Prevention and treatment of acute and chronic radiodermatitis

Abstract

More than half the number of patients with cancer, who are treated with radiotherapy, will have radiodermatitis at some point during their treatment. Radiodermatitis either occurs early on in the treatment period or appears months or up to several years later. Acute radiodermatitis is a burn injury that varies in severity according to both treatment and inherent patient factors. Most acute radiodermatitis reactions resolve after several weeks but some reactions persist and can cause complications. Late-onset radiodermatitis is characterized by telangiectasia that forms on atrophic and fragile skin. These radiodermatitis reactions can have a significant negative impact on concomitant and subsequent therapeutic protocols and most particularly on the patient’s quality of life. Today, treatment of radiodermatitis reactions is in its infancy. Although there is insufficient evidence available to form recommendations that would prevent or reduce radiodermatitis, some advances have been made using low level light therapy (LLLT) or vascular lasers to control the symptoms. Some recent preclinical and clinical research suggests that LLLT has biostimulating properties which allow the tissues to regenerate and heal faster, reduce inflammation, and prevent fibrosis. Also, in late-onset radiodermatitis pulsed dye laser treatment has been shown to be beneficial in clearing radiation-induced telangiectasia. In the absence of evidence-based recommendations, the objective of this paper is to review how to prevent or manage the symptoms of radiodermatitis reactions.

Establishment and characterization of a radiation‐induced dermatitis rat model

“…Radiation-induced dermatitis is a common and serious side effect in patients with breast cancer or head and neck cancer who receive radiotherapy 31,32 ; however, there is currently no effective treatment, thus remaining a significant clinical concern that further negatively affects the patient's quality of life. 3,33 Towards promoting research into the pathophysiology of this response, we successfully established radiation-induced acute and chronic dermatitis rat models using 90 Gy of radiation exposure to the skin.…”

“…2 Acute radiation-induced dermatitis typically occurs within a few days or months after the beginning of irradiation, and is characterized by erythema, ulceration, pigment changes and dry or moist desquamation, whereas chronic radiation-induced dermatitis is defined when the injury lasts a few months or years and is accompanied by delayed healing, along with irreversible and progressive fibrosis. 3,4 Currently, a variety of interventions are used to treat radiation-induced dermatitis, such as washing, typical dermatitis agents (hyaluronic acid, corticosteroid, sucralfate cream), antioxidant agents (vitamin C and vitamin E) and wound dressing (hydrocolloid or hydrogel); however, the majority of patients with a severe form of radiation-induced dermatitis usually requires surgical treatment. 5,6 Despite the wide array of treatment options, the curative effects remain unsatisfactory, imposing a major burden on the patients' quality of life.…”

Radiodermatites: Análise dos Fatores Preditivos em Pacientes com Câncer de Mama

“…Essas dermites são lesões definidas como um conjunto de reações cutâneas decorrentes da destruição de células basais da epiderme, provocadas por exposição à radiação ionizante necessária para eficácia da radioterapia 3 . A radiodermatite aguda inicia-se por volta da terceira semana de tratamento, podendo ocorrer tardiamente após 90 dias do início do tratamento e, apesar dos esforços para minimizar a dose total de radiação, cerca de 80-90% dos pacientes em tratamento radioterápico irão desenvolvê-las em algum grau, porém avalia-se que somente 10-15% em graus mais avançados (descamação úmida e ulceração) 4,5 .…”

Antimicrobial activities of essential oils on microorganisms isolated from radiation dermatitis

“…Radiotherapy is one of the mainstay treatment of cancer therapy and about 50% of the patients with cancer receive some type of radiation therapy during their treatment course [1]. Acute radiation dermatitis, which also called acute radiodermatitis is one of the most common side effects of radiotherapy and radiation-related severe skin reactions may necessitate treatment interruption [2].…”