{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:18:06Z","timestamp":1791645486894,"version":"4.3.4"},"reference-count":19,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"\n Importance<\/jats:title>\n Evidence-based approaches for the prevention of acute radiation dermatitis (ARD) are limited, and additional strategies are necessary to optimize care.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the efficacy of bacterial decolonization (BD) to reduce ARD severity compared with standard of care.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This phase 2\/3 randomized clinical trial was conducted from June 2019 to August 2021 with investigator blinding at an urban academic cancer center and enrolled patients with breast cancer or head and neck cancer receiving radiation therapy (RT) with curative intent. Analysis was performed on January 7, 2022.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Intranasal mupirocin ointment twice daily and chlorhexidine body cleanser once daily for 5 days prior to RT and repeated for 5 days every 2 weeks through RT.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome as planned prior to data collection was the development of grade 2 or higher ARD. Based on wide clinical variability of grade 2 ARD, this was refined to grade 2 ARD with moist desquamation (grade 2-MD).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 123 patients assessed for eligibility via convenience sampling, 3 were excluded, and 40 refused to participate, with 80 patients in our final volunteer sample. Of 77 patients with cancer (75 patients with breast cancer [97.4%] and 2 patients with head and neck cancer [2.6%]) who completed RT, 39 were randomly assigned BC, and 38 were randomly assigned standard of care; the mean (SD) age of the patients was 59.9 (11.9) years, and 75 (97.4%) were female. Most patients were Black (33.7% [n\u2009=\u200926]) or Hispanic (32.5% [n\u2009=\u200925]). Among patients with breast cancer and patients with head and neck cancer (N\u2009=\u200977), none of the 39 patients treated with BD and 9 of the 38 patients (23.7%) treated with standard of care developed ARD grade 2-MD or higher (\n P<\/jats:italic>\n \u2009=\u2009.001). Similar results were observed among the 75 patients with breast cancer (ie, none treated with BD and 8 [21.6%] receiving standard of care developed ARD grade \u22652-MD;\n P<\/jats:italic>\n \u2009=\u2009.002). The mean (SD) ARD grade was significantly lower for patients treated with BD (1.2 [0.7]) compared with patients receiving standard of care (1.6 [0.8]) (\n P<\/jats:italic>\n \u2009=\u2009.02). Of the 39 patients randomly assigned to BD, 27 (69.2%) reported regimen adherence, and only 1 patient (2.5%) experienced an adverse event related to BD (ie, itch).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The results of this randomized clinical trial suggest that BD is effective for ARD prophylaxis, specifically for patients with breast cancer.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT03883828<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoncol.2023.0444","type":"journal-article","created":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T11:33:42Z","timestamp":1683200022000},"page":"940","source":"Crossref","is-referenced-by-count":40,"title":["Bacterial Decolonization for Prevention of Radiation Dermatitis"],"prefix":"10.1001","volume":"9","author":[{"given":"Yana","family":"Kost","sequence":"first","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alana","family":"Deutsch","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Mieczkowska","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roya","family":"Nazarian","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahava","family":"Muskat","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Dean","family":"Hosgood","sequence":"additional","affiliation":[{"name":"Department of Medicine, Albert Einstein College of Medicine, Bronx, New York"},{"name":"Department of Epidemiology and Population Health (Biostatistics), Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Albert Einstein College of Medicine, Bronx, New York"},{"name":"Department of Epidemiology and Population Health (Biostatistics), Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna P.","family":"Daily","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York"},{"name":"Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Ohri","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafi","family":"Kabarriti","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosaku","family":"Shinoda","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York"},{"name":"Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth N.","family":"McLellan","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"6","key":"coi230011r1","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1158\/1055-9965.EPI-16-1023","article-title":"Trends in radiation therapy among cancer survivors in the United States, 2000-2030.","volume":"26","author":"Bryant","year":"2017","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"1","key":"coi230011r2","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.jaad.2019.03.011","article-title":"Characterizing the effects of radiation dermatitis on quality of life: a prospective survey-based study.","volume":"86","author":"Rzepecki","year":"2022","journal-title":"J Am Acad Dermatol"},{"issue":"9","key":"coi230011r3","doi-asserted-by":"publisher","first-page":"2857","DOI":"10.1007\/s00520-017-3701-0","article-title":"Practice patterns for the prophylaxis and treatment of acute radiation dermatitis in the United States.","volume":"25","author":"Lucey","year":"2017","journal-title":"Support Care Cancer"},{"key":"coi230011r4","doi-asserted-by":"publisher","journal-title":"JAMA Oncol","DOI":"10.1001\/jamaoncol.2023.0454"},{"key":"coi230011r5","doi-asserted-by":"publisher","first-page":"2419","DOI":"10.3389\/fmicb.2018.02419","article-title":"Staphylococcus aureus nasal colonization: an update on mechanisms, epidemiology, risk factors, and subsequent infections.","volume":"9","author":"Sakr","year":"2018","journal-title":"Front Microbiol"},{"key":"coi230011r6","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1159\/000106410","article-title":"Environmental risk factors for mycosis fungoides.","volume":"35","author":"Wohl","year":"2007","journal-title":"Curr Probl Dermatol"},{"issue":"3","key":"coi230011r7","doi-asserted-by":"publisher","first-page":"253","DOI":"10.5604\/17331331.1215600","article-title":"The role of Staphylococcus aureus in secondary infections in patients with atopic dermatitis (AD).","volume":"65","author":"Buda","year":"2016","journal-title":"Pol J Microbiol"},{"issue":"2","key":"coi230011r8","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1111\/jde.v49.2","article-title":"Pathogenesis of cutaneous T cell lymphoma: involvement of Staphylococcus aureus.","volume":"49","author":"Fujii","year":"2022","journal-title":"J Dermatol"},{"issue":"5","key":"coi230011r9","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1093\/aje\/kww008","article-title":"Beyond the intensive care unit (ICU): countywide impact of universal ICU Staphylococcus aureus decolonization.","volume":"183","author":"Lee","year":"2016","journal-title":"Am J Epidemiol"},{"issue":"7","key":"coi230011r10","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1007\/s11999-013-2875-0","article-title":"Staphylococcus aureus screening and decolonization in orthopaedic surgery and reduction of surgical site infections.","volume":"471","author":"Chen","year":"2013","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"coi230011r11","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1016\/j.ijrobp.2018.02.006","article-title":"A randomized trial of mometasone furoate 0.1% to reduce high-grade acute radiation dermatitis in breast cancer patients receiving postmastectomy radiation.","volume":"101","author":"Ho","year":"2018","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"coi230011r12","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.jmir.2010.08.005","article-title":"Phase III study of silver leaf nylon dressing vs standard care for reduction of inframammary moist desquamation in patients undergoing adjuvant whole breast radiation therapy.","volume":"41","author":"Aquino-Parsons","year":"2010","journal-title":"J Med Imaging Radiat Sci"},{"issue":"2","key":"coi230011r13","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1200\/JCO.1998.16.2.441","article-title":"Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17.","volume":"16","author":"Fisher","year":"1998","journal-title":"J Clin Oncol"},{"issue":"2","key":"coi230011r14","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/S0936-6555(05)80971-9","article-title":"Can patients wash during radiotherapy to the breast or chest wall? a randomized controlled trial.","volume":"4","author":"Campbell","year":"1992","journal-title":"Clin Oncol (R Coll Radiol)"},{"issue":"6","key":"coi230011r15","first-page":"1019","article-title":"Predicting the severity of radiation skin reactions in women with breast cancer.","volume":"25","author":"Porock","year":"1998","journal-title":"Oncol Nurs Forum"},{"issue":"2","key":"coi230011r16","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/S0167-8140(96)01882-8","article-title":"Double-blind, randomized clinical study comparing hyaluronic acid cream to placebo in patients treated with radiotherapy.","volume":"42","author":"Liguori","year":"1997","journal-title":"Radiother Oncol"},{"issue":"2","key":"coi230011r17","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/S0360-3016(96)00320-3","article-title":"Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity.","volume":"36","author":"Williams","year":"1996","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"coi230011r18","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1002\/pon.v20.3","article-title":"A qualitative analysis of acute skin toxicity among breast cancer radiotherapy patients.","volume":"20","author":"Schnur","year":"2011","journal-title":"Psychooncology"},{"issue":"5","key":"coi230011r19","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1111\/j.1469-0691.2009.02836.x","article-title":"Body site colonization in patients with community-associated methicillin-resistant Staphylococcus aureus and other types of S. aureus skin infections.","volume":"16","author":"Yang","year":"2010","journal-title":"Clin Microbiol Infect"}],"container-title":["JAMA Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/articlepdf\/2804692\/jamaoncology_kost_2023_oi_230011_1689819991.25141.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T12:08:48Z","timestamp":1689854928000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2804692"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2023,7,1]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoncol.2023.0444","relation":{},"ISSN":["2374-2437"],"issn-type":[{"value":"2374-2437","type":"print"}],"subject":[],"published":{"date-parts":[[2023,7,1]]}}}