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Abstract：
BACKGROUND: After radiation therapy most patients experience acute skin toxicity to some degree. The purpose of this systematic review is to assess the available evidence concerning the effectivity of topical therapies on patients with breast cancer that experience radiodermatitis after radiotherapy.
METHODS: The review included clinical trials aimed to evaluate topical therapies for prevention or treatment of acute radiodermatitis in women with breast cancer, which were published between 2009 and 2014. The bibliographic search was carried out in the following databases: PubMed, Cinahl, Cochrane Plus, IBECS and LILACS. The studies were selected independently by peer reviewers using the Critical Appraisal Skills Programme in its Spanish version.
RESULTS: 86 bibliographical references were identified. Twenty full-text articles of clinical trials were assessed and two were excluded because they were not completed; 12 of clinical trials evaluated topical treatment with creams and ointments, three with corticosteroid creams and other three with dressings. The effectivity of human epidermal growth factor cream, linoleic acid emulsion, topical silver sulfadiazine, corticosteroids creams and polyurethane dressings has been shown in these clinical trials.
CONCLUSIONS: Given that radiodermatitis is a dynamic process, these topical agents were effective in different stages of skin toxicity. Some of them delayed the onset, others decreased the development and severity of acute skin toxicity degree and others improved the subjective symptoms (itching, pain, burning). Only polyurethane dressings suggest effectiveness in all stages of skin toxicity, in prevention, management of the different skin toxicity degrees and improvement of wellbeing.
METHODS: The review included clinical trials aimed to evaluate topical therapies for prevention or treatment of acute radiodermatitis in women with breast cancer, which were published between 2009 and 2014. The bibliographic search was carried out in the following databases: PubMed, Cinahl, Cochrane Plus, IBECS and LILACS. The studies were selected independently by peer reviewers using the Critical Appraisal Skills Programme in its Spanish version.
RESULTS: 86 bibliographical references were identified. Twenty full-text articles of clinical trials were assessed and two were excluded because they were not completed; 12 of clinical trials evaluated topical treatment with creams and ointments, three with corticosteroid creams and other three with dressings. The effectivity of human epidermal growth factor cream, linoleic acid emulsion, topical silver sulfadiazine, corticosteroids creams and polyurethane dressings has been shown in these clinical trials.
CONCLUSIONS: Given that radiodermatitis is a dynamic process, these topical agents were effective in different stages of skin toxicity. Some of them delayed the onset, others decreased the development and severity of acute skin toxicity degree and others improved the subjective symptoms (itching, pain, burning). Only polyurethane dressings suggest effectiveness in all stages of skin toxicity, in prevention, management of the different skin toxicity degrees and improvement of wellbeing.
摘要：
背景：放射治疗后，大多数患者会出现一定程度的急性皮肤毒性。这项系统评价的目的是评估有关局部治疗对放疗后发生放射性皮炎的乳腺癌患者的有效性的现有证据。
方法：该综述包括旨在评估局部疗法预防或治疗乳腺癌女性急性放射性皮炎的临床试验，于2009年至2014年间出版。书目搜索在以下数据库中进行：PubMed，Cinahl,CochranePlus,IBECS和LILACS。这些研究是由同行评审员使用西班牙语版本的关键评估技能计划独立选择的。
结果：确定了86篇参考文献。对20篇临床试验的全文文章进行了评估，其中2篇因为未完成而被排除在外；12篇临床试验评估了使用乳膏和软膏的局部治疗，三个用皮质类固醇乳膏，其他三个用敷料。人表皮生长因子乳膏的有效性，亚油酸乳液，局部磺胺嘧啶银，这些临床试验中已显示皮质类固醇乳膏和聚氨酯敷料。
结论：鉴于放射性皮炎是一个动态过程，这些外用药物在皮肤毒性的不同阶段都有效。其中一些延迟了发病，其他人降低了急性皮肤毒性程度的发展和严重程度，其他人改善了主观症状(瘙痒，疼痛,燃烧)。只有聚氨酯敷料表明在皮肤毒性的所有阶段都有效，在预防方面,管理不同程度的皮肤毒性和改善健康。
方法：该综述包括旨在评估局部疗法预防或治疗乳腺癌女性急性放射性皮炎的临床试验，于2009年至2014年间出版。书目搜索在以下数据库中进行：PubMed，Cinahl,CochranePlus,IBECS和LILACS。这些研究是由同行评审员使用西班牙语版本的关键评估技能计划独立选择的。
结果：确定了86篇参考文献。对20篇临床试验的全文文章进行了评估，其中2篇因为未完成而被排除在外；12篇临床试验评估了使用乳膏和软膏的局部治疗，三个用皮质类固醇乳膏，其他三个用敷料。人表皮生长因子乳膏的有效性，亚油酸乳液，局部磺胺嘧啶银，这些临床试验中已显示皮质类固醇乳膏和聚氨酯敷料。
结论：鉴于放射性皮炎是一个动态过程，这些外用药物在皮肤毒性的不同阶段都有效。其中一些延迟了发病，其他人降低了急性皮肤毒性程度的发展和严重程度，其他人改善了主观症状(瘙痒，疼痛,燃烧)。只有聚氨酯敷料表明在皮肤毒性的所有阶段都有效，在预防方面,管理不同程度的皮肤毒性和改善健康。
