Radiodermatitis occurs in more than 50% of patients who undergo radiation therapy (RT) for cancer with or without chemotherapy, with some estimates of the rate of radiodermatitis as high as 95%.1, 2 Early radiodermatitis occurs within 2 months of RT. Late RD occurs more than 2 months after RT, sometimes not occurring until years later.1

Development and Clinical Symptoms

Acute radiodermatitis, which is a type of burn injury, varies in severity and how it responds to therapy. It forms after the delivery of an erythema dose of ionizing radiation to the skin, usually at a dose of 2 Gy or more.

Factors inherent in the patient can affect the severity and response to therapy. In fact, recently researchers revealed an association between a single nucleotide polymorphism in the X-ray repair cross-complementing gene 1 (XRCC1) gene and the development of acute radiodermatitis in patients who underwent RT to treat nasopharyngeal carcinoma (odds ratio [OR] =2.860; P = .006; 95% CI, 1.354-6.043).3

Clinical symptoms usually appear within a few weeks of initiating radiation therapy. Acute radiodermatitis is characterized by the manifestation of red patches, sometimes with desquamation or blistering. Although most cases heal after several weeks, persistent reactions can cause complications.

Chronic radiodermatitis occurs from the administration of suberythema doses of ionizing radiation over a longer stretch of time, such as what would occur in radiologists prior to the implementation of x-ray filters.

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Telangiectasia on atrophic and fragile skin characterizes late-onset radiodermatitis. More commonly known as spider veins, telangiectases are widened, tiny blood vessels that form gradually. They typically form in clusters and gradually. Telangiectasia can significantly affect therapeutic regimens and a patient’s quality of life.