{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T17:08:10Z","timestamp":1776100090736,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CORPG8N0131"],"award-info":[{"award-number":["CORPG8N0131"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005779","name":"Cheng Shiu University","doi-asserted-by":"publisher","award":["CORPG8P0041"],"award-info":[{"award-number":["CORPG8P0041"]}],"id":[{"id":"10.13039\/501100005779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Acute radiation dermatitis (ARD) is a frequent toxicity in head and neck radiotherapy (RT), yet the interplay among skin dose, patient phenotype, treatment modality, and objective biophysical skin responses remains poorly defined. Previous studies have been limited by small sample sizes, older RT techniques, absence of dose\u2013response modeling, or reliance on subjective grading. In this prospective cohort study, we evaluated temporal changes in skin erythema, melanin index, hydration, and sebum using standardized multiprobe devices at baseline (T1), end of RT (T2), and three months post\u2010RT (T3) in 130 patients with head and neck cancer treated by modern photon RT (volumetric modulated arc therapy, VMAT,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200990) or proton RT (intensity\u2010modulated proton therapy, IMPT,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200940). Multivariable analyses examined associations between RT technique, superficial skin dose, baseline phenotypic characteristics, and biophysical outcomes. VMAT and IMPT demonstrated similar temporal biophysical profiles across all time points. Superficial\n                    <jats:bold>s<\/jats:bold>\n                    kin dose, rather than modality or ARD grade, independently predicted higher erythema and melanin indices and lower hydration and sebum at T3. Baseline levels, male sex, and higher Fitzpatrick skin type were strong determinants of biophysical skin response at T2 and T3. Hydration and sebum did not recover to baseline at T3, indicating persistent subclinical barrier and adnexal impairment despite clinical resolution of erythema. These findings suggest that biophysical skin response after head and neck RT is more strongly associated with dose and phenotype. Objective assessments reveal latent barrier dysfunction not captured by standard ARD grading, underscoring the value of integrating skin dose metrics and quantitative monitoring into individualized risk stratification and skin\u2010sparing strategies in modern RT.\n                  <\/jats:p>","DOI":"10.1111\/1346-8138.70146","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T08:51:01Z","timestamp":1768380661000},"page":"645-654","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Biophysical Skin Response in Head and Neck Cancer: Longitudinal Comparison of Modern Photon and Proton Radiotherapy"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2525-1060","authenticated-orcid":false,"given":"Wen\u2010Ling","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Cosmetics and Fashion Styling, Center for Environmental Toxin and Emerging\u2010Contaminant Research Cheng Shiu University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Jie","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0165-771X","authenticated-orcid":false,"given":"Fu\u2010Min","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine  Kaohsiung Taiwan"},{"name":"School of Medicine Chang Gung University College of Medicine  Taoyuan Taiwan"},{"name":"School of Medicine, College of Medicine National Sun Yat\u2010Sen University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-016-0120-y"},{"issue":"6","key":"e_1_2_8_3_1","article-title":"Intensity\u2010Modulated Radiotherapy Versus Volumetric Modulated Arc Therapy in Head and Neck Cancers: A Comparative Analysis of Compliance, Toxicities and Dosimetric Parameters","volume":"17","author":"Jain 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