Roy, I., Fortin, A., & Larochelle, M. (2001). The impact of skin washing with water and soap during breast irradiation: A randomized study. Radiotherapy and Oncology, 58, 333–339.doi: 10.1016/S0167-8140(00)00322-4
To evaluate the impact of washing breast skin with soap and water during radiation therapy on the intensity of acute skin toxicity
Patients were randomized prior to receiving radiation into two groups. In group 1, skin within the treatment field was not allowed to be washed. In group 2, skin within the treatment field could be washed with Dove® or Ivory® soap and water. Patients were not to apply any other materials unless prescribed by a physician. Topical treatment was prescribed for 87% of non-wash patients and 80% of wash patients for a mean duration of 18.2 and 17.6 days, respectively. The topical agents prescribed were topical corticosteroids, eosin, Burow’s solution, and Biafine®. Patients were requested not to tell physicians if they were washing the irradiated area or not. Skin toxicity was independently scored by the author and radiation oncologist.
The study took place at an institution in Quebec, Canada.
The study used a randomized, blinded, controlled trial design.
In group 1, 57% had grade 2 or higher skin toxicity. In group 2, 36% had grade 2 or higher skin toxicity (p = 0.04). Mean time to maximal toxicity score achieved was not different between the groups. Maximal erythema score was not significantly different between the two groups. Incidence of moist desquamation was significantly higher in group 1 (p = 0.03). Dry desquamation (one month after treatment) was experienced by 74% of patients in group 1 compared with 56% of patients in group 2. The difference was not significant. Variables in univariate model significantly associated with acute skin toxicity included group 1, chemotherapy as part of treatment regimen, concomitant chemotherapy, presence of hot spots on dosimetry, and increased patient weight.
Allowing patients to wash irradiated skin did not result in any increased skin toxicity.