Table 3.

Summary of recommendations for radiation dermatitis evaluation and treatment

Preradiotherapy assessment:

Screen patient for radiation hypersensitivity syndromes

Assess for use of medications (eg, chemotherapy) with potential to cause dermatitis

Examine patient for baseline RTOG/CTCAE dermatitis score

Patient recommendations during treatment:

Protect skin from sun exposure

Minimize skin trauma from excessive movement, exposure to extreme temperatures, or adhesives

Gently wash skin with mild soap and water

Apply deodorant/antiperspirant as needed

Radiation treatment planning:

Three-dimensional dosimetric planning with use of field-in-field or IMRT techniques

Improve dose homogeneity to minimize “hot spot” regions

Consider prone positioning for large-breasted women

Consider hypofractionated treatment if otherwise indicated

Practices for radiation dermatitis prevention and treatment:

Skin emollients (not immediately before RT)

Topical steroids (eg, mometasone, betamethasone) for prevention

Consider nonsteroidal agents (eg, silver sulfadiazine, calendula ointment, barrier films)

Consider protective dressings for areas of moist desquamation

Monitor for and treat secondary infections if necessary

Provide reassurance, monitor symptoms for resolution

Abbreviations: RTOG/CTCAE, Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer; IMRT, intensity-modulated radiation therapy; RT, radiotherapy.