Abstract：
OBJECTIVE: This systematic review and meta-analysis aims to evaluate the effects of washing in patients receiving radiotherapy (RT) on radiation dermatitis (RD) severity.
METHODS: A literature search was performed using Ovid MEDLINE, Embase, and Cochrane databases between January 1, 1946, and January 31, 2023. Four randomized controlled trials (RCTs) studying the effects of washing with or without soap on RD were identified. A meta-analysis was conducted for clinician-reported outcomes using RevMan 5.4 and a narrative synthesis for patient-reported outcomes due to a lack of reported data amenable to quantitative comparison in accordance with the Synthesis Without Meta-analysis (SWiM) guidelines. The Cochrane Risk of bias (RoB2) and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria were used to assess risk of bias and certainty of evidence, respectively.
RESULTS: Two RCTs met the inclusion criteria for meta-analysis. Washing with or without soap significantly reduced the incidence of severe RD (OR: 0.32, 95% CI: 0.19-0.55, p < 0.01) and moist desquamation (OR: 0.25, 95% CI: 0.12-0.52, p < 0.01). Two of four trials found an association between washing and reduced itching score (p = 0.38). Pain score was not found to be significantly different with or without washing in any of the four studies (p = 0.07). The two studies that assessed burn scores did not detect any difference between the washing group versus no washing group (p = 0.25). Washing was associated with improved quality of life (QoL) measures in one study.
CONCLUSIONS: Washing with or without soap during RT resulted in less severe RD and less moist desquamation. Given the QoL benefits of washing, it should be advocated as part of routine skin care during RT.
METHODS: A literature search was performed using Ovid MEDLINE, Embase, and Cochrane databases between January 1, 1946, and January 31, 2023. Four randomized controlled trials (RCTs) studying the effects of washing with or without soap on RD were identified. A meta-analysis was conducted for clinician-reported outcomes using RevMan 5.4 and a narrative synthesis for patient-reported outcomes due to a lack of reported data amenable to quantitative comparison in accordance with the Synthesis Without Meta-analysis (SWiM) guidelines. The Cochrane Risk of bias (RoB2) and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria were used to assess risk of bias and certainty of evidence, respectively.
RESULTS: Two RCTs met the inclusion criteria for meta-analysis. Washing with or without soap significantly reduced the incidence of severe RD (OR: 0.32, 95% CI: 0.19-0.55, p < 0.01) and moist desquamation (OR: 0.25, 95% CI: 0.12-0.52, p < 0.01). Two of four trials found an association between washing and reduced itching score (p = 0.38). Pain score was not found to be significantly different with or without washing in any of the four studies (p = 0.07). The two studies that assessed burn scores did not detect any difference between the washing group versus no washing group (p = 0.25). Washing was associated with improved quality of life (QoL) measures in one study.
CONCLUSIONS: Washing with or without soap during RT resulted in less severe RD and less moist desquamation. Given the QoL benefits of washing, it should be advocated as part of routine skin care during RT.
摘要：
目的：本系统综述和荟萃分析旨在评估接受放疗（RT）的患者清洗对放射性皮炎（RD）严重程度的影响。
方法：使用OvidMEDLINE进行文献检索，Embase,1946年1月1日至2023年1月31日之间的Cochrane数据库。确定了四项随机对照试验（RCTs），研究了用或不用肥皂洗涤对RD的影响。使用RevMan5.4对临床医生报告的结果进行荟萃分析，并根据无荟萃分析（SWiM）指南，由于缺乏可进行定量比较的报告数据，对患者报告的结果进行叙述性综合。Cochrane偏差风险(RoB2)和建议分级，评估,发展,和评估(等级)标准用于评估偏倚风险和证据的确定性，分别。
结果：两项RCT符合meta分析的纳入标准。使用或不使用肥皂的洗涤显着降低了严重RD的发生率（OR：0.32，95％CI：0.19-0.55，p<0.01）和潮湿脱屑的发生率（OR：0.25，95％CI：0.12-0.52，p<0.01）。四项试验中有两项发现洗涤和瘙痒评分降低之间存在关联（p=0.38）。在四项研究中的任何一项中，在有或没有清洗的情况下，疼痛评分均未发现显着差异（p=0.07）。评估烧伤评分的两项研究未发现洗涤组与未洗涤组之间的任何差异（p=0.25）。在一项研究中，洗涤与生活质量（QoL）指标的改善有关。
结论：在RT期间使用或不使用肥皂洗涤导致较不严重的RD和较少的潮湿脱屑。鉴于洗涤的QoL好处，应提倡将其作为RT期间常规皮肤护理的一部分。
方法：使用OvidMEDLINE进行文献检索，Embase,1946年1月1日至2023年1月31日之间的Cochrane数据库。确定了四项随机对照试验（RCTs），研究了用或不用肥皂洗涤对RD的影响。使用RevMan5.4对临床医生报告的结果进行荟萃分析，并根据无荟萃分析（SWiM）指南，由于缺乏可进行定量比较的报告数据，对患者报告的结果进行叙述性综合。Cochrane偏差风险(RoB2)和建议分级，评估,发展,和评估(等级)标准用于评估偏倚风险和证据的确定性，分别。
结果：两项RCT符合meta分析的纳入标准。使用或不使用肥皂的洗涤显着降低了严重RD的发生率（OR：0.32，95％CI：0.19-0.55，p<0.01）和潮湿脱屑的发生率（OR：0.25，95％CI：0.12-0.52，p<0.01）。四项试验中有两项发现洗涤和瘙痒评分降低之间存在关联（p=0.38）。在四项研究中的任何一项中，在有或没有清洗的情况下，疼痛评分均未发现显着差异（p=0.07）。评估烧伤评分的两项研究未发现洗涤组与未洗涤组之间的任何差异（p=0.25）。在一项研究中，洗涤与生活质量（QoL）指标的改善有关。
结论：在RT期间使用或不使用肥皂洗涤导致较不严重的RD和较少的潮湿脱屑。鉴于洗涤的QoL好处，应提倡将其作为RT期间常规皮肤护理的一部分。
