Management of acute radiation skin toxicity with wheatgrass extract in breast radiation therapy: pilot study

Acute radiation skin toxicity in breast irradiation occurs in the majority of patients and a variety of topical agents and dressings have been employed in clinical practice, however, there is little empirical evidence to support one protocol for skin care over another. The aim of this investigation was to examine the potential benefits of wheatgrass extract in reducing the severity and delaying the onset of acute radiation skin toxicity in breast irradiation.METHODS: This pilot study was a prospective randomised control trial using one control group employing current best practice (sorbelene cream) and one treatment modification group (wheatgrass extract). Patient recruitment was randomised and blinded to treatment group.RESULTS: A total of 20 ‘lumpectomy’ patients were recruited for the initial pilot phase of this research. The mean weight of the control group was only 67.1 kg compared to 82.4 kg for the experimental group. A bra size greater than 20 was only seen in 14.3% of the control group compared to 50.0% of the experimental group. A cup size greater than or equal to D was only seen in 25% of the control group but 37.5% of the experimental group. The mean planned dose for the experimental group was higher (63.3 Gy) than the control group (59.4 Gy). No statistically significant difference was noted between the control group and the experimental group with respect to the peak ONS rating or time to peak ONS rating for the experimental group. There was a statistically significant improvement in the quality of life of patients in the wheatgrass group (P = 0.014).CONCLUSION: This pilot study demonstrated a trend noted towards decreased severity of acute radiation skin toxicity and increased time to peak incidence which may be strengthened in a larger population. The pilot study provides evidence that wheatgrass offers improved management of the early morbidity associated with breast irradiation.