For Radiodermatitis, a Natural Product Compares Well to the Standard of Care

TON - September 2016, Vol 9, No 5 - Supportive Care
Caroline Helwick

San Antonio, TX—For the treatment of radiodermatitis, a skin product containing calendula (a type of marigold) resulted in faster healing than Aquaphor plus aloe vera gel, according to interim results of a comparative study presented as a poster at the Oncology Nursing Society 41st Annual Congress.

Almost all patients with breast cancer treated with radiation therapy develop some degree of radiodermatitis, and various topical agents can be applied for relief. Results from recent studies comparing calendula to other topical agents have been contradictory, according to Susan Getz, BSN, RN, OCN, Maine Medical Center, Portland, who presented the study.

Ms Getz and colleagues designed an open-label, randomized controlled trial comparing the effectiveness of an ointment containing calendula (the intervention) to Aquaphor plus aloe vera (standard care) in preventing and treating radiodermatitis. They obtained the calendula product from a woman in the community who makes skin care products containing natural substances.

The study enrolled 110 patients, mostly white, with a fair skin type, no smoking history, and a mean age of 51 years. Women were instructed to apply the calendula ointment 4 times a day, or the Aquaphor plus aloe vera 3 times a day.

Outcomes Fairly Similar

The researchers observed no significant differences between product treatment groups for development of skin irritation during each week of radiation, defined as a Radiation Therapy Oncology Group score of ≥2. However, significantly fewer patients using calendula experienced skin irritation 2 weeks after radiation therapy (P = .025), and patients appeared to heal faster, Ms Getz said.

“We were hoping calendula could reduce this irritation. It didn’t significantly do that, but we did see the calendula group heal faster, which we were not expecting,” she stated, explaining that “healing” means they returned to near-baseline appearance.

“Improved time to healing postradiation is an important clinical outcome for these women,” she added.

Skin irritation was assessed week by week, with the following incidence observed for calendula compared with the control arm:

  • 0% versus 2% in week 2
  • 4% versus 8% in week 3
  • 19% versus 23% in week 4
  • 47% versus 41% in week 5
  • 70% versus 50% in week 6
  • 67% versus 83% in week 7
  • 5% versus 24% in week 8.

There were no significant differences between the skin product groups for quality of life or self-reported pain at each week of the study.

Ms Getz now gives her patients a choice between calendula and Aquaphor plus aloe vera gel, but she noted that calendula costs more, and that patients must pay for it.

Source: Getz S, et al. Open label randomized clinical study comparing calendula versus Aquaphor and aloe vera gel in women with breast cancer undergoing radiotherapy. Poster 187.

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Last modified: September 14, 2016