Early-stage breast cancer patients undergoing radiation therapy following breast-conserving surgery experienced significantly less skin irritation when they used a melatonin-containing cream compared with a placebo (a cream without melatonin). The results of this study were recently presented at the 2010 Breast Cancer Symposium.
Treatment for early-stage breast cancer often involves breast-conserving surgery (lumpectomy), which may be followed by radiation therapy to decrease risk of recurrence. The objective of radiation therapy to the breast is to kill cancer cells that could otherwise persist after therapy and cause breast cancer to relapse locally in the breast, surrounding chest wall, or axilla. Radiation therapy uses high-energy X-rays to kill cancer cells that remain in the breast or surrounding lymph nodes after surgery. Radiation therapy is often delivered to the breast and surrounding lymph nodes from a machine outside the body; this is called external beam radiation therapy.
Unfortunately, radiation therapy may cause side effects, often to the site where it is delivered. Side effects to the skin are among the most common side effects caused by radiation therapy. Dermatitis is an inflammation of the skin, which may cause redness, pain, itching, and even blisters or cracked skin. If dermatitis becomes severe enough, optimal dosing and scheduling of radiation is interrupted to allow the skin to heal. Although topical creams are available to help manage skin irritation, many patients may still experience dermatitis caused by radiation therapy. Researchers are evaluating different agents in order to reduce side effects to the skin and allow for optimal delivery of radiation therapy.
In the current randomized, double-blind study, researchers evaluated the efficacy of melatonin-containing cream in managing radiation-induced skin reactions compared with placebo among early-stage breast cancer patients. Forty-seven patients were enrolled in the study after undergoing breast-conserving surgery and staging procedures. Participants received either melatonin-containing cream or placebo during radiation therapy. In order to determine efficacy of the cream, patients provided self-reported data in the form of a questionnaire weekly and two weeks following radiation therapy. Patients were also photographed and examined in order to identify skin irritation.
Fifty-nine percent of the patients in the melatonin group experienced acute dermatitis compared with 90% in the placebo group. All skin reactions were mild or moderate (grade 1 or 2). Women over the age of 50 appeared to derive more of a benefit from the melatonin cream than younger women.
The researchers concluded that melatonin cream appeared to be effective in preventing skin irritations due to radiation therapy in this small study. Additional, larger studies are warranted to confirm these findings.
 Ben-David MA, Elkayam R, Galarenter I and Pfeffer RM. A prospective, double-blind, randomized study of a melatonin-containing cream for radiation-induced breast dermatitis. Presented at the 2010 Breast Cancer Symposium, Washington, DC, October 1-3, 2010. Abstract 123.