Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Supportive Care in Cancer
Published in: Supportive Care in Cancer 9/2023

01-09-2023 | Mometasone | Review

Mepitel Film for the prevention of acute radiation dermatitis in head and neck cancer: a systematic review and meta-analysis of randomized controlled trials

Authors: Shing Fung Lee, Henry C. Y. Wong, Adrian Wai Chan, Saverio Caini, Saba Shariati, Dirk Rades, Raymond J. Chan, Samantha K. F. Kennedy, Julie Ryan Wolf, Corina van den Hurk, Tara Behroozian, Pierluigi Bonomo, Francis C. H. Ho, Edward Chow, Patries Herst

Published in: Supportive Care in Cancer | Issue 9/2023

Login to get access

Abstract

Purpose

This systematic review and meta-analysis evaluates the efficacy of Mepitel Film in preventing acute radiation dermatitis (RD) in patients with head and neck cancer (HNC) across randomized controlled trials (RCTs).

Methods

Embase, MEDLINE, and Cochrane Central Register of Controlled Trials were searched on 5 March 2023 to identify relevant RCTs. RD assessment tools and outcomes were compared across studies. Pooled effect sizes and 95% confidence intervals (CI) were estimated based on random-effects analysis using RevMan 5.4.

Results

Three RCTs conducted between 2018 and 2020 were included. Mepitel Film decreased RD severity when compared to Sorbolene or Biafine but not when compared to mometasone. A per-protocol analysis of two of the trials revealed that, overall, Mepitel Film significantly reduced the incidence of grade 2–3 RD (odds ratio (OR), 0.24; 95% CI, 0.09–0.65; p = 0.005) and moist desquamation (OR, 0.21; 95% CI, 0.10–0.46; p < 0.0001) and decreased average patient, researcher, and combined components of the Radiation-Induced Skin Reaction Assessment Scale (the standardized mean difference (SMD) for patient ratings, − 2.56; 95% CI, − 3.15 to − 1.96, p < 0.00001; SMD for researcher ratings, − 3.47; 95% CI, − 6.63 to − 0.31, p = 0.03; SMD for combined scores, − 3.68; 95% CI, − 6.43 to − 0.92, p = 0.009). Noted issues with Mepitel Film included itchiness and poor adherence.

Conclusion

While there were discrepancies across studies, Mepitel Film demonstrated a decrease in the incidence of grade 2–3 RD and moist desquamation. These findings emphasize the need for further examining Mepitel Film’s efficacy across diverse patient groups and the importance of standardizing RD severity assessment methodologies and control arms.
Appendix
Available only for authorised users
Literature
1.
Barton MB, Jacob S, Shafiq J, Wong K, Thompson SR, Hanna TP, Delaney GP (2014) Estimating the demand for radiotherapy from the evidence: a review of changes from 2003 to 2012. Radiother Oncol 112:140–144CrossRefPubMed
2.
Bolderston A, Lloyd NS, Wong RK, Holden L, Robb-Blenderman L (2006) The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer 14:802–817CrossRefPubMed
3.
Behroozian T, Goldshtein D, Ryan Wolf J, van den Hurk C, Finkelstein S, Lam H, Patel P, Kanee L, Lee SF, Chan AW, Wong HCY, Caini S, Mahal S, Kennedy S, Chow E, Bonomo P, Behroozian T, Goldshtein D, Ryan Wolf J et al (2023) MASCC clinical practice guidelines for the prevention and management of acute radiation dermatitis: part (1) systematic review. eClinicalMedicine 58:101886CrossRefPubMedPubMedCentral
4.
Leventhal J, Young MR (2017) Radiation dermatitis: recognition, prevention, and management. Oncology 31(885-887):894–889
5.
Rzepecki A, Birnbaum M, Ohri N, Daily J, Fox J, Bodner W, Kabarriti R, Garg M, Mehta K, Kalnicki S, McLellan BN (2022) Characterizing the effects of radiation dermatitis on quality of life: a prospective survey-based study. J Am Acad Dermatol 86:161–163CrossRefPubMed
6.
Singh M, Alavi A, Wong R, Akita S (2016) Radiodermatitis: a review of our current understanding. Am J Clin Dermatol 17:277–292CrossRefPubMed
7.
Herst PM, Bennett NC, Sutherland AE, Peszynski RI, Paterson DB, Jasperse ML (2014) Prophylactic use of Mepitel Film prevents radiation-induced moist desquamation in an intra-patient randomised controlled clinical trial of 78 breast cancer patients. Radiother Oncol 110:137–143CrossRefPubMed
8.
Møller PK, Olling K, Berg M, Habæk I, Haislund B, Iversen AM, Ewertz M, Lorenzen EL, Brink C (2018) Breast cancer patients report reduced sensitivity and pain using a barrier film during radiotherapy - a Danish intra-patient randomized multicentre study. Tech Innov Patient Support Radiat Oncol 7:20–25CrossRefPubMedPubMedCentral
9.
Behroozian T, Milton L, Karam I, Zhang L, Ding K, Lou J, Gallant F, Rakovitch E, Tran W, Soliman H, Leung E, Vesprini D, Szumacher E, Chen H, Donovan E, Lam J, Spadafora S, Wronski M, Lavoie C et al (2023) Mepitel Film for the prevention of acute radiation dermatitis in breast cancer: a randomized multicenter open-label phase III trial. J Clin Oncol 41:1250–1264CrossRefPubMed
10.
11.
Wooding H, Yan J, Yuan L, Chyou T-Y, Gao S, Ward I, Herst PM (2018) The effect of Mepitel Film on acute radiation-induced skin reactions in head and neck cancer patients: a feasibility study. Br J Radiol 91:20170298CrossRefPubMed
12.
Anderson G, Ebadi M, Vo K, Novak J, Govindarajan A, Amini A (2021) An updated review on head and neck cancer treatment with radiation therapy. Cancers 13:4912CrossRefPubMedPubMedCentral
13.
Bressan V, Stevanin S, Bianchi M, Aleo G, Bagnasco A, Sasso L (2016) The effects of swallowing disorders, dysgeusia, oral mucositis and xerostomia on nutritional status, oral intake and weight loss in head and neck cancer patients: a systematic review. Cancer Treat Rev 45:105–119CrossRefPubMed
14.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71CrossRefPubMedPubMedCentral
15.
16.
Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savović J, Schulz KF, Weeks L, Sterne JAC (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928CrossRefPubMedPubMedCentral
17.
Guyatt G, Gutterman D, Baumann MH, Addrizzo-Harris D, Hylek EM, Phillips B, Raskob G, Lewis SZ, Schünemann H (2006) Grading strength of recommendations and quality of evidence in clinical guidelines: report from an american college of chest physicians task force. Chest 129:174–181CrossRefPubMed
18.
19.
20.
Yan J, Yuan L, Wang J, Li S, Yao M, Wang K, Herst PM (2020) Mepitel Film is superior to Biafine cream in managing acute radiation-induced skin reactions in head and neck cancer patients: a randomised intra-patient controlled clinical trial. J Med Radiat Sci 67:208–216CrossRefPubMedPubMedCentral
21.
Rades D, Narvaez CA, Splettstößer L, Dömer C, Setter C, Idel C, Ribbat-Idel J, Perner S, Bartscht T, Olbrich D, Schild SE, Carl J (2019) A randomized trial (RAREST-01) comparing Mepitel® Film and standard care for prevention of radiation dermatitis in patients irradiated for locally advanced squamous cell carcinoma of the head-and-neck (SCCHN). Radiother Oncol 139:79–82CrossRefPubMed
22.
Paterson D, Poonam P, Bennett N, Peszynski R, Van Beekhuizen M, Jasperse M, Herst P (2012) Randomized intra-patient controlled trial of mepilex lite dressings versus aqueous cream in managing radiation-induced skin reactions postmastectomy. J Cancer Sci Ther 4:347–356CrossRef
23.
24.
Chan RJ, Blades R, Jones L, Downer TR, Peet SC, Button E, Wyld D, McPhail S, Doolan M, Yates P (2019) A single-blind, randomised controlled trial of StrataXRT® - a silicone-based film-forming gel dressing for prophylaxis and management of radiation dermatitis in patients with head and neck cancer. Radiother Oncol 139:72–78CrossRefPubMed
25.
O’Dell K, Kearney R (2018) Feasibility study: use of a silicone gel in head and neck skin care. Journal of Medical Radiation Sciences 65:99–113
26.
Rutten LI (2018) Feasibility of Strata XRT in the treatment of radiation dermatitis in head and neck cancer patients (Thesis, Bachelor of Radiation Therapy with Honours). University of Otago
27.
Hindley A, Zain Z, Wood L, Whitehead A, Sanneh A, Barber D, Hornsby R (2014) Mometasone furoate cream reduces acute radiation dermatitis in patients receiving breast radiation therapy: results of a randomized trial. Int J Radiat Oncol Biol Phys 90:748–755CrossRefPubMed
28.
Ho AY, Olm-Shipman M, Zhang Z, Siu CT, Wilgucki M, Phung A, Arnold BB, Porinchak M, Lacouture M, McCormick B, Powell SN, Gelblum DY (2018) A randomized trial of mometasone furoate 0.1% to reduce high-grade acute radiation dermatitis in breast cancer patients receiving postmastectomy radiation. Int J Radiat Oncol Biol Phys 101:325–333CrossRefPubMed
29.
Miller RC, Schwartz DJ, Sloan JA, Griffin PC, Deming RL, Anders JC, Stoffel TJ, Haselow RE, Schaefer PL, Bearden JD 3rd, Atherton PJ, Loprinzi CL, Martenson JA (2011) Mometasone furoate effect on acute skin toxicity in breast cancer patients receiving radiotherapy: a phase III double-blind, randomized trial from the North Central Cancer Treatment Group N06C4. Int J Radiat Oncol Biol Phys 79:1460–1466CrossRefPubMed
30.
Neben-Wittich MA, Atherton PJ, Schwartz DJ, Sloan JA, Griffin PC, Deming RL, Anders JC, Loprinzi CL, Burger KN, Martenson JA, Miller RC (2011) Comparison of provider-assessed and patient-reported outcome measures of acute skin toxicity during a phase III trial of mometasone cream versus placebo during breast radiotherapy: the North Central Cancer Treatment Group (N06C4). Int J Radiat Oncol Biol Phys 81:397–402CrossRefPubMed
31.
Liao Y, Feng G, Dai T, Long F, Tang J, Pu Y, Zheng X, Cao S, Xu S, Du X (2019) Randomized, self-controlled, prospective assessment of the efficacy of mometasone furoate local application in reducing acute radiation dermatitis in patients with head and neck squamous cell carcinomas. Medicine 98:e18230CrossRefPubMedPubMedCentral
32.
Fisher J, Scott C, Stevens R, Marconi B, Champion L, Freedman GM, Asrari F, Pilepich MV, Gagnon JD, Wong G (2000) Randomized phase III study comparing Best Supportive Care to Biafine as a prophylactic agent for radiation-induced skin toxicity for women undergoing breast irradiation: Radiation Therapy Oncology Group (RTOG) 97-13. Int J Radiat Oncol Biol Phys 48:1307–1310CrossRefPubMed
33.
Fenig E, Brenner B, Katz A, Sulkes J, Lapidot M, Schachter J, Malik H, Sulkes A, Gutman H (2001) Topical Biafine and Lipiderm for the prevention of radiation dermatitis: a randomized prospective trial. Oncol Rep 8:305–309PubMed
34.
Szumacher E, Wighton A, Franssen E, Chow E, Tsao M, Ackerman I, Andersson L, Kim J, Wojcicka A, Ung Y, Sixel K, Hayter C (2001) Phase II study assessing the effectiveness of Biafine cream as a prophylactic agent for radiation-induced acute skin toxicity to the breast in women undergoing radiotherapy with concomitant CMF chemotherapy. Int J Radiat Oncol Biol Phys 51:81–86CrossRefPubMed
35.
Momm F, Bartelt S, Haigis K, Grosse-Sender A, Witucki G (2005) Spectrophotometric skin measurements correlate with EORTC/RTOG-common toxicity criteria. Strahlenther Onkol 181:392–395CrossRefPubMed
36.
Böhner AMC, Koch D, Schmeel FC, Röhner F, Schoroth F, Sarria GR, Abramian AV, Baumert BG, Giordano FA, Schmeel LC (2020) Objective evaluation of risk factors for radiation dermatitis in whole-breast irradiation using the spectrophotometric L*a*b color-space. Cancers 12:2444CrossRefPubMedPubMedCentral
37.
Schmeel LC, Koch D, Stumpf S, Leitzen C, Simon B, Schüller H, Vornholt S, Schoroth F, Müdder T, Röhner F, Garbe S, Schmeel FC, Schild HH, Wilhelm-Buchstab TM (2018) Prophylactically applied Hydrofilm polyurethane film dressings reduce radiation dermatitis in adjuvant radiation therapy of breast cancer patients. Acta Oncol 57:908–915CrossRefPubMed
38.
Schmeel LC, Koch D, Schmeel FC, Bücheler B, Leitzen C, Mahlmann B, Kunze D, Heimann M, Brüser D, Abramian AV, Schoroth F, Müdder T, Röhner F, Garbe S, Baumert BG, Schild HH, Wilhelm-Buchstab TM (2019) Hydrofilm polyurethane films reduce radiation dermatitis severity in hypofractionated whole-breast irradiation: an objective, intra-patient randomized dual-center assessment. Polymers 11:2112CrossRefPubMedPubMedCentral
Metadata
Title
Mepitel Film for the prevention of acute radiation dermatitis in head and neck cancer: a systematic review and meta-analysis of randomized controlled trials
Authors
Shing Fung Lee
Henry C. Y. Wong
Adrian Wai Chan
Saverio Caini
Saba Shariati
Dirk Rades
Raymond J. Chan
Samantha K. F. Kennedy
Julie Ryan Wolf
Corina van den Hurk
Tara Behroozian
Pierluigi Bonomo
Francis C. H. Ho
Edward Chow
Patries Herst
Publication date
01-09-2023
Publisher
Springer Berlin Heidelberg
Keyword
Mometasone
Published in
Supportive Care in Cancer / Issue 9/2023
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-023-07988-w

Other articles of this Issue 9/2023

Supportive Care in Cancer 9/2023 Go to the issue

Research

Prevalence of palliative radiotherapy abstracts presented at the annual scientific meetings of the Canadian Association of Radiation Oncology: 2003–2021

Research

Effect of chemotherapy and different chemotherapy regimens on bone health among Chinese breast cancer women in different menstrual status: a self-control study

Research

Telephone completion of patient self-reporting health history documents by registered nurses: a survey to evaluate its effectiveness and strategies for improvement

Research

Effects of combined exercises on shoulder mobility and strength of the upper extremities in breast cancer rehabilitation: a 3-week randomized controlled trial

Research

Social determinants of health: a need for better data capture in Asian American patients with hepatocellular cancer

Correspondence

Correspondence on: Effects of prehabilitation on postoperative outcomes in frail cancer patients undergoing elective surgery: a systematic review and meta-analysis
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits