SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Radiation Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1657588
This article is part of the Research TopicEnhancing Radiotherapy Efficacy with Novel Plant and Chemically Derived Radioprotectors and RadiosensitizersView all articles
Efficacy of various plant-derived interventions in the prevention of radiation dermatitis in breast cancer patients:A systematic review and network meta-analysis of randomised controlled trials
Provisionally accepted
- The Second Affiliated Hospital of Xingtai Medical College Department of Radiotherapy, Xingtai, China
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Objective: Radiation dermatitis (RD), a common adverse event among breast cancer patients undergoing post-surgical radiotherapy, may be mitigated through the application of plant-derived substances possessing radioprotective effects. However, comprehensive evaluations comparing the efficacy of different plant-derived compounds are not yet available. The objective of this study is to perform a network meta-analysis (NMA) to evaluate the efficacy of diverse plant-derived substances in preventing RD in patients with breast cancer.Methods:A systematic search was conducted to identify randomized controlled trials (RCTs) published up to April 2025 that investigated the use of plant-derived substances for the prevention of RD in patients with breast cancer. Two authors individually screened the articles, gathered pertinent information, and conducted quality assessments of the studies that were included.Data were synthesized and analyzed using Stata version 15.1.Results:In our NMA, we included 18 RCTs involving 2177 patients and 18 different treatment arms. Regarding the primary and secondary outcomes,Sylimarin derived from Silybum marianum L.(Milk thistle) (SUCRA = 0.934) and Cichorium intybus L.(Chicory) root extract (SUCRA = 0.72) demonstrated the greatest efficacy in mitigating the occurrence of grade ≥2 and grade ≥3 RD. Furthermore, Silymarin (RR = 0.05, 95% CI [0.00, 0.87]) exhibits greater efficacy compared with the standard of care (SOC) in preventing grade ≥2 RD. However, no intervention demonstrated superiority over SOC in preventing grade ≥3 RD.Conclusion: Silymarin has shown promise as treatment for the prevention of grade ≥2 RD in patients undergoing radiotherapy. Future studies with larger sample sizes are needed to substantiate the efficacy of various plant-derived substances.
Keywords: breast cancer, Radiation dermatitis, Plant-derived substances, Systematic review, Network meta-analysis
Received: 01 Jul 2025; Accepted: 10 Oct 2025.
Copyright: © 2025 Li, Hao, Song, Zhang, Zhang, Hao and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mingyu Li, limingyu@syy36.wecom.work
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