Radvansky LJ, Pace MB, Siddiqui A, et al.
American journal of health-system pharmacy : AJHP : official journal of the American Society of.... Date of publication 2013 Jun 15;volume 70(12):1025-32.
1. Am J Health Syst Pharm. 2013 Jun 15;70(12):1025-32. doi: 10.2146/ajhp120467.
Prevention and management of radiation-induced dermatitis, mucositis, and
xerostomia.
Radvansky LJ(1), Pace MB, Siddiqui A.
Author information:
(1)The Ohio State University, 110 Doan Hall, 410 West 10th Avenue, Columbus, OH
43210, USA. lauren.radvansky@osumc.edu
PURPOSE: Current strategies for preventing and managing radiation-induced
dermatitis, mucositis, and xerostomia are reviewed, with an emphasis on
pharmacologic interventions.
SUMMARY: Nearly two thirds of all patients with cancer receive radiation therapy
during the course of treatment, frequently resulting in acute skin and mucosal
toxicities. The severity of radiotherapy-associated toxicities varies according
to multiple treatment- and patient-related factors (e.g., total radiation dose
and dose fractionation schedule, volume of organ or tissue irradiated, use of
concurrent versus sequential chemotherapy, comorbid conditions, functional
performance status). Three major radiation toxicities encountered in clinical
practice are (1) radiation dermatitis, typically managed with a variety of
topical agents such as water-based moisturizing creams or lotions, topical
steroids, antiinflammatory emulsions, and wound dressings, (2) radiation-induced
oral mucositis, which can be managed through proper basic oral care practices,
appropriate pain management, and the use of medicated mouthwashes and oral rinses
and gels, and (3) radiation-induced xerostomia, which can be alleviated with
saliva substitutes, moistening agents, and sialagogues. Pharmacists involved in
the care of patients receiving radiotherapy can play an important role in
optimizing symptom control, educating patients on self-care strategies, and
adverse effect monitoring and reporting.
CONCLUSION: Radiation-induced dermatitis, mucositis, and xerostomia can cause
significant morbidity and diminished quality of life. Pharmacologic interventions
for the prevention and treatment of these toxicities include topical agents for
dermatitis; oral products, analgesics, and palifermin for mucositis; and
amifostine, saliva substitutes, and pilocarpine for xerostomia.
DOI: 10.2146/ajhp120467
PMID: 23719879 [Indexed for MEDLINE]
