Prophylaxis and Management of Acute Radiation-Induced Skin Reactions: A Systematic Review of the Literature

Abstract

Radiation therapy is a common treatment for cancer patients. One of the most common side effects of radiation is acute skin reaction (radiation dermatitis) that ranges from a mild rash to severe ulceration. Approximately 85% of patients treated with radiation therapy will experience a moderate-to-severe skin reaction. Acute radiation-induced skin reactions often lead to itching and pain, delays in treatment, and diminished aesthetic appearance-and subsequently to a decrease in quality of life.Surveys have demonstrated that a wide variety of topical, oral, and intravenous agents are used to prevent or to treat radiation-induced skin reactions. We conducted a literature review to identify trials that investigated products for the prophylaxis and management of acute radiation dermatitis. Thirty-nine studies met the pre-defined criteria, with thirty-three being categorized as prophylactic trials and six as management trials.For objective evaluation of skin reactions, the Radiation Therapy Oncology Group criteria and the U.S. National Cancer Institute Common Toxicity Criteria were the most commonly used tools (65% of the studies). Topical corticosteroid agents were found to significantly reduce the severity of skin reactions; however, the trials of corticosteroids evaluated various agents, and no clear indication about a preferred corticosteroid has emerged. Amifostine and oral enzymes were somewhat effective in preventing radiation-induced skin reactions in phase ii and phase iii trials respectively; further large randomized controlled trials should be undertaken to better investigate those products. Biafine cream (Ortho-McNeil Pharmaceuticals, Titusville, NJ, U.S.A.) was found not to be superior to standard regimes in the prevention of radiation-induced skin reactions (n = 6).In conclusion, the evidence is insufficient to support the use of a particular agent for the prevention and management of acute radiation-induced skin reactions. Future trials should focus on comparing agents and approaches that, in phase i and ii trials, suggest efficacy. These future phase iii randomized controlled trials must clearly distinguish between preventive and management strategies for radiation-induced dermatitis. Only then can evidence-based guidelines be developed, with the hope of standardizing the approach across centres and of improving the prevention and management of radiation-induced dermatitis.

Non-thermal Millimeter Waves Non-Ionizing Radiation of Saccharomyces Cerevisiae – Insights and Interactions.

“…Since MMW are classed as non-ionizing radiation with low 0.3-0.4 meV range of photon energies, their direct exposure is not expected to directly generate Reactive Oxygen Species (ROS) by biochemical degradation unlike ionizing radiation therapies [2,3], which involve higher photon energies and thereby provide only safety restricted applications. We conjecture that MMW elicit therapeutic effects and limit the adversities by the phenomenon of Structure Resonant Energy Transfer (SRET).…”

Reducing Radiation Dermatitis Using a Film-forming Silicone Gel During Breast Radiotherapy: A Pilot Randomized-controlled Trial

“…To our knowledge, this is the first randomized trial demonstrating the superiority of a film-forming silicone gel in reducing in vivo 34: 413-422 (2020) RD during breast RT based on objectively measured physiological skin parameters. Despite decades of investigations, no clear evidence of the superiority of any single topical agent in the prevention of RD has emerged (10,(17)(18)(19)(20)(21)(22)24). Although steroids have been proven to be potent topical agents in reducing RD (31,32), the use of steroids requires a doctor's prescription and is not free of criticism.…”

Morphological Changes in H1299 Human Lung Cancer Cells Following Millimeter-Wave Irradiation

“…In other words, maximum incident power is absorbed in an RPMI 1640 medium layer thickness of 2 mm. As the medium consists mostly of water, we used the heat capacity of water to estimate the temperature increase during irradiation using (3) where is the exposure time, the heat capacity (4.18 J/g•K) and the sample mass (1.50 g). This estimation is based on the assumption that the penetrating power decreases exponentially with depth due to increased absorption of incident energy.…”

“…Common types of treatment methods include surgery, radiotherapy and chemotherapy [2]. However, most conventional treatments to control tumor growth are often reported to give rise to many other detrimental side effects [3,4] due to cross reactions of chemotherapy drugs with healthy tissue and use of ionizing radiations in radiotherapy. Further, post-treatment supportive care after chemotherapy is reported to go only so far as to improve survival rates very slightly [5].…”