, and Lipiderm™. The studies were pooled using frequency of events and risk ratio with 95% confidence intervals, in subgroups according to radiation dermatitis graduation. Conclusion: based on the studies included in this review, trolamine cannot be considered as a standardized product to prevent or treat radiation dermatitis in patients with breast and head and neck cancer.

Gel de Chamomilla Recutita Para Reação de Pele em Paciente Submetido à Quimiorradioterapia: Relato de Caso

O presente relato tem o objetivo de descrever o efeito do gel de Chamomilla recutita (C. recutita) em radiodermatite de paciente submetido a quimiorradioterapia — paciente do sexo masculino, com neoplasia de orofaringe, que fez uso do gel na concentracao de 8,35% na regiao irradiada. A partir da 16a sessao, o paciente apresentou radiodermatite Grau I, segundo escore Radiation Therapy Oncology Group (RTOG), caracterizada por leve eritema da regiao irradiada. A graduacao foi mantida ate o fi nal da radioterapia, com evolucao dos sinais apresentados para hipercromia e descamacao seca. Os beneficios clinicos da C. recutita na prevencao e no tratamento da radiodermatite evidenciam a importância de estudos experimentais, que possam corroborar os resultados descritos, considerando que a intervencao se mostrou uma alternativa de facil implementacao, fornecendo protecao e conforto ao paciente.

Validation of an educative manual for patients with head and neck cancer submitted to radiation therapy.

Objetivo: validar el contenido y la apariencia de manual educativo dirigido a los pacientes con cancer de cabeza y cuello, sometidos a radioterapia. Metodo: investigacion metodologica de caracter descriptivo. Se utilizo la Teoria de la Psicometria para el proceso de validacion, el cual fue realizado por 15 peritos en el area tematica del manual educativo y por dos profesionales de letras y publicidad. Fue considerado un indice de concordancia que fuese, por lo menos, de 80%, para garantizar la validacion del material. Resultados: los items abordados en el instrumento de evaluacion del manual educativo fueron divididos en tres bloques: objetivos, estructura y presentacion, y relevancia. Apenas un item, relacionado al nivel sociocultural del publico-objetivo, obtuvo un indice de concordancia <80%, habiendo sido reformulado con base en las sugestiones de los participantes. Todos los otros items fueron considerados adecuados y/o totalmente adecuados en los tres bloques propuestos: objetivos (92,38%), estructura y presentacion (89,74%), y relevancia (94,44%). Conclusion: el manual educativo propuesto fue considerado valido en lo que se refiere al contenido y a la apariencia. Se sugiere que puede contribuir para la comprension del proceso terapeutico, al cual el paciente con cancer de cabeza y cuello es sometido al realizar la radioterapia, ademas de auxiliar la practica clinica por medio de la consulta de enfermeria.

Validación de manual educativo para pacientes con cáncer de cabeza y cuello sometidos a radioterapia

Objetivo: validar el contenido y la apariencia de manual educativo dirigido a los pacientes con cancer de cabeza y cuello, sometidos a radioterapia. Metodo: investigacion metodologica de caracter descriptivo. Se utilizo la Teoria de la Psicometria para el proceso de validacion, el cual fue realizado por 15 peritos en el area tematica del manual educativo y por dos profesionales de letras y publicidad. Fue considerado un indice de concordancia que fuese, por lo menos, de 80%, para garantizar la validacion del material. Resultados: los items abordados en el instrumento de evaluacion del manual educativo fueron divididos en tres bloques: objetivos, estructura y presentacion, y relevancia. Apenas un item, relacionado al nivel sociocultural del publico-objetivo, obtuvo un indice de concordancia <80%, habiendo sido reformulado con base en las sugestiones de los participantes. Todos los otros items fueron considerados adecuados y/o totalmente adecuados en los tres bloques propuestos: objetivos (92,38%), estructura y presentacion (89,74%), y relevancia (94,44%). Conclusion: el manual educativo propuesto fue considerado valido en lo que se refiere al contenido y a la apariencia. Se sugiere que puede contribuir para la comprension del proceso terapeutico, al cual el paciente con cancer de cabeza y cuello es sometido al realizar la radioterapia, ademas de auxiliar la practica clinica por medio de la consulta de enfermeria.