Acute skin reaction and psychological benefit of washing with a mild cleansing agent during radiation therapy to the breast or chest wall: a randomised control trial

Purpose: i/ To compare the differences between the acute skin reaction of patients undergoing radiation therapy to the breast or chest wall washing with water and a mild cleansing agent (pH=7), and patients washing with water only, and ii/ to determine whether there is any psychological benefit for those patients washing with water and a mild cleansing agent compared to those washing with water only. Methods: Forty three (43) patients receiving tangential radiation therapy for early stage primary breast cancer were randomised to one of two treatment arms: Group 1 - washing with water and a mild cleansing agent (21 patients). Group 2 - washing with water only (22 patients). Acute skin reaction was assessed weekly by a radiation oncologist and radiation therapist using a modified EORTC/RTOG skin reaction scale. Acute skin reaction and psychological benefit was assessed by the patient using a weekly diary skin assessment card. Statistical analysis of the differences in skin reaction and the psychological benefit between the groups was tested. Results: No statistically significant difference between the two treatment groups was found for the degree of skin reaction for weeks one through to five. The study measured a statistically significant psychological benefit for those patients washing with water and a mild cleansing agent (p=0.016). Discussion: Given that there is no statistically significant difference in acute skin reactions between the two groups, the psychological benefit provided to those patients allowed to use a cleansing agent supports the skin care regime of washing with water and a mild cleansing agent.