Sharp, L., Finnilä, K., Johansson, H., Abrahamsson, M., Hatschek, T., & Bergenmar, M. (2013). No differences between Calendula cream and aqueous cream in the prevention of acute radiation skin reactions – Results from a randomised blinded trial. European Journal of Oncology Nursing, 17, 429–435.doi: 10.1016/j.ejon.2012.11.003
To compare two topical agents (Calendula Weleda® cream and Essex® cream) in reducing the risk of severe acute radiation skin reactions in women receiving adjuvant radiation therapy for breast cancer
Patients randomly were assigned one of two creams (Calendula or Essex) and applied a thin layer twice daily from the beginning of radiotherapy through two weeks after their final radiation treatment or until the skin reaction healed. The cream was not applied within two hours of the radiation treatment. Patients were advised to wash daily with nonperfumed soap and told not to apply other topicals in the radiation field. Patients completed questionnaires related to quality of life (European Organization for Research and Treatment of Cancer [EORTC]-QLQ C30), sleep (MOS), and symptoms (e.g., pain, tenderness, burning, pulling, itching) related to the radiation field on a visual analog scale.
Researchers found no statistically significant difference in severe acute radiation skin reactions in the group using Calendula cream versus the group using Essex cream (a water-based topical emollient, which is the standard of care in that institution.) Severe acute radiation skin reaction (RTOG/EORTC grade less than or equal to 2) was 23% in the Calendula group versus 19% in the Essex group. There were no differences in patient-reported outcomes in terms of pain, burning, itching, pulling, or tenderness at the radiation site. However, there was a statistically significant difference in patient evaluation of application and absorption of the cream in favor of Essex cream.
There was no difference in severe acute radiation skin reactions in women with breast cancer using Calendula cream or Essex cream during radiation therapy.
Patients with breast cancer undergoing curative radiation therapy may experience a less severe acute radiation skin reaction using twice daily application of Calendula cream or an aqueous-based cream. Future studies could include patients with other types of cancer and different treatment fields to compare benefits of these topical emollients.