Phase III, prospective, interventional, multicentric, comparative, randomized, open study with 2 parallel arms, evaluating the efficacy of Cicaderma ointment vs standard management of each site in preventing the onset of grade \> 2 radiodermatitis according to the National Cancer Institute - Common Terminology Criteria for Adverse Events-Version (NCI-CTCAE-V5)
Breast cancer is the most common cancer in women. It accounts for more than 1/3 of new cancer cases and is the 1st cause of death for women. Management usually includes tumorectomy or mastectomy precede or not by a chemotherapy, then adjuvant irradiation that can be supplemented with adjuvant chemotherapy and / or hormone therapy. Radiotherapy uses ionizing radiation (photons, electrons ...) to destroy cancer cells and consists in precisely directing these radiations on the area to be treated while preserving as much as possible healthy tissues and surrounding organs. Radiation-induced dermatitis is a skin lesion that occurs after exposure to ionizing radiation and is commonly seen in patients. Acute radiodermatitis occurs in the days or weeks following the start of irradiation with different degrees of severity (dry or exsudative radiodermatitis, acute radionecrosis) They are responsible for an alteration of patients' quality of life (pain, sensitivity to UV radiation, discomfort sensations ...), which may lead to a temporary or even permanent therapeutic interruption and reduce the probability of tumor control. The management of these dermatitis is very heterogeneous, no study having demonstrated the superiority of a preventive or curative treatment. Trolamine (Biafine®) is to date the only topic with a Marketing Authorization (MA) for the treatment of radiation-induced secondary erythema. A study conducted on 254 patients at the Léon Bérard Center from 1999 to 2001 demonstrated that the preventive use of a calendula-based topical was associated with a statistically significant reduction of grade 2 radiodermitis compared to trolamine in patients presenting an early breast cancer treated with post-operative irradiation. However, this calendula ointment, which does not have the MA in the indicated indication, was in practice more difficult to apply than trolamine. Currently, skin hygiene measures to be applied are systematically explained to patients before carrying out post-operative radiotherapy (cotton clothing, neutral soap, etc.). Some centers such as Center Léon Bérard recommend the systematic use of a topic after each session, while others recommend hygiene measures or implement other options (essential oils ...). However, the effectiveness of these current practices on the prevention of radiodermatitis has not yet been demonstrated. It is a phase III, prospective, interventional, multicentric, comparative, randomized, open study with 2 parallel arms Patients will be randomized (1 :1) in Arm A (hygiene measures + preventive treatment with Cicaderma ointment) or Arm B (preventive treatment according to the site recommendations (at least the hygiene measures) with a stratification (site, body mass index ≤25 vs \>25 and RT hypofractionning).
Cicaderma ointment (2 applications / day: after the radiotherapy session) and in the evening) + simple hygiene rules
Simple hygiene rules according to the site recommandations including eventually a maximum of one topical treatment
Institut Sainte-Catherine
Avignon, France
RECRUITINGInstitut Curie
Paris, France
RECRUITINGInstitut Curie
Saint-Cloud, France
NOT_YET_RECRUITINGComparison of the Cicaderma ointment efficacy versus the standard management of each site in preventing the onset of grade >= 2 radiodermatitis (NCI-CTCAE-V5)
Number of patients presenting \>= 2 radiodermatitis according to the National Cancer Institute - Common Terminology Criteria for Adverse Events-Version (NCI-CTCAE-V5)
Time frame: Up to 30+/-4 days after the end of radiotherapy interruption
Patients' satisfaction
Patients' satisfaction evaluated using the "Patient's evaluation of the preventive management of radiodermatits" - Likert scale in 5 points (from very unsatisfied to very satisfied)
Time frame: 30+/-4 days after the end of radiotherapy interruption
Patients' quality of life: DLQI questionnaire
Patients' quality of life evaluated using the Dermatology Life Quality Index (DLQI) questionnaire (validated questionnaire composed of 10 items leading to a global score)
Time frame: Up to 30+/-4 days after the end of radiotherapy interruption
Patients' pain in the irradiated area: numeric scale
Patients' pain evaluated using a numeric scale from 0 (no pain) to 10 (unbearable pain)
Time frame: Up to 30+/-4 days after the end of radiotherapy interruption
Rate of temporary or permanent RT interruption related to the onset of grade 3 radiodermatitis
Temporary or permanent radiotherapy interruption related to the onset of grade 3 radiodermatitis observed during patients' treatment period
Time frame: Through radiotherapy completion, an average of 5 weeks
Rate of prurit onset whatever the grade
Prurit onset whatever the grade observed
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Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
248
Time frame: Up to 30+/-4 days after the end of radiotherapy interruption
Doses of radiation therapy received
Doses of radiation therapy received during each radiotherapy session
Time frame: Through radiotherapy completion, an average of 5 weeks
Delay of onset of the first cutaneous event (radiodermatitis or prurit) grade ≥2
Onset of the first grade \>= 2 cutaneous event (radiodermatitis or prurit)
Time frame: Up to 30+/-4 days after the end of radiotherapy
Compliance with the Cicaderma ointment application (experimental arm)
Compliance evaluated according to the ointment tubes brought back by the patients (not used or partially used) and patient's diary
Time frame: Up to 30+/-4 days after the end of radiotherapy
Determination of the factors measured prior to treatment initiation which are associated to the onset of grade ≥2 radiodermatitis (cup size)
Cup size
Time frame: At inclusion
Determination of the factors measured prior to treatment initiation which are associated to the onset of grade ≥2 radiodermatitis (phototype)
Phototype
Time frame: At inclusion