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Calendula Officinalis For Radiation of Breast

Phase III Randomized Trial of Calendula Officinalis Compared With Trolamine for the Prevention of Acute Dermatitis During Irradiation for Breast Cancer

P. Pommier, F. Gomez, M.P. Sunyach, A. D'Hombres, C. Carrie, X. Montbarbon

From the Department of Radiation Oncology and the Department of Biostatistics, Centre Léon Bérard, Lyon, France

Address reprint requests to Xavier Montbarbon, MD, Department of Radiation Oncology, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France; e-mail: Montbarb@lyon.fnclcc.fr

PURPOSE: The effectiveness of nonsteroid topical agents for the prevention of acute dermatitis during adjuvant radiotherapy for breast carcinoma has not been demonstrated.

The goal of this study was to compare the effectiveness of calendula (Pommade au Calendula par Digestion; Boiron Ltd, Levallois-Perret, France) with that of trolamine (Biafine; Genmedix Ltd, France), which is considered in many institutions to be the reference topical agent.

PATIENTS AND METHODS: Between July 1999 and June 2001, 254 patients who had been operated on for breast cancer and who were to receive postoperative radiation therapy were randomly allocated to application of either trolamine (128 patients) or calendula (126 patients) on the irradiated fields after each session.

The primary end point was the occurrence of acute dermatitis of grade 2 or higher. Prognostic factors, including treatment modalities and patient characteristics, were also investigated.

Secondary end points were the occurrence of pain, the quantity of topical agent used, and patient satisfaction.

RESULTS: The occurrence of acute dermatitis of grade 2 or higher was significantly lower (41% v 63%; P < .001) with the use of calendula than with trolamine.

Moreover, patients receiving calendula had less frequent interruption of radiotherapy and significantly reduced radiation-induced pain.

Calendula was considered to be more difficult to apply, but self-assessed satisfaction was greater. Body mass index and adjuvant chemotherapy before radiotherapy after lumpectomy were significant prognostic factors for acute dermatitis.

CONCLUSION: Calendula is highly effective for the prevention of acute dermatitis of grade 2 or higher and should be proposed for patients undergoing postoperative irradiation for breast cancer.

Supported by a grant from the Department of Research and Development, Boiron Ltd, France.

Role of the funding source: The sponsors of this study had no role in the collection, analysis, or interpretation of data, nor in the writing of the report or the decision to submit the article for publication.

Journal of Clinical Oncology, Vol 22, No 8 (April 15), 2004: pp. 1447-1453

DOI: 10.1200/JCO.2004.07.063

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