***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The purpose of this study was to assess the effectiveness of a recombinant human epidermal growth factor (EGF)-based cream for the prevention of acute radiation dermatitis in breast cancer patients receiving radiotherapy ( RT ) . MATERIAL S AND METHODS Between December 2012 and April 2013 , 40 breast cancer patients who received postoperative RT were prospect ively enrolled in this study and r and omly assigned to receive human recombinant EGF-based cream ( intervention group ) or general supportive skin care ( control group ) . The grade of radiation dermatitis and pain score were examined at weekly intervals during RT and 6 weeks after RT completion . RESULTS All patients completed the planned RT and complied well with instructions for applying the study cream and general supportive skin care . In the intervention group , radiation dermatitis of maximum grade 3 , 2 , and 1 developed in 3 ( 15 % ) , 11 ( 55 % ) , and 6 patients ( 30 % ) , respectively . In comparison , in the control group , radiation dermatitis of maximum grade 3 , 2 , and 1 developed in 8 ( 40 % ) , 10 ( 50 % ) , and 2 patients ( 10 % ) , respectively . The intervention group showed lower incidence of grade 3 radiation dermatitis than the control group ( p=0.068 in univariate analysis and p=0.035 in multivariate analysis ) . There was no statistically significant difference in the maximal pain score between the two groups ( p=0.934 ) . CONCLUSIONS This single-blind r and omized preliminary study showed that recombinant human EGF-based cream can have a beneficial role in preventing or minimizing radiation dermatitis in breast cancer patients . To confirm the results of our study , additional studies with a large sample size are required Background : A side effect of  radiotherapy for breast cancer is acute radiodermatitis . It is a common practice to keep irradiated skin dry on account of data from the 1950s that suggested this regimen limits dermatitis . However , severe dryness of the skin induced by irradiation results in itching and discomfort . Dry skin is characterized by scaliness , epidermal barrier dysfunction , and reduced stratum corneum hydration , and these signs and symptoms are reduced by treatment with an emulsion . Patients and Methods : We performed a r and omized , controlled , open-label study with 66 patients ( ITT population ) , treating the irradiated skin in one group ( n = 34 ) with an oil-in-water emulsion ( WO1932 ) , while leaving the other group untreated ( n = 32 ) . Clinical scoring ( ONS radiation skin reaction scoring , pruritus ) and biophysical measurements ( stratum corneum hydration and transepidermal water loss ( TEWL ) , as a marker of skin barrier function ) were determined at day 1 ( directly after termination of the radiation therapy ) , day 8 , and day 47 ( ± 7 ) . Results : Irradiation increased the ONS score and pruritus , whereas skin hydration and TEWL were reduced . The primary hypothesis that the increase in skin hydration was significantly greater in the emulsion-treated compared to the untreated group as early as after 8 days of treatment could not be confirmed . At the end of the study ( day 47 ± 7 ) , however , normalization of stratum corneum hydration was more advanced in the treatment group compared to the untreated group and nearly reached the values of the contralateral healthy breast skin . ONS score and pruritus also revealed an advantage for the emulsion-treated group . TEWL did not show significant changes during emulsion treatment . No adverse events were caused by the treatment regimens Conclusion : Treatment of radiodermatitis with an oil-in-water emulsion  was well tolerated , enhanced stratum corneum hydration , improved clinical indicators , and provided relief from itching . Hintergrund : Eine häufige Nebenwirkung der Strahlentherapie bei Brustkrebs ist die Radiodermatitis . Üblicherweise wird die Haut trocken gehalten , da nach Untersuchungen aus den 50er Jahren so die Haut am wenigsten geschädigt wird . Starke Hauttrockenheit i m Rahmen der Bestrahlung führt jedoch zu Missempfindungen und Juckreiz . Trockene Haut weist eine Schuppung , eine Hautbarrierestörung und einen erniedrigten Wassergehalt des Stratum corneum auf . Patienten und Method en : In einer kontrollierten , r and omisierten , unverblindeten Studie beh and elten wir 34 von 66 Brustkrebspatientinnen ( ITT- Population ) mit einer Öl-in-Wasser-Emulsion ( WO1932 ) , 32 Patienten blieben unbeh and elt . Wir untersuchten den klinischen Befund ( ONS-Score ) , fragten nach dem Juckreiz und führten biophysikalische Messungen des Wassergehalts des Stratum corneum und des transepidermalen Wasserverlusts ( TEWL ) als Marker der Hautbarrierefunktion am 1 . , 8 . und letzten Tag ( Tag 47 ± 7 ) durch . Ergebnisse : Die Bestrahlung führte zu erhöhten ONS- und Prurituswerten und erniedrigten Werten des Wassergehalts der Haut und des TEWL . Die primäre Hypothese , dass sich die Hauthydration bereits nach 8 Tagen Beh and lung gegenüber der unbeh and elten Gruppe signifikant verbesserte , konnte nicht bestätigt werden . Jedoch hatte sich nach 47 ± 7 Tagen in der Beh and lungsgruppe der erniedrigte Wassergehalt des Stratum corneum weitgehend normalisiert . I m Gegensatz zur unbeh and elten Kontrollgruppe wurden in der Beh and lungsgruppe auf der bestrahlten Brust fast die Werte der kontralateralen , gesunden Brust erreicht . Der Juckreiz und die ONS-Punktzahl nahmen stärker in der Beh and lungsgruppe ab . Klinisch zeigte sich eine stärker ausgeprägte Besserung der Symptome in der Cremetherapiegruppe . Der TEWL als Marker der Barriere änderte sich nicht signifikant . Die Beh and lung führte zu keinen unerwünschten Nebenwirkungen . Schlussfolgerung : Die Beh and lung mit der Emulsion wurde gut toleriert . Die Ergebnisse zeigen , dass WO1932 das klinische Bild verbesserte , den Wassergehalt des Stratum corneum erhöhte und den Juckreiz reduzierte Radiation therapy is a common treatment for cancer patients . One of the most common side effects of radiation is acute skin reaction ( radiation dermatitis ) that ranges from a mild rash to severe ulceration . Approximately 85 % of patients treated with  radiation therapy  will experience a moderate-to-severe skin reaction . Acute radiation-induced skin reactions often lead to itching and pain , delays in treatment , and diminished aesthetic appearance- and subsequently to a decrease in quality of life . Surveys have demonstrated that a wide variety of topical , oral , and intravenous agents are used to prevent or to treat radiation-induced skin reactions . We conducted a literature review to identify trials that investigated products for the prophylaxis and management of acute radiation dermatitis .  Thirty-nine studies met the pre-defined criteria , with thirty-three being categorized as prophylactic trials and six as management trials . For objective evaluation of skin reactions , the Radiation Therapy Oncology Group criteria and the U.S. National Cancer Institute Common Toxicity Criteria were the most commonly used tools ( 65 % of the studies ) . Topical corticosteroid agents were found to significantly reduce the severity of skin reactions ; however , the trials of corticosteroids evaluated various agents , and no clear indication about a preferred corticosteroid has emerged .  Amifostine and oral enzymes  were somewhat effective in preventing radiation-induced skin reactions in phase II and phase III trials respectively ; further large r and omized controlled trials should be undertaken to better investigate those products . Biafine cream ( Ortho-McNeil Pharmaceuticals , Titusville , NJ , U.S.A. ) was found not to be superior to st and ard regimes in the prevention of radiation-induced skin reactions ( n = 6).In conclusion , the evidence is insufficient to support the use of a particular agent for the prevention and management of acute radiation-induced skin reactions . Future trials should focus on comparing agents and approaches that , in phase I and II trials , suggest efficacy . These future phase III r and omized controlled trials must clearly distinguish between preventive and management strategies for radiation-induced dermatitis . Only then can evidence -based guidelines be developed , with the hope of st and ardizing the approach across centres and of improving the prevention and management of radiation-induced dermatitis External beam radiotherapy with high doses provokes many acute skin reactions , such as erythema and moist desquamation . Many topical preparations are used in radiation oncology departments in the skin care . Sucralfate humid gel , a colloidal physical form of the anti-ulcer drug sucralfate , promotes epithelial regeneration and activates cell proliferation . Based on this knowledge , we performed a non-r and omized clinical trial to evaluate the efficacy of topical sucralfate gel in 30 breast cancer patients receiving postoperative accelerated hypofractionated photon beam therapy .  The comparison was performed with 30 patients as historical controls . The acute reaction of the skin was significantly lower in the group receiving the sucralfate gel ( p<0.05 , Mann Whitney test ) , while 90 % of the patients had no evidence of radiation induced skin toxicity . There was no  sucralfate gel related toxicity reported by any patient in this study . More patients in a r and omized way are needed for more definite results Erythema occurs in 80 - 90 % of women treated for breast cancer with radiation therapy .  There is currently no st and ard treatment for radiation-induced skin reactions . This study investigates the clinical efficacy of Mepilex Lite dressings in reducing radiation-induced erythema in women with breast cancer . A total of 28 patients were recruited ; of these , 24 participants presented with 34 erythematous areas of skin for analysis . When erythema was visible , each affected skin area was r and omly divided into two similar halves : one half was treated using Mepilex Lite dressings , the other half with st and ard aqueous cream .  Skin reactions were assessed by the Radiation-Induced Skin Reaction Assessment Scale . We also evaluated any potential dose build-up by the dressings using a white water phantom , the dose distribution over the breast via thermoluminescent dosimeters ( TLDs ) and the surface skin temperature with an infrared thermographic scanner . Mepilex Lite dressings significantly reduced the severity of radiation-induced erythema compared with st and ard aqueous cream ( p < 0.001 ) , did not affect surface skin temperature and caused only a small ( 0.5 mm ) dose build-up . TLD measurements showed that the inframammary fold was exposed to significantly higher doses of radiation than any other breast region ( p < 0.0001 ) . Mepilex dressings reduce radiation-induced erythema Purpose This study aim ed to evaluate the effectiveness of topical silver sulfadiazine ( SSD ) in preventing acute radiation dermatitis in women receiving radiotherapy for breast cancer . Methods A r and omized controlled clinical trial was conducted on patients with breast cancer referred for radiotherapy after treatment with mastectomy and chemotherapy . The patients were r and omized into the intervention ( n = 51 ) and control ( n = 51 ) groups and were instructed on general skin care during radiotherapy . The intervention group received SSD cream 1 % , three times a day , 3 days a week , for 5 weeks during radiotherapy and one week thereafter . A blinded observer assessed the severity of dermatitis weekly ( for 6 weeks ) and grade d it from 0 to 4 according to the Radiation Therapy Oncology Group criteria . Results The two groups were similar in baseline characteristics . Two patients in the control group discontinued the radiotherapy course because of severe skin injuries ( grade s 3 and 4 ) . The intervention group encountered significantly less severe dermatitis during radiotherapy compared to the controls . The total score of skin injury was also lower in the intervention group compared with controls ( 5.49 ± 1.02 vs. 7.21 ± 1.76 , p < 0.001 ) . A multivariate analysis found that the use of SSD cream ( p < 0.001 ) and flat chest wall anatomy ( p = 0.008 ) were significantly associated with a decreased skin injury . Conclusions SSD cream reduced the severity of radiation-induced skin injury compared with general skin care alone . Further studies in patients with other types of cancer and also comparing SSD cream with other topical agents are warranted Purpose : More than 80 % of patients with breast cancer undergoing postsurgical radiotherapy ( RT ) will develop radiodermatitis and approximately 10 % of these patients show grade 3 lesions . Side effects may reduce the patient ’s compliance and can be limiting factors to follow RT protocol s. Therefore , there is a high need for more effective prophylactic treatments . In this study , a silymarin-based cream ( Leviaderm ® ) was tested in comparison to our st and ard of care ( SOC ) at the involved site . Methods : A total of 101 patients were evaluated after breast-conserving surgery followed by RT with 50.4 Gy plus boost 9–16 Gy .  Of these , 51 patients were treated with the silymarin-based cream . In addition , 50 patients were documented receiving a panthenol-containing cream interventionally , if local skin lesions occurred . The acute skin reactions were classified according to the RTOG and VAS ( Visual Analogue Scale ) scores . Results : The median time to toxicity was 
    Output:
    
The effectivity of human epidermal growth factor cream , linoleic acid emulsion , topical silver sulfadiazine , corticosteroids creams and polyurethane dressings has been shown in these clinical trials .
Given that radiodermatitis is a dynamic process , these topical agents were effective in different stages of skin toxicity .
Some of them delayed the onset , others decreased the development and severity of acute skin toxicity degree and others improved the subjective symptoms ( itching , pain , burning ) .
Only polyurethane dressings suggest effectiveness in all stages of skin toxicity , in prevention , management of the different skin toxicity degrees and improvement of wellbeing