Mepitel Film versus StrataXRT for the prevention of radiation dermatitis in post-mastectomy radiotherapy: a systematic review and meta-analysis of randomized controlled trials

Clinical Snapshot

Key Findings

• P Value: P = 0.93

• Effect Size: RR 1.03 for StrataXRT vs Mepitel Film

• Primary Outcome: No significant difference in moist desquamation between interventions

• Nnt Or Sensitivity: Mepitel Film showed superior protection against grade 2-3 RD (RR 1.34, 95% CI 1.10-1.64)

• Confidence Interval: 95% CI 0.52-2.04

Clinical Application

Both interventions appear feasible but evidence base too limited for definitive recommendations Relevant to Australian oncology practice; both products likely available through hospital formularies; aligns with Cancer Australia guidelines for supportive care Post-mastectomy breast cancer patients receiving adjuvant radiotherapy

Abstract

BACKGROUND: Radiation dermatitis (RD) affects up to 90% of patients receiving post-mastectomy radiotherapy, with moist desquamation causing significant morbidity. Barrier films and dressings such as Mepitel Film and StrataXRT have been shown to be effective compared to moisturizers, but their relative effectiveness remains debated. This systematic review and meta-analysis compares these interventions for preventing RD. METHODS: Following PRISMA guidelines, we systematically searched MEDLINE, Embase, and Cochrane Library through March 14, 2026. An additional grey literature search was performed in clinicaltrials.gov and Google Scholar. Eligible studies were RCTs directly comparing StrataXRT and Mepitel Film in breast cancer patients receiving adjuvant radiation therapy. Two reviewers independently screened studies, extracted data, and assessed risk of bias using RoB 2.0 and certainty of evidence with the GRADE appraoch. Meta-analysis used random-effects models to pool risk ratios (RR) for moist desquamation, and incidence of grade 2 and 3 RD, with I2 statistics quantifying heterogeneity. RESULTS: From 33 screened records, two intra-patient, non-inferiority RCTs (n = 120) met inclusion criteria. Both studies randomized medial/lateral chest wall halves to each intervention in post-mastectomy patients. Pooled analysis revealed no significant difference in moist desquamation incidence between StrataXRT (21.7%) and Mepitel Film (20.0%) (RR 1.03; 95% CI 0.52-2.04; P = 0.93), with low heterogeneity (I2 = 35%). Secondary outcomes showed Mepitel Film significantly reduced grade 2 or 3 RD (RR 1.34, 95% CI 1.10-1.64, P = 0.004). However, Mepitel Film trended toward higher incidence of itchiness (10.8% vs. 5.0%, P = 0.11). Patient preference data were conflicting, with one trial favoring StrataXRT for ease of use and the other showing no clear preference. CONCLUSION: While StrataXRT and Mepitel Film demonstrated similar efficacy for preventing moist desquamation, Mepitel Film offered superior protection against grade 2 to 3 RD. However, this conclusion should be interpreted with caution given the underlying methodological limitations of the included studies, including small and potentially underpowered sample sizes, and variations in radiation fractionation schedules and RT techniques.

References

1. 1.Wong, H. C. Y., Tang, L., Yang, C., Caini, S., Tse, S. T. W., & Chow, E. (2026). Mepitel Film versus StrataXRT for the prevention of radiation dermatitis in post-mastectomy radiotherapy: a systematic review and meta-analysis of randomized controlled trials. Supportive Care in Cancer. https://doi.org/10.3389/fonc.2021.738851