Prevention and treatment of dermal toxicity in children receiving anti-tumor radiation

Radiation therapy, being an integral part of malignant neoplasms treatment in children, is unfortunately inevitably accompanied by a high frequency of adverse dermatological reactions. Development of radiodermatitis — from erythema and dryness to oozing lesion, painfulness and ulcerations — is a considerable clinical problem, significantly deteriorates the quality of life of young patients and creates the risk of infectious complications, that could potentially lead to interruptions in life-saving treatment. Critically important is that currently there are almost no randomized controlled studies in the pediatric population specifically devoted to systematic assessment of profile, severity and optimal management of dermatological toxicity caused by radiation therapy. This article focuses on the urgent need and crucial significance of comprehensive supportive skin therapy during and after radiation. Such care includes regular and targeted use of special dermatoprotective products. Moisturizing creams and ointments are designed to combat dryness, desquamation and maintain the integrity of the hydrolipid barrier. Barrier agents (often based on zinc, silicone or special polymers) create a protective film that minimizes friction, mechanical damage and contact with irritants as well as promote healing. The main objectives of this strategy are effective management of clinical manifestations of acute radiodermatitis, maximum possible prevention and minimization of severe skin lesions, as well as significant acceleration of their recovery and re-epithelization processes in the post-radiation period. The obtained results and collated recommendations are of significant practical interest to a wide range of specialists — dermatologists, pediatric oncologists, pediatricians and radiotherapists, who directly comprehensively treat children with malignant tumors, undergoing radiation therapy, and strive to optimize their treatment tolerability and quality of life.