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Bacterial decolonisation effective against radiation dermatitis

Presented By
Ms Yana Kost, Albert Einstein College of Medicine, NY, USA
ASCO 2022

Bacterial decolonisation of Staphylococcus aureus could effectively decrease the severity of radiation dermatitis and prevent moist desquamation in patients with breast or head-and-neck cancer who received radiotherapy. Moreover, this approach is safe, easy, and cost-effective, according to the authors.

Ms Yana Kost (Albert Einstein College of Medicine, NY, USA) and colleagues demonstrated that nasal colonisation with Staphylococcus aureus prior to radiotherapy is a predictor of grade ‚Č•2 radiation dermatitis. Therefore, a randomised phase 2 trial (NCT03883828) was developed to compare a strategy of bacterial decolonisation with standard-of-care in patients (n=80) with breast cancer or head-and-neck cancer who were planned to receive fractionated radiotherapy (‚Č•15 fractions) [1]. Patients in the bacterial decolonisation arm received intranasal mupirocin ointment, twice daily, and chlorhexidine body wash, once daily, for 5 consecutive days prior to radiotherapy initiation. This strategy was repeated every other week for 5 days during radiotherapy.

The median radiation dermatitis grade was significantly lower in the bacterial decolonisation arm than in the standard-of-care arm (1.19 vs 1.58; P=0.019), meeting the primary endpoint of this trial. In addition, grade ‚Č•2 moist desquamation could effectively be prevented by the bacterial decolonisation approach (0% vs 23.68%; P=0.002). Furthermore, the data showed that nasal Staphylococcus aureus colonisation rates were decreased in the bacterial decolonisation arm from baseline to post-radiotherapy (13.16% to 7.89%), whereas an opposite pattern was noted in the standard-of-care arm (15.79% to 23.68%). Despite these results, no significant differences in quality-of-life between the 2 patient groups were reported.

Ms Kost concluded that bacterial decolonisation was an effective strategy to reduce radial dermatitis severity and prevent moist desquamation in the study population. She argued that bacterial decolonisation is safe, easy, cost-effective, and avoids infection and skin atrophy, concerns that are associated with the use of topical steroids.

  1. Kost Y, et al. Bacterial decolonization to prevent acute radiation dermatitis: A randomized controlled trial. LBA12003, ASCO 2022 Annual Meeting, 3‚Äď7 June, Chicago, IL, USA.

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