The Use of Antioxidants in Radiotherapy-Induced Skin Toxicity

Abstract

Radiation-induced skin damage is one of the most common complications of radiotherapy. In order to combat these side effects, patients often turn to alternative therapies, which often include antioxidants. Antioxidants such as those in the polyphenol chemical class, xanthine derivatives, tocepherol, sucralfate, and ascorbate have been studied for their use in either preventing or treating radiotherapy-induced skin damage. Apart from their known role as free radical scavengers, some of these antioxidants appear to alter cytokine release affecting cutaneous and systemic changes. We review the role of antioxidants in treating and preventing radiation-induced skin damage as well as the possible complications of using such therapy.

The neck burn scar contracture: a concept of effective treatment

“…Fibrotic tissue changes and excessive capillary formation, telangiectasia, often result from chronic radiation injury, with disposing to ulcers, skin tearing, tissue shrinkage or atrophy and subsequent limitation of motion, pain, and thrombosis obstruction [14]. The tissue is characterized by a marked disruption in healing and increased susceptibility to infection.…”

Topical silymarin administration for prevention of acute radiodermatitis in breast cancer patients: A randomized, double‐blind, placebo‐controlled clinical trial

“…During radiotherapy, around 95% of patients develop some degree of inflammatory symptoms, such as erythema, dry or moist desquamation, edema, and ulcers. A severe radiodermatitis, for example, moist desquamation, ulcers, and skin fibrosis, may necessitate discontinuation of the radiotherapy, which may negatively influence the outcome and impair patients' quality of life (Amber et al, ). The pathogenesis of radiodermatitis is rather complex and comprises a combination of radiation tissue injury followed by an inflammatory reaction.…”

“…Thereafter, increased level of proinflammatory cytokines like interleukin (IL)‐1, IL‐6, and IL‐8 and tumor necrosis factor (TNF)‐α leads to inflammatory response and damage (Kole, Kole, & Moran, ). Increased levels of IL‐1 and TNF‐α have been shown to stimulate the production of metalloproteases causing degradation of dermal components and disruption of the basal cell layer (Amber, Shiman, & Badiavas, ). Milk thistle ( Silybum marianum L.), belongs to Asteraceae family, is a well‐known herb for its hepatoprotective effects.…”

Ionizing radiation promotes CCL27 secretion from keratinocytes through the cross talk between TNF‐α and ROS

“…This radiation toxicity of the skin, also known as radiation dermatitis or radiodermatitis, can be characterized by erythema, moist desquamation, hair loss, and painful swelling of the skin . Concerns about the severe skin injury induced by radiation toxicity can lead physicians to reduce radiation dosages, which in turn reduces the efficiency of radiotherapy . Thus, further understanding of the pathophysiology of radiation‐induced skin injury is critical to the development of new methods of radiotherapy that minimize radiation toxicity of the skin.…”

“…[2,3] Concerns about the severe skin injury induced by radiation toxicity can lead physicians to reduce radiation dosages, which in turn reduces the efficiency of radiotherapy. [4] Thus, further understanding of the pathophysiology of radiation-induced skin injury is critical to the development of new methods of radiotherapy that minimize radiation toxicity of the skin.…”