Skin Toxicity in Palliative Radiation Therapy

Radiation therapy, commonly used for palliative care in metastatic cancer patients, often led to skin toxicity, which was dose-related and influenced by various treatment and patient factors. Acute skin reactions included erythema, hyperpigmentation, dryness, pain, itchiness, hair loss, and desquamation, while late reactions involved telangiectasias, fibrosis, pigmentation changes, dryness, ulcers, and wound healing issues. Preventative measures for acute toxicity included gentle soap washing and prophylactic hydrocortisone cream, though other interventions lacked robust supporting data and varied widely among providers. Additionally, radiation recall dermatitis could occur, mimicking acute reactions in previously irradiated areas after systemic agent administration.