v. 4, n.

12, 2024

MANAGEMENT AND
International PREVENTION OF
Journal of ACUTE RADIATION

Health DERMATITIS: A
LITERATURE REVIEW
Science João Victor Oinhos de Oliveira
Faculdade Brasileira de Cachoeiro
(MULTIVIX)
Cachoeiro de Itapemirim - ES
https://orcid.org/0009-0008-6072-3055

Valentina de Monteiro Bontempo

Faculdade Ciências Médicas Minas Gerais
(FCMMG)
Belo Horizonte - MG
https://orcid.org/0009-0004-8992-3430

Luísa Tristão Sanches

Centro Universitário Ingá (UNINGÁ)
Maringá - PR
https://orcid.org/0009-0003-5283-2300

Giovanna Maiolli Signori

Universidade Luterana do Brasil (ULBRA)
Canoas - RS
https://orcid.org/0000-0002-5743-9570

Ana Júlia Pagnan

Centro Universitário Max Planck (UniMAX)
Indaiatuba - SP
https://orcid.org/0009-0005-0582-5671

Nadine Ribeiro Porto Fernandes

Faculdade Brasileira de Cachoeiro
(MULTIVIX)
Cachoeiro de Itapemirim - ES
All content in this magazine is
https://orcid.org/0009-0005-3584-4769
licensed under a Creative Com-
mons Attribution License. Attri-
bution-Non-Commercial-Non-
Derivatives 4.0 International (CC
BY-NC-ND 4.0).

International Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594122423014

1
Letícia Barroso Luniere Abstract: INTRODUCTION: Acute
Centro Universitário CEUNI (FAMETRO) radiation dermatitis is one of the most
Manaus - AM common skin complications in patients
https://orcid.org/0009-0007-5273-3176 undergoing radiotherapy, with an incidence
that can vary from 50% to 95%, depending on
Rachel Neves Nicolau the type of cancer and the treatment regimen.
Centro Universitário CEUNI (FAMETRO) The prevalence of this condition is especially
Manaus - AM
high in cancers that require radiation therapy
https://orcid.org/0009-0009-7256-5119
in areas with a high density of hair follicles,
such as breast cancer and head and neck
Larissy da Silva Maciel
Faculdade Brasileira de Cachoeiro cancer. GOAL: To address current strategies
(MULTIVIX) for management and prevention of acute
Cachoeiro de Itapemirim - ES radiation dermatitis in patients undergoing
https://orcid.org/0009-0007-6817-7354 radiotherapy. METHODOLOGY:
Bibliographic review carried out in October
Natalia Luiz da Silva Teixeira Bastos 2023. Literature searches were carried out
Centro Universitário Zarns (ZARNS in the PubMed databases. 333 articles were
SALVADOR) found and after applying inclusion and
Salvador - BA exclusion criteria, 23 articles were selected
https://orcid.org/0000-0002-4784-3991 to form the collection. DISCUSSION:
Although there is little data regarding the
Julia Matsura Teles Costa real effectiveness of topical use after each
Universidade Federal de Ouro Preto (UFOP) radiotherapy session, some topical products,
Ouro Preto - MG such as homeopathic ointments traditionally
https://orcid.org/0009-0001-4980-3723 used for skin irritations, appear as a promising
treatment for burns and radiation-induced
Amanda Carolina Zicatti da Silveira
dermatitis, improving healing. by inhibiting
Pontifícia Universidade Católica de São Paulo
the inflammatory process and the activity of
São Paulo - SP
https://orcid.org/0000-0001-8963-9553 matrix metalloproteinases. Furthermore, it
is known that Biafine emulsion can prevent
grade 3 radiodermatitis and Calendula
officinalis has shown a reduction in
dermatitis in patients with early breast cancer
with postoperative radiotherapy. FINAL
CONSIDERATIONS: Despite improvements
in radiotherapy techniques, 90% of patients
develop acute radiation dermatitis and up to
25% pruritus, occurring frequently, especially
in the following days and weeks. Therefore, it
is important that patients adopt some general
skin care measures, such as avoiding sun
exposure, washing the skin with warm water
and neutral soap, keeping the irradiated area
clean and dry, using water-based moisturizers

International Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594122423014

2
and loose-fitting clothing. Topical steroid dermatitis persists as a prominent adverse
applications for radiodermatitis. reaction, potentially negatively affecting
Keywords: Acute radiation dermatitis, quality of life. of the patient, compromising
Radiotherapy, Treatment. aesthetics, and in severe cases, causing
infection, sepsis and treatment interruptions
INTRODUCTION (BEHROOZIAN T. et al., 2023).
Radiotherapy is a central pillar in the Given the above, this study aimed to
treatment of malignant tumors. However, evaluate current management and prevention
in addition to its cytotoxic effect on tumor strategies for acute radiation dermatitis in
cells, radiation exerts a marked destructive patients undergoing radiotherapy. Using a
effect on normal tissue cells in the irradiation narrative approach, we intend to investigate
field. Depending on variables such as age, and evaluate the safety and effectiveness of
physical conditions, skin types, location and strategies that include topical medications,
duration of exposure, patients undergoing skin care and other interventions in reducing
radiotherapy may develop different adverse the severity of acute radiation dermatitis
skin manifestations (YANG X. J. et al., 2020). and possible side effects resulting from skin
Acute radiation dermatitis, defined as exposure to radiation. The aim, therefore, is
its onset within 90 days after exposure to provide valuable insights that can guide
to radiation, is a common adverse effect medical practice and offer a positive impact
of radiotherapy, developing in up to 95% on the quality of life of patients facing this
of patients undergoing such treatment adverse condition that is so common in
(BEHROOZIAN T. et al., 2023). Typical patients undergoing radiotherapy.
clinical manifestations include erythema,
edema, pigmentation changes, hair loss, and METHODOLOGY
wet or dry scaling. In more severe cases, This is a narrative bibliographic review
infection and necrosis may occur (ZETNER developed according to the criteria of the
D. et al., 2023). PVO strategy, an acronym that represents:
The pathophysiology of radiation dermatitis population or research problem, variables
is complex, being influenced by a myriad and outcome. Used to prepare the research
of factors such as the total dose of radiation through its guiding question: “How effective
administered, the fractionation regimen, and safe are current strategies for managing
the volume of tissue irradiated, concomitant and preventing acute radiation dermatitis in
systemic therapy and comorbidities present. patients undergoing radiotherapy?”. In this
Exposure to radiation results in extensive sense, according to the parameters mentioned
genetic damage, breaking the double strands above, the population of this research refers to
of nuclear and mitochondrial DNA, and patients undergoing radiotherapy who present
inhibiting the ability of cells to divide and or are at risk of developing acute radiation
replicate, culminating in radiation-induced dermatitis to evaluate current therapeutic
dermatitis (ZASADZIŃSKI K. et al., 2022). approaches and their effectiveness for the
Due to technological advances aimed at management and prevention of this condition.
improving skin dose homogeneity and The search was carried out using the PubMed
mitigating the severity of skin reactions, such Central (PMC) database, using the following
as intensity-modulated radiotherapy and search strategy: (Acute Radiation Dermatitis)
skin preservation techniques, acute radiation AND (Radiotherapy) AND ((Treatment) OR

International Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594122423014

3
(Prevention) OR (Management)). cell division and replication (ROSENTHAL
From this search, 333 articles were found, A. et al., 2019).
subsequently submitted to the selection The different phases of the cell cycle present
criteria. The inclusion criteria were: articles varying levels of sensitivity to radiation
in English and Portuguese, published in the (FUZISSAKI A. M. et al., 2021). The ability
last five years and studies such as systematic to affect cells in the G2 and mitosis phases -
reviews, meta-analysis, cohort studies, clinical the most radiosensitive - leads to apoptosis,
trials, as well as other types of research available impairing cell proliferation and migration
in full that addressed the themes proposed and resulting in general cell depletion.
for this research. The exclusion criteria were: Ionizing radiation can alter collagen
duplicate articles, available in abstract form, structures and suppress cell proliferation
which did not directly address the proposal in irradiated wounds (FUZISSAKI A. M.
studied and which did not meet the other et al., 2021) (ROSENTHAL A. et al., 2019).
inclusion criteria. A total of 23 articles were Reduced angiogenesis and increased levels
selected to compose the present study. of transforming growth factor β (TGF-β)
lead to changes in blood vessels, increasing
DISCUSSION endothelial fibrosis, causing occlusion of the
Radiation Dermatitis (RD) is a common vascular lumen and subsequent tissue hypoxia.
condition that occurs subsequent to Furthermore, reduced expression of the
Radiotherapy (RT), significantly impacting apoptosis inhibitor gene and overexpression
patients’ quality of life, with up to 85% of of apoptosis-inducing genes, such as p35,
treated patients experiencing moderate to attributed to radiation, result in excessive
severe skin reactions such as edema, erythema, apoptosis in the tissue (YANG X. et al.,
depigmentation and necrosis (ROSENTHAL 2020). The sum of these processes causes skin
A. et al.,2019). Toxicity resulting from RT damage with tissue destruction, reduction of
manifests itself within a period ranging from functional stem cells, initiation of epidermal
hours to weeks after exposure (ROSENTHAL and dermal inflammatory responses and
A. et al., 2019). As described by Yang X. et necrosis (ROSENTHAL A. et al., 2019).
al. (2020), the initial phase is characterized As pointed out by Olivia D. et al. (2018),
by erythema and scaling, progressing to the individual genetic variations, along with
development of ulcers and telangiectasias and, other factors such as breast size, body mass
eventually, evolving into chronic conditions index, smoking status, and RT modality, may
such as atrophy and fibrosis. Progressive influence acute skin reactions and related
endometritis occurs due to gradual occlusion symptoms. Among the genes involved, XRCC2
of the microvasculature and consequent plays a role in DNA repair caused by radiation.
hypoxia. Fibrosis, a harmful and irreversible Genetic damage, together with the generation
chronic condition, appears weeks to years of reactive oxygen species and other structural
after exposure to radiation, adversely affecting changes in tissues, triggers epidermal and
patients’ quality of life (YANG X. et al., 2020). dermal inflammatory responses, in addition
The biological effects of RT manifest hours to cellular necrosis, culminating in DR, which
to weeks after exposure, causing extensive significantly affects patients’ quality of life
genetic damage that results in the irreversible (ROSENTHAL A. et al.,2019).
breakage of nuclear and mitochondrial DNA Fuzissaki A. M. et al. (2021), highlights
double strands, thus inhibiting the capacity for that a greater amount of breast adipose

International Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594122423014

4
tissue in breast RT is associated with the women received tamoxifen. The presence of
development of skin toxicities. Adipose tissue diabetes has been reported as an unfavorable
exposed to radiation becomes a source of prognostic factor for toxicity, especially late
autotaxin secretion, which is responsible subcutaneous fibrosis, in univariate and
for the production of lysophosphatidic acid. multivariate analyzes of hypofractionated RT.
This cycle triggers a persistent inflammatory Currently, there is no consensus on the
process that promotes the activation of control or prevention of radiodermatitis
nuclear factor Kappa B, the expression of the (RD). In general, recommendations include
enzyme cyclooxygenase-2 (COX-2) and the skin cleansing, hydration, photoprotection
signaling of the secretion of inflammatory and general practices, such as wearing loose,
cytokines, chemokines and growth factors, cotton clothing to avoid irritation (GOBBO
including transforming growth factor. alpha. M. et al, 2023). Approximately 85% of patients
A factor of statistical relevance is the high undergoing radiotherapy will experience
skin phototype, such as V or VI, associated noticeable skin reactions, ranging from
with high eumelanin. The synthesis of this mild erythema and dry scaling to confluent
melanin variant is stimulated by the action moisture and ulceration, resulting in decreased
of alpha melanocyte-stimulating hormone. quality of life (THANTHONG S. et al, 2020).
A correlation was observed between the high Furthermore, these conditions can limit the
frequency of single nucleotide polymorphisms therapeutic dose administered and/or lead to
in the melanocortin 1 receptor gene and severe temporary or even permanent interruption of
acute skin toxicity (FUZISSAKI A. M. et al., radiotherapy (RACADOT S. et al, 2023).
2021). According to Olivia D. et al. (2018), There is currently no standard skin care
the XRCC2 gene, involved in DNA repair, for radiodermatitis available. Products
is associated with burns; and the immune such as hyaluronic acid cream, aloe
response gene interferon gamma has been vera gel, topical vitamin C, chamomile,
associated with pruritus. almond cream, and trolamine have shown
In the study conducted by Bhangoo R. S. et inconsistent effectiveness, as have daily
al. (2022), it was observed that DR was more hygiene, topical corticosteroids and
prevalent in patients treated for breast cancer, antibiotics, and silver sulfadiazine. On the
followed by gastrointestinal and lung cancer. other hand, photobiomodulation therapy
The analysis also revealed that the majority has demonstrated significant efficacy in
of affected patients were Caucasians with preventing DR in breast cancer patients (HYE
Fitzpatrick 1–2 skin phototypes, indicating P. et al, 2019).
increased sensitivity to the sun. In another As indicated by Racadot S. et al.
research, Borm J. K. et al (2018) explored the (2023), in recent decades, treatments have
incidence of erythema in breast cancer patients become more effective with milder adverse
undergoing conservation therapy before RT, effects, based on histological type and
noting that grade 1 or 2 erythema was evident molecular characteristics. However, despite
in the majority of cases, while erythema was improvements in radiotherapy techniques,
not was observed in 28.9% of cases. Finally, 90% of patients develop acute radiation
Fuzissaki A. M. et al. (2021) highlighted dermatitis. Dermatitis associated with
that premenopausal patients with positive ionizing radiation is common, especially in
lymph nodes were treated with adjuvant the subsequent days and weeks, manifesting
chemotherapy, while postmenopausal as dry or exudative radiodermatitis, or acute

International Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594122423014

5
radionecrosis. These conditions can not only able to improve nutritional status, quality of
negatively affect the patient’s quality of life, but life and survival. Photobiomodulation is also
also limit the therapeutic dose administered capable of reducing the need for radiotherapy
and/or lead to temporary or even permanent interruptions, directly contributing to the
interruption of radiotherapy. Prophylactic prognosis (GOBBO M. et al, 2023). According
treatment is preferred to delay the onset to Gobbe M. et al. (2023), photobiomodulation
and reduce the severity of skin reactions, has biostimulant properties that favor faster
which can contribute to increasing patients’ tissue regeneration and healing, in addition
adherence to cancer treatment, in addition to to presenting analgesic properties, reducing
improving quality of life. Patients undergoing inflammation and fibrosis, without causing
radiotherapy must be instructed to keep their notable side effects. Photobiomodulation
skin moist to reduce the chance of developing also reduces the need for radiotherapy
acute radiodermatitis (THANTHONG S. et interruptions, directly contributing to the
al., 2020). prognosis (GOBOO M. et al., 2023).
Given the current prevalence of the It was found that the incidence of
problem, several studies and methods have severe radiodermatitis (grade 3) and pain
been developed with the aim of finding new was significantly lower in patients who
prevention and skin management strategies underwent photobiomodulation at the end of
in the face of radiotherapy (RT). In line with radiotherapy. However, it was observed that
Robijns J. et al. (2022), skin barrier protectors patients undergoing radiotherapy showed an
appear to reduce the risk of confluent wet increase in physical and mental stress, and that
peeling, improve patient comfort, and decrease photobiomodulation could exacerbate these
pain and itching. These protectors can be symptoms, causing a decrease in treatment
applied to different regions of the skin under adherence (GOBBO M. et al, 2023).
different types of radiotherapy. Additionally, The preventive application of
Zasadziński K. et al. (2022) highlight that the photobiomodulation is effective in reducing
possible side effects of applying the barrier the incidence of wet desquamation in
film, such as itching or rash, are mild and, patients with breast cancer, and can stabilize
for the most part, self-limited. Dressings the degree of pigmentation and improve
have the advantage of creating a moist, the function of the skin barrier during
stable environment that facilitates faster re- radiotherapy. In general, research suggests
epithelialization of radiation-damaged skin, that photobiomodulation has biostimulant
with some having antimicrobial and anti- properties that allow for faster tissue
inflammatory characteristics that help prevent regeneration and healing (GOBBO M. et al,
or heal radiation damage. 2023).
Photobiomodulation involves the According to Thanthong S. et al. (2020),
application of low-power light sources in prophylactic treatment is preferable to delay
the visible and infrared spectrum, aiming the onset and reduce the severity of skin
to promote healing and reduce pain, in reactions, which can contribute to increasing
addition to counteracting inflammation and patients’ adherence to cancer treatment, in
offering antimicrobial properties. Its use has addition to improving quality of life. A crucial
been growing in cancer patients due to its point is to instruct patients to keep their
applicability in different areas of the body and to skin moist in order to reduce the chance of
treat different side effects, in addition to being developing acute radiodermatitis. Finally,

International Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594122423014

6
it was found that there were no adverse to promote a refining process with calcium
events related to photobiomodulation, and hydroxide, a compound that has the ability
that the incidence of grade 3 DR was only to maintain the advantageous properties of
9 %, demonstrating the preventive effect of olive oil and remove unwanted free fatty acids
reducing the severity of radiodermatitis, being (CHITAPANARUX I. et al, 2019). The olive
a safe and clinically viable practice (HYE P. et oil emulsion was applied twice a day, from
al, 2019). the first day of radiotherapy until two weeks
According to Robijns J. et al. (2022), after its completion. The only side effect
radiodermatitis can worsen due to friction, presented by one of the patients involved in
shear, allergens, chemicals, body fluids and the research was the presence of a temporary
friction with the skin and tissues. The use tingling sensation after applying the product
of a skin barrier protector can prevent the (CHITAPANARUX I. et al., 2019). However,
desquamation of superficial keratinocytes the final result of the emulsion was satisfactory.
in the stratum corneum, thus keeping the Its use significantly reduced the intensity of
skin barrier function intact and preventing the acute skin reaction induced by radiation,
worsening of radiodermatitis. This way, a postponed skin toxicity and increased the
skin barrier protector composed of a tetra quality of life of patients, being characterized
acrylic polymer with 2-octyl-cyanoacrylate as an effective and safe prophylactic treatment
was developed. When applied to the skin, (CHITAPANARUX I. et al., 2019).
it forms a waterproof, robust and long- Topical corticosteroids are also effective
lasting film, which physically acts against in reducing symptoms associated with DR
moisture, irritants and abrasion, creating an (post-radiotherapy dermatitis), such as pain,
environment conducive to dermatitis wound burning or itching, although they must
healing (ROBIJNS J. et al., 2022). In the study, preferably be used only on intact skin, as
the barrier protector was applied twice a week they can delay wound healing or promote
to the irradiated area, and it was observed infection in scenarios of advanced wet
that the use of the product was beneficial in peeling (DEJONCKHEERE C.S. et al., 2023).
reducing pain, itching and moist scaling, in Mometasone Furoate (MMF) is a potent
addition to being classified as safe for use in corticosteroid, with a low risk of skin atrophy,
cancer patients. undergoing radiotherapy has a prolonged effect lasting 24 hours and
(ROBIJNS J. et al., 2022). has a strong inhibitory effect on IL-6 activity,
The main mechanism of skin injury both at the transcriptional and protein levels,
from radiation involves the production of during radiotherapy. (LIAO Y. et al., 2019). In
free radicals and the reduction of the skin’s the study by Liao Y. et al. (2019), a randomized
antioxidant capacity. With this in mind, trial was carried out in which patients applied
Chitapanarux I. et al. (2019) described a thin layer of MMF, once a day, from the date
that olive oil has moisturizing and anti- of the first radiotherapy until 2 weeks after
inflammatory properties, in addition to the end of it. It was observed in the study
antioxidant compounds, such as phenolics, that the characteristic of radiation injury
tocopherol, squalene and triterpenic changes according to the seasons. In winter,
acids, making it a very positive product dry and patchy skin peeling occurred after
in the management of dermatitis caused MMF application, while wet peeling increased
by radiation. However, to maintain all the significantly in summer. It was inferred that
beneficial properties of olive oil, it is necessary the difference in results occurred due to

International Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594122423014

7
the large variation in ambient temperature post-radiation dermatitis. Due to its anti-
(LIAO Y. et al., 2019). Furthermore, it was inflammatory effects similar to those of
also concluded that the local application of benzydamine, which result in the reduction
MMF significantly reduced itching and pain of edema and inhibition of dermatitis induced
in irradiated skin, regardless of the dose of by harmful agents, chamomile is seen as a
radiotherapy, proving that the use of this potential topical anti-inflammatory agent
substance post-radiotherapy can prevent (FERREIRA E. B. et al., 2020). Olive oil is
acute radiation dermatitis (LIAO Y. et al., also relevant in reducing the intensity of the
2019). acute skin reaction induced by radiation
Ointments for the treatment of DR were (CHITAPANARUX I. et al., 2019). Before
also evaluated, such as Centella asiatica, using the gel, patients were instructed to
a medicine used to heal wounds and skin avoid sun exposure, and to perform self-care
diseases; Thunbergia laurifolia, which after radiotherapy, including oral hydration
accelerates the rate of healing in burns and (approximately 2 liters of water per day) and
has antinociceptive and anti-inflammatory general skin care (washing with moisturizing
effects; and Cucumis sativus, which has soap and drying the area with a soft towel)
soothing properties against skin irritation (FERREIRA E. B. et al., 2020). Chamomile gel
and swelling. However, the results showed was used three times a day in the irradiated
that no cream was effective in preventing or area, throughout the radiotherapy period. At
delaying radiodermatitis, only that cucumber the end of the study, it was seen that the cost
cream could be useful in recovering the skin of chamomile gel is about a third of the cost
after exposure to radiation, reducing the of urea cream. Furthermore, it was observed
severity of grade 1 dermatitis after 1 month that the gel can delay or reduce itching and
of use (THANTHONG S. et al, 2020). There burning sensations, in addition to reducing
is still a lack of data on the real effectiveness the development of hyperpigmentation,
of using a topical after each radiotherapy having a more positive action than urea cream
session. However, Cicaderma ointment, a (FERREIRA E. B. et al., 2020).
homeopathic ointment traditionally used Finally, Doxepin is a tricyclic antidepressant
for skin irritations, appears as a promising that has promising antihistamine, anti-
treatment for burns and radiation-induced inflammatory and analgesic properties,
dermatitis, improving healing by inhibiting having the lowest number of side effects
the inflammatory process and the activity of among active treatment creams (SHARIATI
matrix metalloproteinases. Furthermore, it L. et al., 2020). In the study by Shariati L. et al.
is known that Biafine emulsion can prevent (2020), it was proposed to use a 5% Doxepin
grade 3 radiodermatitis, and that Calendula cream on the irradiated areas, three times
officinalis has shown reduced DR in a day, for seven days, starting from the last
patients with early breast cancer undergoing week of radiotherapy. After the period of use,
postoperative radiotherapy (RACADOT S. et it was verified that the incidence of grade 3
al, 2023). dermatitis was not detected in the treated
Natural alternatives were also explored, group. Furthermore, a great improvement in
highlighting chamomile. The gel from radiodermatitis was noted. It was therefore
this plant can delay or reduce itching and found that Doxepin cream is an affordable,
burning sensations, as well as minimize easy-to-use product with the ability to
the development of hyperpigmentation in prevent pain and irritation, making it a

International Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594122423014

8
potential treatment for dermatitis in patients can generate their own side effects, requiring
undergoing radiotherapy (SHARIATI L. et al., a careful balance in their application. Despite
2020). significant advances, the review highlights the
need for more large-scale clinical studies. This
FINAL CONSIDERATIONS is essential to strengthen the evidence base and
The results of this literature review guide future practices, especially considering
point to the importance of keeping the skin the frequency of clinical manifestations of
moist in cancer patients as a preventive Radiodermatitis and its impact on a large
measure against Radiodermatitis, a proportion of cancer patients around
common and challenging complication in the world. Fully understanding the best
radiotherapy treatment. This review details approaches to preventing and treating
the effectiveness of various interventions to Radiodermatitis will not only improve skin
treat and prevent Radiodermatitis, including care, but also the overall cancer treatment
barrier protectants, wound dressings, experience, minimizing side effects and
photobiomodulation, cicaderma, doxepin improving outcomes for patients.
and chamomile gel. Each of these methods
demonstrates potential in treating different AUTHORIZATIONS/
side effects of radiotherapy, contributing to ACKNOWLEDGMENT
improving the quality of life and survival of When submitting the work, the authors
cancer patients. Furthermore, it was observed become responsible for the entire content of
in studies that the use of olive oil emulsions and the work.
topical corticosteroids shows an improvement
in the side effects of radiotherapy. However, QUOTES
it is important to note that these treatments According to ABNT standards.

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International Journal of Health Science ISSN 2764-0159 DOI https://doi.org/10.22533/at.ed.1594122423014

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