Prospective evaluation of acute radiation – induced skin reactions in patients after head and neck radiotherapy

Shahla Naeemi, Mohsen Bakhshandeh, Hojatolah Sabouri, Mehran Yar Ahmadi, Daem Roshani



     Acute Radiation- induced Skin reaction (ARISR) is a common side effect in the majority of patients receiving radiotherapy. ARISR is often characterized by swelling, redness, pigmentation, dry and moist desquamation, edema, ulceration, bleeding and necrosis of the Skin. This study was carried out to evaluate prevalence and severity of ARISR in patients with head and neck cancer undergoing radiotherapy and determining skin dose–response relationship. From December 2014 to September 2015, we evaluated 88 patients with head and neck cancer. The acute skin toxicity was scored based on RTOG toxicity criteria. Analysis of data using statistical software SPSS (version20) and ANOVA or chi- square test was done, with P  0.05 considered as significant. 98.86% of patients experienced dermatitis, but were mild in most cases.There was no significant differences in age, sex, stage, and field size between patients with dermatitis.


Radiotherapy, head and neck cancer, acute radiation- induced Skin reaction

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- Little JW, Falace DA, Miller CS, Rhodus NL. Dental management of the medically compromised Patient.6th ed. St Louis: Mosby; 2002.

- Dobrossy L. Epidemiology of head and neckcancer: magnitude of the problem. CancerMetastasis Rev 2006; 24(1): 9-17.

- Maddock–Jennings W, Wilkinson JM, Shillington D. Novel approaches to radiation-induced skin reactions: a literature review. Complement TherClinPract 2005; 11:224–31.

- Maduro JH, Pras E, Willemse PH, deVries EG: Acute and long-term toxicityfollowing radiotherapy alone or in combination with chemotherapy forlocally advanced cervical cancer. Cancer Treat Rev 2003; 29(6):471–488.

- Porock D. Factors influencing the severity of radiation skin and oralmucosal reactions: development of a conceptual framework. Eur J CancerCare (Engl) 2002; 11(1):33–43.

- Sitton E. Early and late radiation-induced skin alterations. Part II: Nursingcare of irradiated skin. OncolNurs Forum 1992; 19(6):907–912.

- Hymes SR, Strom EA, Fife C: Radiation dermatitis: clinical presentation,pathophysiology, and treatment. J Am AcadDermatol 2006; 54(1):28–46.

- Noble-Adams R. Radiation-induced reactions 1: an examination of thephenomenon. Br J Nurs 1999; 8(17):1134–1140.

- McFerran TA. A Dictionary of Nursing. Cambridge: Oxford University Press; 1998.

- McQuestion M. Evidence based skin care management in radiation therapy. SeminOncolNurs 2006; 22:163–73.

- Aistars.J. Validity of skin care protocols for external radiotherapy. Clinical Journal of Oncology Nursing 2006;(10) 4.

- Vaz A, Pinto-Neto A, Conde D, Costa-Paiva L, Morais S, Esteves S: Quality oflife of women with gynecologic cancer: associated factors. Arch GynecolObstet 2007; 276(6):583–589.

- Cohn AB, Lang PO, Agarwal JP, Peng SL, Alizadeh K, Stenson KM, et al. Free-flap reconstruction in the doubly irradiated patient population.PlastSurgNurs 2008; 122:125–132.

-Hede K. Research groups promoting proton therapy "lite". JNCI.

; 98:1682-1684.

- Barkham A. Radiotherapy skin reactions. Professional Nurse 1993; 8(11):732–736.

- Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med 2006;354: 567–78.

- Vuong T, Franco E, Lehnert S, et al. Silver leaf nylon dressing to prevent radiation dermatitis in patients undergoing chemo¬therapy and external beam radiotherapy to the perineum. Int J RadiatOncolBiolPhys 2004; 59:809–14.

- Canhua X, Alexandra H, Qiang Z, Kian A, David I, Rosenthal, et al .Symptom Clusters in Patients with Head and Neck Cancer Receiving Concurrent Chemoradiotherapy. Oral Oncol 2013; 49(4): 360-366.

- Chen Y, Tsang N, Tseng C. Control gel formula dressing in the care of acute skindamage by radiation therapy in head and neck cancer patients. European Journal of Cancer1997; (8):33.

- O’Rourke ME. Enhanced cutaneous effects in combined modality therapy. OncologyNursing Forum 1987; 14(6):31–35.

- See A, Wright S, Denham J W. A pilot study of Dermofilm in acute radiation-desquamative skin reactions. Clinical Oncology (Royal College of Radiologists)1998; 10:182–185.

- Suga T, Ishikawa A, Kohda M, Otsuka Y, Yamada S, Yamamoto N, et al. Haplotype-based analysis of genes associated with risk of adverseskin reactions after radiotherapy in breast cancer patients. Int J RadiatOncolBiolPhys 2007; 69(3):685–693.

-Archambeau J O, Pezner R, Wasserman T etal. Pathophysiology of irradiated skin and

breast. International Journal of Radiation Oncology, Biology, Physics1995; 31(5):1171–1185.

- Giro C, Berger B, Bolke E. High rate of severe radiation dermatitis duringradiation therapy with concurrent cetuximab in head and neck cancer: results ofa survey in EORTC institutes. RadiotherOncol 2009; 90(2): 166–171.

- Mendenhall WM, Parsons JT, Million RR. T1-2 squamouscell carcinoma at the glottic larynx treated with radiationtherapy. Relationship of dose fraction factors to localcontrol and complications. Int J RadiatOncolBiolPhys1988; 5:1267–73.

- Lee IJ, Koom WS, Lee CG, Kim YB, Yoo SW, Keum KC, et al. Risk factors and dose-effect relationship for mandibular osteoradionecrosis in oral and oropharyngeal cancer patients.Int J RadiatOncol, Biol, Phys2009; 75(4):1084–91.

-Alvarenga LM, Maniglia JV, Goloni-Bertollo. M. Epidemiologic evaluation of head and neck patients in a university hospital of Northwestern Sao paulo State . BraZ J otorhinolaryngol 2008; 74(1): 68-73.

- Marie K, Miho Watanabe N, Rintaro H, Hiroki K, Takuro H, Aki K, et al. Initial experience of radiotherapy plus cetuximab for Japanese head and neck neck cancer patients. Journal of Radiation Research 2015: 1-7



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EISSN: 2008-4978

PISSN: 2008-496X