Skin: the basic model for relating dose, time, and fractionation

Management of Radiation Side Effects to the Skin

Radiation therapy (RT) is an essential component for management of many cancers. Veterinary health care professionals must counsel owners about the potential side effects of RT, the anticipated management plan, and associated costs. For most veterinary patients treated with RT, acute radiation side effects are mild; however, careful radiation treatment planning and appropriate management of acute side effects are essential to try to prevent chronic sequelae and the need for ongoing wound care. This article reviews acute and late side effects to the skin and their management.

The clinical and histopathological effects of prednisone on acute radiation-induced dermatitis in dogs: a placebo-controlled, randomized, double-blind, prospective clinical trial

This study evaluated and compared the clinical and histopathological effects of prednisone on acute radiation-induced dermatitis (ARID) in dogs treated with 48 Gray of fractionated irradiation targeted to the skin surface. The study was designed as a double-blind, randomized, placebo-controlled prospective clinical trial. Twenty-two otherwise healthy companion dogs completed the clinical study. Three dogs were excluded from complete histopathological analysis because the owner declined one (one dog) or both (two dogs) biopsies. The study duration for each dog was 36 days from the start of radiation therapy (RT) to the first re-examination post RT. Dogs were treated with either oral prednisone at 0.5 mg kg(-1) or sugar pill, daily. All dogs received 48 Gray of fractionated, standardized RT, beginning 2 weeks after tumour excision. Acute Radiation Morbidity Scores, Cutaneous Toxicity Extent and Severity scores, digital images, and impression cytology were carried out on days 1, 8, 15, 22 and 36. Four-millimetre skin specimens from days 15 (RT-11) and 36 (2 weeks after the last RT dose) were scored by a pathologist and a dermatologist, blind to specimen identity. A one-way analysis of variance for longitudinal data was used to compare scores between groups. Spearman's rho correlation coefficient was used to measure strength of association between clinical and histopathology scores (HPS). There was no significant difference in CUTES, AMS or HPS scores between groups. There was a strong correlation between clinical and HPS scores. Prednisone did not decrease ARID severity clinically or histopathologically.

Radiation-induced reactions. 1: An examination of the phenomenon

In this article, the first in a series of three, the author examines the phenomenon of radiation-induced skin reactions. This includes a description of the theoretical aspects of radiation and its effect on the skin, the prevalence and significance of skin reactions seen in clinical practice and a summary of the assessment tools that have been used in their evaluation. From this information, an analysis of the key signs and symptoms of radiation-induced skin reactions is presented. These clinical indicators and descriptors are then available to be used as the basis for the development of a comprehensive yet specific assessment tool. In part two, these descriptions are integrated into an assessment tool to measure radiation-induced skin reactions and the radiation-induced skin reaction assessment scale (RISRAS) is described. In part three the methods and results from the initial evaluation of the RISRAS are reported.