Radiodermatitis: epidemiology, pathogenesis, prevention and management

Artūras Kriukas1, Norvilė Jotautaitė1

1 Lithuanian University of Health Sciences, Faculty of Medicine

Abstract

Radiation dermatitis is a relevant problem because it is the most common side effect of radiotherapy which is commonly used for a treatment of cancer. The first signs of radiation dermatitis can be seen in 24 hours from initial radiotherapy fraction and increase during treatment because ionizing radiation tends to accumulate. Radiation-induced skin changes are divided into acute and chronic. Many scientists run clinical trials to find effective agent for prophylaxis of radiation dermatitis. Unfortunately, there is no single agent that could prevent radiodermatitis. Wound dressing, secondary infection prevention or treatment is needed when desquamation appears. Development of agents to prevent radiation dermatitis is necessary because it is common problem among cancer patients.

Objectives. To review an epidemiology, risk factors, pathogenesis, clinical features, prevention and management of radiation dermatitis.

Methods. A review was made by using PubMed and UpToDate databases. Randomized controlled trials, meta-analysis, clinical cases published from 2004 to 2019 in English were included in this study.

Conclusions. Radiodermatitis is found in up to 95% of patients after radiotherapy. Radiodermatitis arising before 90 days after initial radiotherapy fraction is considered acute. Clinical features of radiodermatitis include erythema, desquamation, skin necrosis and fibrosis. Washing, topical steroids and moisturizing could prevent severe radiation dermatitis.

Keywords: radiation dermatitis, radiodermatitis, ionizing radiation, prevention, treatment.