About this trial
In the randomized DAI-BREAC trial, a reminder app will be prospectively tested that reminds breast cancer patients four times each day to perform the required skin care. This will likely contribute to the reduction of grade ≥2 radiation dermatitis in these patients. A total of 268 patients will be randomized to receive standard skin care supported by a reminder app (Arm A) or standard skin care alone (Arm B). Stratification will be done using the three factors treatment volume, radiation boost, and at least one risk factor of dermatitis. Secondary aims include pain (radiation fields), patient satisfaction with the reminder app (Arm A only), impact of the app on the use of health technology (Arm A only), and benefit from support by staff members of the treating Department of Radiation Oncology and/or the UKSH academy regarding the use of the app (Arm A only).
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Histologically proven invasive breast cancer
Indication for adjuvant hypo-fractionated radiotherapy
Possession of and ability to use a smartphone
Female gender
Disqualifiers
Pregnancy, Lactation
Expected non-compliance
Trial design
Parallel
Treatments tested in this trial
Standard skin care
Other interventionFrom the start of radiotherapy, standard skin care has to be performed by the patient. This may vary at the participating centers. At the site in Lübeck, it includes fatty cream with 2-10% urea (fatty cream alone, if patients do not tolerate urea) and, in case of pruritus, addition of mometasone furoate cream. In case of grade ≥2 moist desquamation or grade ≥3 radiation dermatitis, each day antiseptic agents will be administered for wound cleansing followed by administration of silicon or calcium alginate bandage. This treatment will be continued until moist desquamation radiation disappears and radiation dermatitis improves to grade 2. Fatty cream with 2-10% urea is applied to the irradiated skin four times daily. Mometasone furoate cream: In addition to the fatty cream with 2-10% urea, mometasone furoate cream (solution 0.1%) is applied to the irradiated skin once daily.
Reminder App
DeviceIn addition to standard skin care, patients are supported by a Reminder App. The purpose of the app is to remind the patients in an intuitive, unobtrusive and supportive way to perform skin care. By default, patients are reminded four times a day, but they will also be able to define a notification schedule that best suits their personal needs. The patients may postpone each required care procedure for up to 2 hours. With each procedure, the patients are guided through the skin care with simple and self-explanatory illustrations. To increase the patients' motivation, they will additionally earn points for regular and punctual performed care procedures. The patients receive a hand-out including instructions how to properly perform skin care, but they can also find an information page within the application that includes similar instructions.
Treatment groups
Trial outcomes
Primary outcomes
Prevention of grade ≥2 radiation dermatitis
Radiation dermatitis will be assessed according to CTCAE v5.0.
Secondary outcomes
Pain score
Pain (skin within radiation fields) will be assessed with a visual analogue scale (self-assessment, ranging from 0 = no pain to 10 = maximum pain). Furthermore, the intake of analgesics will be documented.
Rate of patient satisfaction with the reminder app
Patient satisfaction with the reminder app will be assessed with a specific questionnaire (Arm A only).
Degree of the impact of the reminder app
Impact of the reminder app on the use of health technology will be assessed with a specific questionnaire (Arm A only).
Rate of patient satisfaction with support
4\. Benefit from support by staff members of the treating Department of Radiation Oncology and/or the UKSH academy regarding the use of the reminder app will be assessed with a specific questionnaire (Arm A only).
Sponsors and contacts
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University Hospital Schleswig-Holstein
Lead sponsor
University of Southern Denmark
Collaborator
Medical School Hamburg
Collaborator