Falkowski, S., Trouillas, P., Duroux, J. L., Bonnetblanc, J. M., & Clavère, P. (2011). Radiodermatitis prevention with sucralfate in breast cancer: fundamental and clinical studies. Supportive Care in Cancer, 19, 57–65.

To determine if sucralfate has a role in the prevention of radiodermatitis. A 1% concentration of sucralfate in lotion was tested.

Several zones on the breast were laid out by the investigators, with one zone in the irradiated field left untreated, one with sucralfate, and one that was not within the field of radiation therapy (RT). All patients were instructed to apply sucralfate lotion twice a day, one to two hours prior to treatment and within two hours after RT.

• The sample was comprised of 21 women with breast cancer.
• Median age was 58.3 years.
• Patients were receiving no concomitant chemotherapy treatment.
• The treatment dose was 45 Gy.

Unspecified

The study used a quasiexperimental design—patients were used as their own controls.

• Spectrophotometry was used to measure the response of skin on all zones compared to the zone that was not within the field of RT. Differences between the control radiated zone and the control zone that was not within the field of RT were analyzed. Changes in brightness and skin tonality were used to indicate the degree of erythema.
• Radiation Therapy Oncology Group (RTOG) acute skin toxicity scale
• Patients were evaluated once a week at 10 Gy, 20 Gy, 30 Gy, 40 Gy, and 50 Gy.
• Additional variables included prior surgery, tumor location, prior chemotherapy, skin phototype, other cutaneous diseases, and systemic diseases.

• Skin became darker and redder by spectrophotometry with irradiation for all patients, with maximum skin response at weeks 4 and 5.
• No differences existed in redness between sucralfate-treated and untreated areas.
• Six patients had skin reactions between weeks 4 and 5 that were graded I and II on the RTOG scale.
• Researchers suggested that the use of spectrophotometry was more effective than the RTOG scale for evaluation of skin changes.

No radioprotective effect was demonstrated with sucralfate.

• The study had a small sample size.
• The authors did not state who did the rating/skin examination, and actual RTOG scale results were not reported.
• Other studies have used a higher concentration of sucralfate (7%).