Current Approaches for Reducing Treatment Toxicities in Radiotherapy Side Effects Management
DOI:
https://doi.org/10.56294/saludcyt20251591Keywords:
Adaptive Radiotherapy, Intensity-Modulated Radiation Therapy (IMRT), Radioprotectors, Side Effects Management, Treatment Toxicities, RadiotherapyAbstract
Radiotherapy is an important part of treating many types of cancer because it targets and kills cancerous cells. But even though it works well as a treatment, it often has bad side effects because it exposes good cells around the tumor to radiation without meaning to. These side effects can be very harmful during treatment, lowering the quality of life for the patient and maybe even making it harder to give the tumor the right amount of radiation. Recent improvements in radiation treatments and ways to deal with side effects have focused on reducing these harmful effects while keeping the treatment effective. One important way to lower the side effects of radiotherapy is to improve the way the treatment is given. Different methods, like intensity-modulated radiation therapy (IMRT), image-guided radiation therapy (IGRT), and proton therapy, make it possible to give radiation more precisely, protecting good cells around the tumor from too much exposure. These methods use high-tech imaging methods and complex computer programs to precisely target tumors and lower the risk of side effects. Using tailored radiation, which takes into account changes in the body and anatomy during treatment, makes treatment even more accurate. Along with improvements in technology, a multidisciplinary approach to managing toxins has become more important. Combining drug treatments, like radioprotectors and tailored therapies, has been looked into as a way to lessen the damage that radiation does to healthy cells. The goal of these chemicals is to protect healthy cells from radiation damage while not affecting the treatment of cancer cells. Biomarker-based methods are also making it easier to predict and customize treatment plans.
References
[1] Suh, H.J.; Florez, A.; Sacristan, V.; Rodriguez Martinez, A.; Fernandez, F.; Vilanova-Trillo, L.; Constenla, M.; Pereiro, M. Cutaneous adverse events in patients receiving anticancer therapy in a tertiary hospital setting: The old and the new. Int. J. Dermatol. 2021, 60, 208–216.
[2] Yang, J.J.; So, N.; Maloney, N.J.; Arzeno, J.; Clifton, K.K.; Bach, D.Q. Inadequate and delayed characterization of cutaneous reactions for US Food and Drug Administration-approved oncologic drugs from 2011–2020 leading to medication discontinuation. J. Am. Acad. Dermatol. 2021, 85, 1351–1352.
[3] Lacouture, M.E.; Anadkat, M.; Jatoi, A.; Garawin, T.; Bohac, C.; Mitchell, E. Dermatologic Toxicity Occurring During Anti-EGFR Monoclonal Inhibitor Therapy in Patients with Metastatic Colorectal Cancer: A Systematic Review. Clin. Color. Cancer 2018, 17, 85–96.
[4] McNoe, B.M.; Gage, R.; Signal, L. What can Aotearoa New Zealand learn from the Australian Sunsmart Story? A qualitative study. Aust. N. Z. J. Public. Health 2022, 46, 387–393.
[5] Olsen, C.M.; Pandeya, N.; Green, A.C.; Ragaini, B.S.; Venn, A.J.; Whiteman, D.C. Keratinocyte cancer incidence in Australia: A review of population-based incidence trends and estimates of lifetime risk. Public Health Res. Pract. 2022, 32, e3212203.
[6] Dreno, B.; Khosrotehrani, K.; De Barros Silva, G.; Wolf, J.R.; Kerob, D.; Trombetta, M.; Atenguena, E.; Dielenseger, P.; Pan, M.; Scotte, F.; et al. The role of dermocosmetics in the management of cancer-related skin toxicities: International expert consensus. Support. Care Cancer 2023, 31, 672.
[7] Bray, F.N.; Simmons, B.J.; Wolfson, A.H.; Nouri, K. Acute and Chronic Cutaneous Reactions to Ionizing Radiation Therapy. Dermatol. Ther. 2016, 6, 185–206.
[8] Hymes, S.R.; Strom, E.A.; Fife, C. Radiation dermatitis: Clinical presentation, pathophysiology, and treatment 2006. J. Am. Acad. Dermatol. 2006, 54, 28–46.
[9] Spałek, M. Chronic radiation-induced dermatitis: Challenges and solutions. Clin. Cosmet. Investig. Dermatol. 2016, 9, 473–482.
[10] Fogarty, G.; Shumack, S. Common dermatology questions and answers about the radiation treatment of skin cancer in the modern era. Int. J. Radiol. Radiat. Ther. 2018, 5, 108–114.
[11] Cohen-Hallaleh, R.B.; Smith, H.G.; Smith, R.C.; Stamp, G.F.; Al-Muderis, O.; Thway, K.; Miah, A.; Khabra, K.; Judson, I.; Jones, R.; et al. Radiation induced angiosarcoma of the breast: Outcomes from a retrospective case series. Clin. Sarcoma Res. 2017, 7, 15.
[12] Bhangoo, R.S.; Cheng, T.W.; Petersen, M.M.; Thorpe, C.S.; DeWees, T.A.; Anderson, J.D.; Vargas, C.E.; Patel, S.H.; Halyard, M.Y.; Schild, S.E.; et al. Radiation recall dermatitis: A review of the literature. Semin. Oncol. 2022, 49, 152–159.
[13] Delanian, S.; Porcher, R.; Balla-Mekias, S.; Lefaix, J.L. Randomized, placebo-controlled trial of combined pentoxifylline and tocopherol for regression of superficial radiation-induced fibrosis. J. Clin. Oncol. 2003, 21, 2545–2550.
[14] Fernández, E.; Morillo, V.; Salvador, M.; Santafé, A.; Beato, I.; Rodríguez, M.; Ferrer, C. Hyperbaric oxygen and radiation therapy: A review. Clin. Transl. Oncol. 2021, 23, 1047–1053.
[15] Lacouture, M.E.; Sibaud, V.; Gerber, P.A.; van den Hurk, C.; Fernandez-Penas, P.; Santini, D.; Jahn, F.; Jordan, K. Prevention and management of dermatological toxicities related to anticancer agents: ESMO Clinical Practice Guidelines. Ann. Oncol. 2021, 32, 157–170.
[16] Ensslin, C.J.; Rosen, A.C.; Wu, S.; Lacouture, M.E. Pruritus in patients treated with targeted cancer therapies: Systematic review and meta-analysis. J. Am. Acad. Dermatol. 2013, 69, 708–720.
[17] Allegra, A.; Di Salvo, E.; Casciaro, M.; Musolino, C.; Pioggia, G.; Gangemi, S. The Impact of Immunological Checkpoint Inhibitors and Targeted Therapy on Chronic Pruritus in Cancer Patients. Biomedicines 2020, 9, 2.
[18] Badwy, M.; Baart, S.J.; Thio, H.B.; Huygen, F.; de Vos, C.C. Electrical neurostimulation for the treatment of chronic pruritus: A systematic review. Exp. Dermatol. 2022, 31, 280–289.
[19] Sibaud, V. Anticancer treatments and photosensitivity. J. Eur. Acad. Dermatol. Venereol. 2022, 36 (Suppl. S6), 51–58.
[20] Bernerd, F.; Passeron, T.; Castiel, I.; Marionnet, C. The Damaging Effects of Long UVA (UVA1) Rays: A Major Challenge to Preserve Skin Health and Integrity. Int. J. Mol. Sci. 2022, 23, 8243.
[21] Dummer, R.; Rinderknecht, J.; Goldinger, S.M. Ultraviolet A and Photosensitivity during Vemurafenib Therapy. N. Engl. J. Med. 2012, 366, 480–481.
[22] Mittal, S.; Khunger, N.; Kataria, S.P. Nail Changes with Chemotherapeutic Agents and Targeted Therapies. Indian Dermatol. Online J. 2022, 13, 13–22.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Simranjeet Nanda, Satya Sundar Gajendra Mohapatra, Rapaka Sudhir, Rashmi Gudur, Jagmeet Sohal, Jennifer D (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
