Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC Skin Toxicity Study Group Journal Article


Authors: Wong, R. K. S.; Bensadoun, R. J.; Boers-Doets, C. B.; Bryce, J.; Chan, A.; Epstein, J. B.; Eaby-Sandy, B.; Lacouture, M. E.
Article Title: Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC Skin Toxicity Study Group
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. © 2013 Springer-Verlag Berlin Heidelberg.
Keywords: cancer chemotherapy; review; placebo; drug dose reduction; cancer radiotherapy; breast cancer; nausea; patient education; practice guideline; head and neck cancer; systematic review; pentoxifylline; patient compliance; brain cancer; emollient agent; methylprednisolone; telangiectasia; alpha tocopherol; ascorbic acid; hyaluronic acid; zinc; guidelines; radiation sickness; chymotrypsin; radiation dermatitis; trypsin; sucralfate; skin fibrosis; beclometasone; betamethasone; mometasone furoate; light emitting diode; pulsed dye laser; papain; chamomile; sulfadiazine silver; calendula extract; almond oil; antiperspirant agent; dexpanthenol; silver dressing
Journal Title: Supportive Care in Cancer
Volume: 21
Issue: 10
ISSN: 0941-4355
Publisher: Springer Verlag  
Date Published: 2013-10-01
Start Page: 2933
End Page: 2948
Language: English
DOI: 10.1007/s00520-013-1896-2
PROVIDER: scopus
PUBMED: 23942595
DOI/URL:
Notes: --- - "Export Date: 1 October 2013" - "CODEN: SCCAE" - "Source: Scopus"
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  1. Mario E Lacouture
    457 Lacouture