Green Tea Ingredient Shows Promise for Preventing Severe Radiation Dermatitis

By Patricia A. Sheiner MD

June 02, 2022

NEW YORK (Reuters Health) - Prophylactic use of a green tea constituent significantly reduced the incidence and severity of radiation-induced dermatitis (RID) in breast cancer patients in a randomized trial, researchers say.

The incidence of grade 2 or worse RID was significantly lower in patients treated with the green tea constituent - epigallocatechin-3-gallate, or EGCG - than in the placebo group (50.5% vs 72.2%;P=0.008), Dr. Hanxi Zhao and colleagues from the Shandong Cancer Hospital and Institute in China reported in JAMA Dermatology.

EGCG has the potential to become a new skin care option for patients receiving radiotherapy, the investigators believe.

In their randomized, double blind trial, 165 patients (median age, 46) were assigned 2:1 to receive either EGCG solution (660 μmol/L) or placebo (0.9% NaCl saline) sprayed to the whole radiation field three times a day, from day 1 of radiotherapy until two weeks after radiation completion. Patients were evaluated weekly for signs of RID using the Radiation Therapy Oncology Group (RTOG) scale and the Skin Toxicity Assessment Tool.

Most cases of RID began two to three weeks after the start of radiotherapy, but the average interval to RID appearance was delayed in the EGCG group compared to the placebo group (3.27 weeks vs 2.89 weeks; P=0.001).

The mean RID index was significantly lower in the EGCG group (5.22 vs 6.21; t = −3.79; P<0.001). The EGCG group also had a lower rate of grade 3 or worse RID, but the difference was not statistically significant (3.6% vs 9.3%; P=0.16).

Compared to the placebo group, the EGCG group had significantly lower rates of grade 2 burning feeling (19.8% vs 44.4%), itching (41.4% vs 72.2%), pain (13.5% vs 24.1%), and tenderness (21.6% vs 46.3%).

There were no serious adverse effects related to the application of either EGCG or placebo.

"Green tea extract and its principal active ingredient, EGCG, are gaining attention with increased usage for radiation-induced damage," the authors said.

However, they note, "Freshly prepared EGCG saline solution was used in the present study, which might limit its actions. Ointment formulation is being developed to improve the skin penetration and intradermal uptake and facilitate further multicenter studies."

In the meantime, they conclude, "Use of EGCG has the potential to become a new standard of skin care for patients receiving radiotherapy"

SOURCE: JAMA Dermatology, online June 1, 2022.