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

source extracted confidence: high 2026-04-09

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

Li et al., 2025 | Front Oncol | Systematic Review

Citation

Li Mingyu, Hao Jianping, ... Zhao Lijun. 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. Front Oncol. 2025;15:1657588. doi:10.3389/fonc.2025.1657588

Abstract

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. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420251063723.

Key Findings

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

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population breast cancer
Sample Size 2177
Age Range See abstract
Condition See abstract

MeSH Terms

  • No MeSH terms indexed

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: milk-thistle

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09