Forde Elizabeth, Van den Berghe Ludwig, Buijs Monica, Cardone Antonella, Daly Jacqueline, Franco Pierfrancesco, Julka-Anderson Naman, Lechner Wolfgang, Marignol Laure, Marvaso Giulia, Nisbet Heather, O'Donovan Anita, Russell Nicola S, Scherer Philipp
Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College Dublin, Dublin, Ireland.
Trinity St. James's Cancer Institute, Dublin, Ireland.
Radiat Oncol. 2025 Mar 29;20(1):46. doi: 10.1186/s13014-025-02624-9.
There is a substantial body of literature addressing the prevention, acute management, and follow-up care of radiation induced dermatitis (RID). The quality and application of this evidence, however, is inconsistent and its interpretation varies widely. While several national guidelines have been developed to standardise practices locally, many of these resources are not publicly available. On behalf of the European Society for Radiotherapy and Oncology (ESTRO) Radiation Therapist (RTT) Committee, an international writing group consisting of 12 experts from radiotherapy and two patient representatives composed a recommendation document for the management of RID.
The consensus for these recommendations was generated based on available international guidelines, and supplemented with evidence-based review articles on the topic. These recommendations focus on the prevention and practical management of early stage RID by avoiding skin trauma and maintaining hygiene. Addressing pain and inflammation in higher grades is also covered. The current literature refutes some of the traditional recommendations, especially restricting washing as well as the use of deodorant or the potential dose build-up of lotions which has been included and rectified in recent guidelines. In addition, the importance of grading the severity, including a baseline assessment is presented. The benefit of clear, and non-contradictory communication within the multidisciplinary team as well as patient involvement (e.g. PROMs or similar) is highlighted. Furthermore, the importance of recognising different skin types and skin tones, and the impact on how RID changes these in their appearance is stressed.
This document provides practical, actionable recommendations for the clinical management of RID, referencing the supporting literature. These recommendations have, however, identified a lack of high-level evidence, especially for agent-specific recommendations.
有大量文献论述放射性皮炎（RID）的预防、急性处理及后续护理。然而，这些证据的质量和应用并不一致，其解读也存在很大差异。虽然已经制定了若干国家指南以在当地规范实践，但其中许多资源并未公开。代表欧洲放射治疗与肿瘤学会（ESTRO）放射治疗师（RTT）委员会，一个由12名放射治疗专家和两名患者代表组成的国际写作小组撰写了一份关于RID管理的推荐文件。
这些推荐意见的共识是基于现有的国际指南，并辅以关于该主题的循证综述文章而形成的。这些推荐意见侧重于通过避免皮肤创伤和保持卫生来预防和实际处理早期RID。还涵盖了处理较高级别疼痛和炎症的内容。当前文献驳斥了一些传统推荐意见，特别是限制清洗以及使用除臭剂或乳液潜在的剂量累积问题，这些在最近的指南中已被纳入并修正。此外，还介绍了对严重程度进行分级的重要性，包括基线评估。强调了多学科团队内部清晰且不矛盾的沟通以及患者参与（如患者报告结局测量或类似方式）的益处。此外，强调了认识不同皮肤类型和肤色的重要性，以及RID对其外观变化的影响。
本文献为RID的临床管理提供了实用、可操作的推荐意见，并参考了相关支持文献。然而，这些推荐意见发现缺乏高级别证据，尤其是针对特定药物的推荐意见。
