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Fifty\u2010seven patients with newly diagnosed NPC and treated with PBT were enrolled. ARD was recorded weekly based on the criteria of Common Terminology Criteria for Adverse Events version 4.0 at treatment visits (1st to 7th weeks) and 1\u2009week (8th week) and 1\u2009month (11th week) after the completion of PBT. The maximum ARD grade was 1, 2, and 3 in 26 (45.6%), 24 (42.1%), and 7 (12.3%) of the patients, respectively. The peak incidence of grade 2 and 3 ARD was observed during the period of the 6th to 8th weeks. Treatment of ARD included topical corticosteroid alone in 24 (42.1%) patients, topical corticosteroid plus silver sulfadiazine in 33 (57.9%) patients, and non\u2010adhering silicone dressing to cover severe skin wound area in 25 (43.8%) patients. In the 11th week, most grade 2 and 3 ARD had disappeared and 93.0% of the patients had ARD of grade 1 or lower. In the binary logistic regression model, we identified habitual smoking (odds ratio [OR]: 5.2, 95% confidence interval [CI]: 1.3\u201018.8, <jats:italic>P<\/jats:italic>\u00a0=\u2009.012) and N2 to N3 nodal status (OR: 4.9, 95% CI: 1.6\u201015.4, <jats:italic>P<\/jats:italic>\u00a0=\u2009.006) as independent predictors of grade 2 and 3 ARD. The results show ARD is a major concern for patients with NPC treated with PBT, especially those with habitual smoking or advanced nodal status. Topical corticosteroid, silver sulfadiazine, and non\u2010adhering silicone dressing are effective for treating ARD induced by PBT.<\/jats:p>","DOI":"10.1111\/iwj.13897","type":"journal-article","created":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T07:02:00Z","timestamp":1658818920000},"page":"499-507","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Acute radiation dermatitis among patients with nasopharyngeal carcinoma treated with proton beam therapy: Prognostic factors and treatment outcomes"],"prefix":"10.1111","volume":"20","author":[{"given":"Ko\u2010Chun","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Education Kaohsiung Chang\u2010Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Hung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kaohsiung Chang\u2010Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui\u2010Ching","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang\u2010Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"},{"name":"Department of Medicine Chang Gung University College of Medicine  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tai\u2010Lin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Yen","family":"Chien","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang\u2010Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"},{"name":"Department of Medicine Chang Gung University College of Medicine  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Ling","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Cosmetics and Fashion Styling Center for Environmental Toxin and Emerging\u2010Contaminant Research, Cheng Shiu University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0165-771X","authenticated-orcid":false,"given":"Fu\u2010Min","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Medicine Chang Gung University College of Medicine  Taoyuan Taiwan"},{"name":"Department of Radiation Oncology Kaohsiung Chang\u2010Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,26]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Global Cancer Observatory: Cancer Today","author":"Bray F","year":"2018"},{"key":"e_1_2_8_3_1","unstructured":"Particle Therapy Co\u2010Operative Group.Particle therapy facilities in clinical operation.https:\/\/www.ptcog.ch\/index.php\/facilities-in-operation. 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