Systemic corticoids in the treatment of severe radiodermitis. A series of cases
Article Sidebar
Main Article Content
Abstract
Introduction: radiodermitis is one of the most frequent side effects of radiotherapy and affects approximately 95% of the patients who receive it. Acute radiodermitis occurs within 90 days after the start of treatment, has a profound impact on the quality of life of patients and may be the cause of premature discontinuation of radiotherapy. Its treatment is complex and the role of systemic corticosteroids in it has not yet been evaluated.
Materials and methods: descriptive study of 6 patients older than 18 years with severe radiodermatitis, treated with systemic corticosteroids when they did not respond to initial topical therapy. With a 6-month follow-up, between June 1, 2019 and May 30, 2020 at the Dermatology Service of the Italian Hospital of Buenos Aires.
Results: treatment with systemic corticosteroids was indicated at a dose of meprednisone 40 mg/day or equivalent, for 5 days, with complete resolution of the symptoms in a maximum period of 15 days.
Discussion: in the literature, we have not found scientific papers that report or evaluate the usefulness of systemic corticosteroids in severe radiodermatitis. We propose to demonstrate their usefulness in this pathology.
Conclusion: the objective of this work is to communicate our experience in patients with severe acute radiodermatitis, with great repercussions on the general state, who evolved with rapid resolution of the symptoms and adequate symptomatic management, with the use of systemic corticosteroids.
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
Hegedus F, Mathew LM, Schwartz RA. Radiation dermatitis: an overview. Int J Dermatol. 2017;56(9):909-914. https://doi.org/10.1111/ijd.13371 DOI: https://doi.org/10.1111/ijd.13371
Yokota T, Zenda S, Ota I, et al. Phase 3 randomized trial of topical steroid versus placebo for prevention of radiation dermatitis in patients with head and neck cancer receiving chemoradiation. Int J Radiat Oncol Biol Phys. 2021;111(3):794-803. https://doi.org/10.1016/j.ijrobp.2021.05.133. DOI: https://doi.org/10.1016/j.ijrobp.2021.05.133
Wolf JR, Gewandter JS, Bautista J, et al. Utility of topical agents for radiation dermatitis and pain: a randomized clinical trial. Support Care Cancer. 2020;28(7):3303-3311. https://doi.org/10.1007/s00520-019-05166-5. DOI: https://doi.org/10.1007/s00520-019-05166-5
Dörr W, Hendry JH. Consequential late effects in normal tissues. Radiother Oncol. 2001;61(3):223-231. https://doi.org/10.1016/s0167-8140(01)00429-7. DOI: https://doi.org/10.1016/S0167-8140(01)00429-7
Rosenthal A, Israilevich R, Moy R. Management of acute radiation dermatitis: a review of the literature and proposal for treatment algorithm. J Am Acad Dermatol. 2019;81(2):558-567. https://doi.org/10.1016/j.jaad.2019.02.047. DOI: https://doi.org/10.1016/j.jaad.2019.02.047
Lorette G, Machet L. Lésions cutanées induites par la radiothérapie: prévention, traitements [Radiation-induced skin toxicities: prevention, treatment]. Cancer Radiother. 2001;5 Suppl 1:116s-120s. https://doi.org/10.1016/S1278-3218(01)80017-2. DOI: https://doi.org/10.1016/S1278-3218(01)80017-2
Mendelsohn FA, Divino CM, Reis ED, et al. Wound care after radiation therapy. Adv Skin Wound Care. 2002;15(5):216-224. https://doi.org/10.1097/00129334-200209000-00007.
Wickline MM. Prevention and treatment of acute radiation dermatitis: a literature review. Oncol Nurs Forum. 2004;31(2):237-247. https://doi.org/10.1188/04.ONF.237-247. DOI: https://doi.org/10.1188/04.ONF.237-247
D'haese S, Bate T, Claes S, et al. Management of skin reactions during radiotherapy: a study of nursing practice. Eur J Cancer Care (Engl). 2005;14(1):28-42. https://doi.org/10.1111/j.1365-2354.2005.00510.x. DOI: https://doi.org/10.1111/j.1365-2354.2005.00510.x
Boström A, Lindman H, Swartling C, et al. Potent corticosteroid cream (mometasone furoate) significantly reduces acute radiation dermatitis: results from a double-blind, randomized study. Radiother Oncol. 2001;59(3):257-265. https://doi.org/10.1016/s0167-8140(01)00327-9. DOI: https://doi.org/10.1016/S0167-8140(01)00327-9
Hughes J, Rustin M. Corticosteroids. Clin Dermatol. 1997;15(5):715-721. https://doi.org/10.1016/s0738-081x(97)00020-5. DOI: https://doi.org/10.1016/S0738-081X(97)00020-5
Mendelsohn FA, Divino CM, Reis ED, et al. Wound care after radiation therapy. Adv Skin Wound Care. 2002;15(5):216-224. https://doi.org/10.1097/00129334-200209000-00007. DOI: https://doi.org/10.1097/00129334-200209000-00007
Bolderston A, Lloyd NS, Wong RK, et al. The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer. 2006;14(8):802-817. https://doi.org/10.1007/s00520-006-0063-4. DOI: https://doi.org/10.1007/s00520-006-0063-4
BBrazzini B, Pimpinelli N. New and established topical corticosteroids in dermatology: clinical pharmacology and therapeutic use. Am J Clin Dermatol. 2002;3(1):47-58. https://doi.org/10.2165/00128071-200203010-00005. DOI: https://doi.org/10.2165/00128071-200203010-00005