To evaluate the relative efficacy of topical
steroids in preventing radiation
dermatitis (RD). Multiple databases including Medline, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), China
Biological Medicine (SinoMed), and Wanfang Database were searched for randomized controlled trials (RCTs) of RD prevention in patients with
cancer from inception to November 26, 2021, followed by an update on June 1, 2021. Six RCTs evaluating the efficacy of topical
steroids in preventing RD in a total of 661 patients with
cancer were included. RD incidence was lower with topical
steroids compared with placebo at week 3 (relative risk [RR] = 0.68, 95% confidence interval [CI]: 0.31-1.50) and at
radiation therapy (RT) completion (RR = 0.97, 95% CI: 0.93-1.00). Topical
steroids demonstrated a less risk of developing
dermatitis of
Radiation Therapy Oncology Group (RTOG) grades 2 and 3 at the completion of RT (RR = 0.66, 95% CI: 0.55-0.80 and RR = 0.54, 95% CI: 0.38-0.77, respectively). However, topical
steroids did not reduce RTOG grades 1 and 2
dermatitis at week 3(RR = 0.73, 95% CI: 0.45-1.14 and RR = 0.66, 95% CI: 0.27-1.60, respectively). Notably, the use of topical
steroids did not decrease RD incidence when patients received combined
chemotherapy (RR = 0.60, 95% CI: 0.42-0.86), and an obvious reduction in the incidence of RD at RT completion was found when patients used the topical
steroids twice-daily (RR = 0.66, 95% CI: 0.47-0.93, P = 0.02). Topical
steroids reduced RD incidence in patients receiving RT. Thus, twice-daily topical
steroids may be recommended for patients at the beginning of RT.