Research advances in the prevention and treatment of radiation-induced dermatitis / 中华放射肿瘤学杂志

Radiation-induced dermatitis (RD) is one of the most common complications induced by radiotherapy in cancer patients.The incidence and severity of RD are largely associated with the risk factors of patients.RD can severely affect the quality of life,even discontinue the treatment and reduce the tumor control rate in severe patients.Currently,randomized control trials evaluating the preventive measures for acute RD have been rarely conducted.The clinical interventions for acute RD significantly vary.In this article,the pathogenesis,risk factors,clinical manifestations,evaluation,prevention and treatment of RD were investigated.

Fluoroscopy-induced Subacute Radiation Dermatitis in Patient with Hepatocellular Carcinoma / 대한소화기학회지

Radiation dermatitis can develop after fluoroscopy-guided interventional procedures. Cases of fluoroscopy-induced radiation dermatitis have been reported since 1996, mostly documented in the fields of radiology, cardiology and dermatology. Since diagnosis and treatment of fluoroscopy-induced radiation dermatitis can be difficult, high grade of suspicion is required. The extent of this reaction is determined by radiation dose, duration of exposure, type of procedure, and host factors and can be aggravated by concomitant use of photosensitizers. Follow-up is important after long and complicated procedures and efforts to minimize radiation exposure time will be necessary to prevent radiation dermatitis. Herein, we report a case of a 58-year-old man with hepatocellular carcinoma presenting with subacute radiation dermatitis after prolonged fluoroscopic exposure during transarterial chemoembolization and chemoport insertion. Physicians should be aware that fluoroscopy is a potential cause of radiation dermatitis.

The safety and efficacy of EGF-based cream for the prevention of radiotherapy-induced skin injury: results from a multicenter observational study

PURPOSE: This study was designed to evaluate the efficacy and safety of topically applied recombinant human epidermal growth factor (rhEGF) for the prevention of radiation-induced dermatitis in cancer patients. MATERIALS AND METHODS: From December 2010 to April 2012, a total of 1,172 cancer patients who received radiotherapy (RT) of more than 50 Gy were prospectively enrolled and treated with EGF-based cream. An acute skin reaction classified according to the Radiation Therapy Oncology Group 6-point rating scale was the primary end point and we also assessed the occurrence of edema, dry skin, or pruritus. RESULTS: The percentage of radiation dermatitis with maximum grade 0 and grade 1 was 19% and 58% at the time of 50 Gy, and it became 29% and 47% after completion of planned RT. This increment was observed only in breast cancer patients (from 18%/62% to 32%/49%). Adverse events related to the EGF-based cream developed in 49 patients (4%) with mild erythema the most common. Skin toxicity grade >2 was observed in 5% of the patients. Edema, dry skin, and pruritus grade > or =3 developed in 9%, 9%, and 1% of the patients, respectively. CONCLUSION: Prophylactic use of an EGF-based cream is effective in preventing radiation dermatitis with tolerable toxicity. Further studies comparing EGF cream with other topical agents may be necessary.

Efficacy of Shiunko in Treating Radiation-induced Scalp Dermatitis / 日本東洋医学雑誌

PURPOSE: Radiation-induced scalp dermatitis is a type of burn caused by radiotherapy for brain tumors, and often impairs patients' quality-of-life (QOL). In this study, we evaluated the efficacy of shiunko for the treatment of radiation-induced scalp dermatitis. Shiunko is an ointment invented by Sheishu Hanaoka in the early 19th century and is known to treat burns more effectively than steroids.METHODS: Twenty-two patients (12 men and 10 women; age range between 51 to 74 years-old, mean 63.1) with malignant brain tumors were involved in this study. The histological diagnoses were malignant glioma (13 cases), malignant lymphoma (6 cases), and metastasis (3 cases). Performed radiotherapies were as follows: whole brain in 9 cases and local in 13 cases. Symptoms were as follows: redness in 18 cases, burning pain in 13 cases, itching in 13 cases, and erosion in 3 cases. Shiunko was applied in the same manner as when treating with standard ointment. Efficacy was evaluated according to symptom improvement rates: excellent (more than 80%), good (more than 50%), fair (less than 50%), and no effect (less than 30%).RESULTS: Favorable therapeutic effects were observed in all patients (16 excellent cases, 6 good cases). The efficacy was confirmed within a few hours in patients who showed quick response to this treatment.CONCLUSION: Shiunko can be expected to be an effective ointment for treating radiation-induced scalp dermatitis.

Radiation Dermatitis after GDC Embolization: Case Report

Guglielmi Detachable Coil(GDC) embolization is interventional radiology procedure for the management of aneurysm. The technique is recommended in case of patients' poor general condition, difficult surgical approach, but there is concerning about complications due to radiation exposure. We experienced a patient of radiation-induced dermatitis after GDC embolization. She presented with erythema, pus-like discharge, ulceration on scalp and right preauricular area, which symptoms was improved with medical managements. The authors report the case with pertinent literature review.