Prevention and Management of Acute Radiation Dermatitis

Publication Date: March 26, 2023
Last Updated: March 29, 2023

Summary of Recommendations

Prevention

Topical non-steroidal agents
• 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

Topical non-steroidal agents
• 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

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

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

Supplemental Methodology Resources

Systematic Review Document