ICO study: efficacy in radiotherapy

ICO HOSPITALET CLINICAL STUDY (Barcelona): effectiveness of GGcare products in radiotherapy

AUTHOR: Juan L. Ribes "Coordinator of Radiotherapy Oncology Nursing Consultation nurse" ICO Barcelona.
DURATION: From January to December 2020.
INTRODUCTION: The prevention and treatment of induced radiodermatitis is an inevitable adverse effect. It is minimized with the care of nurses and the use of appropriate products. In this document we present a test to understand in depth the effectiveness of GGcare products.
HYPOTHESIS: The combination of soothing body cream and relieving repairing oil is a highly recommended protocol for the prevention and reduction of radiodermitis in breast cancer.
METHODOLOGY: 14 patients with breast cancer were studied, undergoing onco-radiotherapy treatments and divided into 2 subgroups: normofractionated (25 sessions 50 Gy) and hypo-fractionated (15 sessions 40.05 Gy) . This division is made because skin reactions are different in presentation times.

Results:
Normofractionated:
- Elasticity: loss of 2.8% from the beginning to end of treatment. Average loss of other creams 10%.
- Hydration: loss of 5.66% from the beginning to the end of treatment. Average loss other creams 10-12%.
- Melanin: 7.5% increase from the beginning to the end of treatment. Average increase of other creams 12-18%.
- Erythema: increase 22.08% from the beginning to the end of treatment. Average increase of other creams 15-25%.

Hypofractionated:
- Elasticity: loss of 11.3% from the beginning to the end of treatment. Average loss of other creams 10%.

- Hydration: loss of 2% from the beginning to the end of treatment. Average loss of other creams 10-12%.

- Melanin: loss 1.1% from the beginning to the end of treatment. Average increase of other creams 12-18%.
- Erythema: 20% increase from the beginning to the end of treatment. Average increase of other creams 15-25%.

Discussion:
Different reactions are observed between normo and hypo. It is due to the difference in dose/session.Increases loss of elasticity in hiccups; but, on the other hand, it better protects the loss of hydration and good aesthetic results with low melanin production. The reaction regarding erythema is very similar.

Conclusions:
Very good response in both normofractionated and hypofractionated. In many of the measured parameters, it has a better response than most rated creams. Our hypothesis is reaffirmed that the combination of Soothing Body Cream and Relieving Repair Oil is a highly recommended protocol.
Note: the use of Relieving Repair Oil should not be applied before the treatment to avoid a bolus effect.

Presentation and conclusion:
- Unlike other valuation studies, this one is based on objective measurements.
- 4 essential parameters are assessed in the skin, highly indicated in onco-radio.
- As the photos of the study patients demonstrate, the skin reacts in a very mild-moderate way.

NORMOFRACTIONATED
- Elasticity: loss of 2.8% from the beginning to the end of treatment . Average loss of other creams 10%.
ASSESSMENT: The usual loss in RDT treatment is much lower than that of other creams. The good response is related, in the medium term, to recovering basal elasticity as soon as possible.
- Hydration: loss of 5.66% from the beginning to the end of treatment. Average loss other creams 10-12%.
RATING:  Very interesting that the loss of hydration is less to avoid peeling Grade 2.
- Melanin: increase 7.5% from the beginning to the end of treatment. Average increase other creams 12-18%.
ASSESSMENT: There is always an increase in melanin from the 2nd half of the treatment and it is greater in phototypes III-IV, due to the increase in melanocyte activity. Its excessive growth produces hyperpigmentation of the skin and aesthetically these spots take a long time to recover.For this reason, the excellence of the little increase.
- Erythema: increase 22.08% from the beginning to the end of treatment. Average increase of other creams15-25%.
RATING: In this case, the increase is very similar to the rest of the creams. An inevitable effect that occurs due to increased vascularization. The most important thing is to stay at Grade I and avoid peeling. It is achieved with good hydration control.

HYPOFRACTIONATED
- Elasticity: loss of 11.3% from the beginning to the end of treatment. Average loss of other creams 10%.
ASSESSMENT: The differential reaction between norm and hypo is marked. Very similar to the rest of the creams.
- Hydration: loss of 2% from the beginning to the end of treatment. Average loss of other creams 10-12%.
RATING: Very interesting that the loss of hydration is less to avoid flaking Grade 2.
- Melanin: losses 1.1% from the beginning to the end of treatment. Average increase of other creams 12-18%.
ASSESSMENT: There is always an increase in melanin from the 2nd half of the treatment and it is greater in phototypes III-IV due to the increase in melanocyte activity. Its excessive growth produces
hyperpigmentation of the skin and aesthetically these spots take a long time to recover. Therefore, the
excellence of the little increase.
- Erythema: 20% increase from the beginning to the end of treatment. Average increase of other creams 15-25%.
RATING: In this case the increase is very similar to the rest of the creams. An inevitable effect that is produced
by the increase in vascularization. The important thing is to stay at Grade I and avoid peeling with good hydration control.

DIFFERENCE BETWEEN NORMO AND HYPO
- Fractionated normo treatments: the maximum important reaction occurs in the last sessions and a few days later.
- Hypofractionated treatments: the maximum important reaction is 1 week after completion.
In both cases, the good data provided by the protocol is very important, specifically in hydration; aesthetically avoid peeling and minimal increases in melanin. Note: It is advisable to maintain the same care in the following 15-20 days.

PRODUCT APPLICATION GUIDELINES
Soapy, purifying oil: Use as a normal shower gel, even as a shampoo. Essential for radiotherapy in the intimate area.
Body cream, soothing: Apply 2 times a day. In case of itching, redness and extreme dryness, apply as needed.
Repairing, relieving oil: Apply 3 times a day. Important: apply just after the radiotherapy session, never before. The skin in the area to be treated must be clean of any product before the session.