Treatment of radiation-induced mucocutaneous toxicity
- 465 Downloads
During radiotherapy 80% to 90% of all patients will develop some degree of inflammation symptoms, such as erythema, dry or wet desquamation, skin folds, or mucositis depending on radiation-and patient-related factors and the extent of irradiated skin or mucosal areas. Up to now radiation induced local reactions represent still an important toxicity factor. Cutaneous and mucosal side effects may reduce the patient's compliance and can be limiting factors to follow radiotherapy protocols. Therefore, there is a high need for effective prophylactic and therapeutic treatments. Basically, guidelines recommend the avoidance of mechanical, chemical and thermal irritants, especially the exposure to high temperatures. To delay onset of radiodermatitis various preventive topicals may be applied like aqueous cream formula with or without antioxidative agents. In general, the treatment of radiodermatitis primarily should maintain moisture and skin permeability and consists of hydrophilic creams, antioxidative and anti-inflammatory topicals. Hydrocolloid dressings may reduce and improve wound healing in grade 2 and 3 reactions. Supportive therapy of radiation-induced mucositis includes the maintenance of oral care protocols and adequate nutrition during the course of treatment. A sufficient oral health status is one of the most important factors for prevention of severe oral complications. The MASCC guidelines recommend furthermore the use of non-medicated rinses with saline or sodium bicarbonate 4 to 6 times daily. Further approaches suggest the use of local anaesthetics and systemic analgesics for severe mucositis. Besides local preventive agents and supportive care protocols, modern radiation treatment techniques remain the most promising intervention in reducing the degree of skin reactions.
KeywordsIrradiation mucositis radiodermatitis
- Hoffmann W, Rodemann HP, Schmidberger H, Weiss E, Bamberg M. Enhanced muco-cutaneous toxicity of radiotherapy in a patient with chronic GVHD and secondary malignancy. Annal Oncol, 5: 377–9, 1994Google Scholar
- Sauer R (Koordinator Leitlinie Mammakarzinom), Budach W, Dunst J, Feyer P, Haase W, Harms W, Sautter-Bihl M, Souchon R, Wenz F. Leitlinien in der Radioonkologie. Leitlinie Radiotherapie des Mammakarzinoms. Strahlenther Onkol, 182(1): 17–8, 2006Google Scholar
- Von Bultzingslowen I, Brennan MT, Spijkervet FK, et al. Growth factors and cytokines in the prevention and treatment of oral and gastrointestinal mucositis Support Care Cancer, 14: 519–27, 2006Google Scholar