Initial Patient Perspectives on a Novel Intervention for Radiation Dermatitis: A Single Institutional Experience

Purpose: Radiation dermatitis remains a challenging side effect of radiotherapy. Historical management provides some relief but falls short of effectively managing severe cases. Silverlon, a recent advancement, offers the potential to address radiation dermatitis management. Therefore, the purpose of this study was to investigate patient perspectives on the ease of use of a novel intervention for radiation dermatitis.

Methodology: Eleven patients undergoing breast and head and neck radiation trialed silverlon. Two were excluded from the analysis for failure to follow protocol. Silverlon was tested at different time points during treatment. Patients filled surveys about ease of use, compliance to suggested frequency of use, whether silverlon was tested concurrently with water-based emollients, effect of the product on skin, and pain relief.

Results: Patients were surveyed after a week of use. Four underwent breast radiotherapy while seven underwent head and neck cancer radiation. Seven patients tested silverlon during the latter half of treatments; fractionation schemes ranged from 15 – 33. Eight patients had CTCAE grade 1 dermatitis while grading for the last patient was not recorded. Eight patients reported ease of use. Four reported ease of compliance; of the four, three had breast cancer. Four head and neck patients had difficulty complying with the protocol; because the product would not stay in place. Therefore, two of them stopped after less than two days. All breast patients affixed the product to their bras. During the trial period, seven patients exclusively used the product while one alternated with Aquaphor, and another did not report this. Two patients reported adverse effects from the product: exacerbation of rash in a breast patient and an allergic reaction in a head and neck patient. Seven patients with grade 1 dermatitis did not report the effect of the product on their skin. One patient reported a cooling effect on the treatment field while another reported that the product appeared to be aiding in wound healing. Two patients reported pain relief from use. One patient reported no pain relief while six patients reported non-applicability.

Conclusions: Silverlon appears to be easy to use and mitigates radiation dermatitis in breast cancer patients. Overall, breast cancer patients had a more favorable view of the product than head and neck patients. Likely because there is an in-built mechanism whereby breast patients can benefit from this product by attaching it to the inner lining of their bra. This preliminary data will be used to design a proof of concept trial with breast cancer patients.

References: Singh M, et al.. Radiodermatitis: A Review of Our Current Understanding. Am J Clin Dermatol. 2016 Jun;17(3):277-92. doi: 10.1007/s40257-016-0186-4.

Hemati S, et al.. Topical silver sulfadiazine for the prevention of acute dermatitis during irradiation for breast cancer. Support Care Cancer. 2012 Aug;20(8):1613-8. doi: 10.1007/s00520-011-1250-5.