Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC Skin Toxicity Study Group
- 14 August 2013
- journal article
- review article
- Published by Springer Science and Business Media LLC in Supportive Care in Cancer
- Vol. 21 (10), 2933-2948
- https://doi.org/10.1007/s00520-013-1896-2
Abstract
Radiation dermatitis (RD) results from radiotherapy and often occurs within the first 4 weeks of treatment, although late effects also occur. While RD may resolve over time, it can have a profound effect on patients’ quality of life and lead to dose modifications. A study group of international, interdisciplinary experts convened to develop RD prevention and treatment guidelines based on evidence from randomized, controlled trials. Evidence-based recommendations were developed after an extensive literature review. Randomized, controlled trials with standardized measurement of outcomes were considered the best evidence, and a majority of the recommendations were formulated from this literature. The adoption of washing with water, with or without a mild soap, and allowing the use of antiperspirants is supported by randomized trials. Use of topical prophylactic corticosteroids (mometasone) is recommended to reduce discomfort and itching. There is some evidence that silver sulfadiazine cream can reduce dermatitis score. There is insufficient evidence to support, and therefore the panel recommends against the use of trolamine, topical sulcrate, hyaluronic acid, ascorbic acid, silver leaf dressing, light-emitting diode lasers, Theta cream, dexpanthenol, calendula, proteolytic enzymes, sulcralfate, oral zinc, and pentoxifylline. Moreover, there is no evidence to support the superiority for any specific intervention in a reactive fashion. For patients with established radiation-induced telangiectasia and fibrosis, the panel suggests the use of pulse dye laser for visual appearance, and the use of pentoxifylline and vitamin E for the reduction of fibrosis.Keywords
This publication has 74 references indexed in Scilit:
- Can we decrease the skin reaction in breast cancer patients using hyaluronic acid during radiation therapy? Results of phase III randomised trialRadiotherapy and Oncology, 2011
- Mometasone Furoate Effect on Acute Skin Toxicity in Breast Cancer Patients Receiving Radiotherapy: A Phase III Double-Blind, Randomized Trial From the North Central Cancer Treatment Group N06C4International Journal of Radiation Oncology*Biology*Physics, 2011
- Mepilex Lite dressings for the management of radiation-induced erythema: a systematic inpatient controlled clinical trialThe British Journal of Radiology, 2010
- Randomized Comparison of Dry Dressings Versus Hydrogel in Management of Radiation-Induced Moist DesquamationInternational Journal of Radiation Oncology*Biology*Physics, 2007
- Topical betamethasone for prevention of radiation dermatitisIndian Journal of Dermatology, Venereology and Leprology, 2007
- Evidence-Based Skin Care Management in Radiation TherapySeminars in Oncology Nursing, 2006
- The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guidelineSupportive Care in Cancer, 2006
- The Standardization of Radiation Skin Care in British Columbia: A Collaborative ApproachOncology Nursing Forum, 2005
- Does aqueous or sucralfate cream affect the severity of erythematous radiation skin reactions? A randomised controlled trialRadiotherapy and Oncology, 2004
- Skin Protection by Sucralfate Cream During Electron Beam TherapyActa Oncologica, 1994