Hemati, S., Asnaashari, O., Sarvizadeh, M., Motlagh, B. N., Akbari, M., Tajvidi, M., & Gookizadeh, A. (2012). Topical silver sulfadiazine for the prevention of acute dermatitis during irradiation for breast cancer. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 20(8), 1613–1618.

To evaluate the effectiveness of topical silver sulfadiazine to prevent radiation dermatitis in women receiving radiotherapy for breast cancer

Patients were randomized to intervention and control groups and were matched by the investigator in terms of the flatness of the chest wall. Patients in the intervention group were instructed to apply 1% silver sulfadiazine cream to the irradiated field every eight hours for three consecutive days. No application was done on the days they received radiation therapy. Use of the cream was continued for one week after completion of radiotherapy. Both groups were educated in general skin care. No other creams were to be applied to the radiation field. Skin in the field was examined weekly by a random radiation oncologist who was not informed of patient group assignment.

• The study sample was comprised of 102 female patients with breast cancer.
• Mean age was 48.4 years.
• Chemotherapy had to be completed at least three weeks prior to study entry.  

The study took place in an outpatient setting in Iran.

Patients were undergoing active antitumor treatment.

The study used a single blind randomized controlled trial design.

The Radiation Therapy Oncology Group scoring of skin toxicity was used.

 From the second week onward, patients who received the silver sulfadiazine cream showed lower grades of skin injury (p < 0.002).

Silver sulfadiazine was more effective than no treatment in reducing the severity of radiation-induced dermatitis.

• The study had a risk of bias due to no blinding.
• Measurement validityand reliability are questionable.
• Patient adherence to use was not evaluated. 

Silver sulfadiazine was more effective than no skin treatment to reduce severity of radiation-induced dermatitis. It would be more helpful to determine the difference between this approach and other topical treatments, which have been shown to have some efficacy.