Wong RK, Bensadoun RJ, Boers-Doets CB, Bryce J, Chan A, Epstein JB, Eaby-Sandy B, Lacouture ME, et al.
Supportive care in cancer : official journal of the Multinational Association of Supportive Car.... Date of publication 2013 Oct 1;volume 21(10):2933-48.
1. Support Care Cancer. 2013 Oct;21(10):2933-48. doi: 10.1007/s00520-013-1896-2.
Epub 2013 Aug 14.
Clinical practice guidelines for the prevention and treatment of acute and late
radiation reactions from the MASCC Skin Toxicity Study Group.
Wong RK(1), Bensadoun RJ, Boers-Doets CB, Bryce J, Chan A, Epstein JB, Eaby-Sandy
B, Lacouture ME.
Author information:
(1)Department of Radiation Oncology, Radiation Medicine Program, Princess
Margaret Cancer Center, University of Toronto, 610 University Avenue, Toronto,
M5G 2M9, Canada, Rebecca.wong@rmp.uhn.on.ca.
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.
DOI: 10.1007/s00520-013-1896-2
PMID: 23942595 [Indexed for MEDLINE]
