Prevention and Management of Acute Radiation Dermatitis
Summary of Recommendations
Prevention
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): no recommendation.
Topical corticosteroids
• Consensus to recommend (≥75%): mometasone and betamethasone.
• Near-consensus supporting recommendation (60–74%): no recommendation.
Barrier films and dressings
• Consensus to recommend (≥75%): silicone-based polyurethane (Mepitel film) for breast cancer and polyurethane film (Hydrofilm).
• Near-consensus supporting recommendation (60–74%): silicone-based polyurethane (Mepitel film) for head and neck cancer and silver nylon dressing.
Laser therapy
• Consensus to recommend (≥75%): photobiomodulation or low-level laser therapy for breast cancer.
• Near-consensus supporting recommendation (60–74%): no recommendation.
Natural and miscellaneous agents
• Consensus to recommend (≥75%): olive oil.
• Near-consensus supporting recommendation (60–74%): curcumin (turmeric)-based products and silymarin-based products.
Growth factors and oral agents
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): enzyme mixture (papain, trypsin, and chymotrypsin).
Antibiotics
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): sulfadiazine silver.
Antiperspirant or deodorant
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): no recommendation.
Alternative and multicomponent therapies
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): lotion (3% urea, polidocanol, and hyaluronic acid).
Management
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): doxepin and hydroactive colloid gel.
Topical corticosteroids
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): no recommendation.
Barrier films and dressings
• Consensus to recommend (≥75%): foam dressings (Mepilex Lite).
• Near-consensus supporting recommendation (60–74%): silicone-based polyurethane (Mepitel film). Laser therapy
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): no recommendation.
Natural and miscellaneous agents
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): no recommendation.
Growth factors and oral agents
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): no recommendation.
Alternative and multicomponent therapies
• Consensus to recommend (≥75%): no recommendation.
• Near-consensus supporting recommendation (60–74%): no recommendation.
Recommendation Grading
Disclaimer
Overview
Title
Prevention and Management of Acute Radiation Dermatitis
Authoring Organization
Multinational Association of Supportive Care in Cancer
Publication Month/Year
March 26, 2023
Last Updated Month/Year
April 1, 2024
Supplemental Implementation Tools
Document Type
Guideline
Country of Publication
Global
Document Objectives
Acute radiation dermatitis is a frequent adverse effect of radiotherapy, but standardisation of care for acute radiation dermatitis is lacking. Due to the conflicting evidence and variability in current guidelines, a four-round Delphi consensus process was used to compile opinions of 42 international experts on care for people with acute radiation dermatitis on the basis of the evidence in existing medical literature. Interventions for acute radiation dermatitis prevention or management that reached at least 75% consensus were recommended for clinical use. Six interventions could be recommended for the prevention of acute radiation dermatitis: photobiomodulation therapy and Mepitel film in people with breast cancer, Hydrofilm, mometasone, betamethasone, and olive oil. Mepilex Lite dressings were recommended for the management of acute radiation dermatitis. Most interventions were not recommended due to insufficient evidence, conflicting evidence, or lack of consensus to support use, suggesting a need for further research. Clinicians can consider implementing recommended interventions in their practice to prevent and manage acute radiation dermatitis until additional evidence becomes available.
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Ambulatory, Outpatient, Radiology services
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Management, Prevention
Diseases/Conditions (MeSH)
D003872 - Dermatitis, D011827 - Radiation, D017453 - Dermatitis, Irritant, D017484 - Dermatitis, Phototoxic, D011830 - Radiation Effects
Keywords
cancer, radiotherapy, dermatitis, Fractionated radiotherapy, Radiation Dermatitis