A phase III trial comparing an anionic phospholipid-based cream and aloe vera-based gel in the prevention of radiation dermatitis in pediatric patients

Forty-five pediatric patients (median age, 11 years) with various diagnoses who received at least 23.4 Gy participated. APP cream and aloe vera gel were symmetrically applied within the irradiated field after each treatment. Three measures were collected before, during and after completion of treatment: subject's skin comfort, dermatologic assessment, and common toxicity criteria (CTC).Significant differences in specific variables favoring APP cream use were noted in some patients including skin comfort variables, dry (p = 0.002), soft (p = 0.057), feels good (p = 0.002), rough (p = 0.065), smooth (p = 0.012) and dermatologic variables, dryness (p = 0.013), erythema (p = 0.002) and peely (p = 0.008). Grouped CTC scores were supportive of APP cream (p = 0.004). In comparing the first and last assessments, two dermatologic variables, dryness (p = 0.035) and peely (p = 0.016), favored APP cream.APP cream is more effective than aloe vera-based gel for prevention and treatment of radiation dermatitis.The prevention and treatment of radiation dermatitis is required for all radiation oncology patients, regardless of the intensity of therapy. Skin care is an important function of the radiation oncology nursing staff, and the skin is routinely evaluated by the attending physician. Reducing skin toxicity is important, because it allows a patient to complete a continuous course of RT and minimizes the intensity of radiochemotherapy interactions that are common among patients who receive combined modality therapy. No product has been identified as the superior treatment for radiation dermatitis. Therefore, skin reactions remain a common cause of patient discomfort and cancer treatment delay.The epidermis (the outer skin) consists of four layers: the stratum basale (the internal layer), the stratum spinosum, the stratum granulosum, and the stratum corneum (the surface layer). The stratum corneum is impermeable, and its cells, the corneocytes, are considered dead tissue. The seba