Ask an answerable question (PICO)：
Radiation dermatitis is a common side effect of radiotherapy, which most frequently used therapeutic modalities in Head and neck Cancer. However, patients who suffer from radiation dermatitis may also have substantial discomfort and pain, even lead to local or systemic infections, which could affect the quality of life. To date the literature contains no consensus or universal standard for preventing and management of radiotherapy skin toxicities. Therefore, preventing radiation-induced dermatitis is important issue for patients treated with radiotherapy for Head and Neck Cancer. The clinical problem is Prophylaxis of Radiation-Induced Dermatitis in Patients with Head and Neck Cancer by using Herbal Creams.
The Method and Analysis of Literature Review：
PICO keyword search was set according to the empirical nursing steps, and synonyms were retrieved by MESH in the PubMed Clinical Key Cochrane Library and Huayi online Library. Limit the Chinese and English literature within ten years, which meets the search restrictions and PICO’s the article has 2 randomized controlled trials. This article uses the Chinese version of the Critical Appraisal Skill Program (CASP) RCT checklist developed by Better Value Healthcare in the UK to evaluate the effectiveness, importance/influence, and clinical applicability.
Critical Appraisal：
Included in the review of reading articles according to Oxford CEBM 2011 Levels of Evidence to make articles classification, analyzes the article belongs to Level 2, read an article with the three evaluation results are not clear, so the judge for Level 3. According to the characteristics of the cases, all the subjects were head and neck cancer patients who received radiation treatment (>18 years old), and the intervention measures used aloe-containing products as skin care. The measurement method used NCI CTCAE (National Cancer Institute Common Terminology Criteria for Adverse Events) or RTOG (the Radiation Therapy Oncology Group) to assess the severity of radiation dermatitis. The two studies were statistically significant (p <.04; p <.012).
Clinical Application of Evidence：
Using 7 steps to improve the empirical knowledge of translation, at the same time to analyze the results. Study period since August 20, 2019 to December 31, 2019, applied in 3 patients with head and neck cancer with radiation therapy, the doctor explained to the patient after obtaining permission from the patient consultation regions physicians use Ruyi-Jinhuang Gao.
Evaluation of Effectiveness：
The clinical evidence-based nursing applied in three patients with Radiation Therapy of head and neck cancer, The evaluation method used RTOG (Radiation Therapy Oncology Group) to assess the severity of radiation dermatitis. After the treatment, the radiation therapy dose was 66Gy, RTOG grade All maintained at level 1, with a pain score of 2 points.
Conclusions and Recommendations：
Through empirical literature search results, show that radioactive dermatitis in head and neck cancer patients receiving radiation treatment process is unable to avoid toxic reaction, in order to avoid the patient treatment caused by radioactive dermatitis was forced to interrupt, according to the empirical results show that the traditional Chinese medicine external treatment to reduce radioactive dermatitis, may be more better than the control group, the clinical trial in three cases the result is similar with the literature, do have to delay the time and the severity of radioactive dermatitis occurs, however, still need more large clinical trials to prove its effect of treatment and prevention.
