Top Line: Does Mepitel film reduce skin toxicity from whole breast or chest wall radiation?
The Study: Mepitel film (MF) is a silicone-based polyurethane material that has been used in two trials (with mixed results) to reduce radiation dermatitis in breast cancer patients. The porous silicone film adheres to dry, intact skin but not moist skin or wounds. In this randomized trial, 376 patients with either large breast size (36 inches or cup size C or greater) receiving whole breast radiation (58%) or any breast size receiving post-mastectomy radiation (42%) were randomized to have MF placed on the breast or chest wall daily during radiation. MF was placed on the first day of treatment, and it was replaced on the last day of treatment and left in place for two weeks after treatment. 3% of patients developed an allergic rash to the film and were treated on the standard arm. Most patients (93%) were treated with moderate hypofractionation, and there were no differences in the rates of bolus (14% v 12%) or boost (29% v 30%) in the MF v standard arms. MF significantly reduced the rate of CTCAE grade 2 or 3 dermatitis (16% v 46%) compared to standard skin care. This included a significant reduction in grade 3 dermatitis from 14% to 3% and moist desquamation from 19% to 8%. Clinically, mastectomy patients had the most ease in using MF. Some patients reported that MF made showering and exercise difficult due to the need to avoid saturation of the MF. In addition, it was difficult to keep MF adhered near the axilla.
TBL: Prophylactic Mepitel film on the breast or chest wall significantly reduces skin toxicity for patients with large breasts receiving whole breast or past-mastectomy radiation. | Behroozian, J Clin Oncol 2022