{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:39:03Z","timestamp":1787024343906,"version":"build-2736575974"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Current strategies for preventing and managing radiation-induced dermatitis, mucositis, and xerostomia are reviewed, with an emphasis on pharmacologic interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Nearly two thirds of all patients with cancer receive radiation therapy during the course of treatment, frequently resulting in acute skin and mucosal toxicities. The severity of radiotherapy-associated toxicities varies according to multiple treatment- and patient-related factors (e.g., total radiation dose and dose fractionation schedule, volume of organ or tissue irradiated, use of concurrent versus sequential chemotherapy, comorbid conditions, functional performance status). Three major radiation toxicities encountered in clinical practice are (1) radiation dermatitis, typically managed with a variety of topical agents such as water-based moisturizing creams or lotions, topical steroids, antiinflammatory emulsions, and wound dressings, (2) radiation-induced oral mucositis, which can be managed through proper basic oral care practices, appropriate pain management, and the use of medicated mouthwashes and oral rinses and gels, and (3) radiation-induced xerostomia, which can be alleviated with saliva substitutes, moistening agents, and sialagogues. Pharmacists involved in the care of patients receiving radiotherapy can play an important role in optimizing symptom control, educating patients on self-care strategies, and adverse effect monitoring and reporting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radiation-induced dermatitis, mucositis, and xerostomia can cause significant morbidity and diminished quality of life. Pharmacologic interventions for the prevention and treatment of these toxicities include topical agents for dermatitis; oral products, analgesics, and palifermin for mucositis; and amifostine, saliva substitutes, and pilocarpine for xerostomia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2146\/ajhp120467","type":"journal-article","created":{"date-parts":[[2013,5,29]],"date-time":"2013-05-29T16:28:19Z","timestamp":1369844899000},"page":"1025-1032","source":"Crossref","is-referenced-by-count":73,"title":["Prevention and management of radiation-induced dermatitis, mucositis, and xerostomia"],"prefix":"10.1093","volume":"70","author":[{"given":"Lauren J.","family":"Radvansky","sequence":"first","affiliation":[{"name":"Hematology\/Oncology, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus; at the time of writing, she was Postgraduate Year 2 Oncology Pharmacy Resident, The University of Texas MD Anderson Cancer Center (MD Anderson), Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makala B.","family":"Pace","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute, University of Utah Health Care, Salt Lake City; at the time of writing, she was Clinical Pharmacy Specialist\u2014 Thoracic\/Head & Neck Medical Oncology, MD Anderson"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Thoracic\/Head & Neck Medical Oncology, MD Anderson"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2020071622255149800_b1-0701025","doi-asserted-by":"crossref","first-page":"10","DOI":"10.3322\/caac.20138","article-title":"Cancer statistics, 2012","volume":"62","author":"Siegel","year":"2012","journal-title":"CA Cancer J Clin."},{"key":"2020071622255149800_b2-0701025","unstructured":"American Society for Radiation Oncology. Fast facts about radiation therapy. www.astro.org\/News-and-Media\/Media-Resources\/FAQs\/Fast-Facts-About-Radiation-Therapy\/Index.aspx (accessed 2012 Apr 30)."},{"key":"2020071622255149800_b3-0701025","first-page":"2","article-title":"The discipline of radiation oncology","volume-title":"Perez and Brady\u2019s principles and practice of radiation oncology","author":"Halperin","year":"2008","edition":"5th ed"},{"key":"2020071622255149800_b4-0701025","first-page":"320","article-title":"Late effects of cancer treatment on normal tissues","author":"Constine"},{"key":"2020071622255149800_b5-0701025","first-page":"289","article-title":"Radiation oncology","volume-title":"De-Vita, Hellman, and Rosenberg\u2019s cancer: principles and practice of oncology","author":"Morgan","year":"2011","edition":"9th ed"},{"key":"2020071622255149800_b6-0701025","first-page":"2011","article-title":"Supportive care and quality of life","volume-title":"Perez and Brady\u2019s principles and practice of radiation oncology","author":"Deng","year":"2008","edition":"5th ed"},{"key":"2020071622255149800_b7-0701025","doi-asserted-by":"crossref","first-page":"5160","DOI":"10.1200\/JCO.2010.31.2520","article-title":"The future of radiation oncology in the United States from 2010 to 2020: will supply keep pace with demand?","volume":"28","author":"Smith","year":"2010","journal-title":"J Clin Oncol."},{"key":"2020071622255149800_b8-0701025","unstructured":"Bureau of Labor Statistics, Department of Labor. Occupational outlook handbook: pharmacists. www.bls.gov\/ooh\/healthcare\/pharmacists.htm (accessed 2012 Apr 30)."},{"key":"2020071622255149800_b9-0701025","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jaad.2005.08.054","article-title":"Radiation dermatitis: clinical presentation, pathophysiology, and treatment 2006","volume":"54","author":"Hymes","year":"2006","journal-title":"J Am Acad Dermatol."},{"key":"2020071622255149800_b10-0701025","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.soncn.2011.02.009","article-title":"Evidence-based skin care management in radiation therapy: clinical update","volume":"27","author":"McQuestion","year":"2011","journal-title":"Semin Oncol Nurs."},{"key":"2020071622255149800_b11-0701025","unstructured":"National Cancer Institute, National Institutes of Health, Department of Health and Human Services. Common terminology criteria for adverse events (CTCAE), version 4.03 (June 14, 2010). http:\/\/evs.nci.nih.gov\/ftp1\/CTCAE\/About.html (accessed 2012 May 8)."},{"key":"2020071622255149800_b12-0701025","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1093\/annonc\/mdm400","article-title":"Consensus guidelines for the management of radiation dermatitis and coexisting acne-like rash in patients receiving radiotherapy plus EGFR inhibitors for the treatment of squamous cell carcinoma of the head and neck","volume":"19","author":"Bernier","year":"2008","journal-title":"Ann Oncol."},{"key":"2020071622255149800_b13-0701025","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1007\/s00520-006-0063-4","article-title":"The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline","volume":"14","author":"Bolderston","year":"2006","journal-title":"Support Care Cancer."},{"key":"2020071622255149800_b14-0701025","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/S0009-9260(79)80217-2","article-title":"Effectiveness of topical steroids in the control of radiation dermatitis: a randomised trial using 1% hydrocortisone cream and 0.05% clobetasone butyrate (Eumovate)","volume":"30","author":"Glees","year":"1979","journal-title":"Clin Radiol."},{"key":"2020071622255149800_b15-0701025","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1046\/j.1365-2133.2002.04751.x","article-title":"Topical corticosteroid therapy for acute radiation dermatitis: a prospective, randomized, double-blind study","volume":"146","author":"Schmuth","year":"2002","journal-title":"Br J Dermatol."},{"key":"2020071622255149800_b16-0701025","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1159\/000211516","article-title":"Biafine applied on human epidermal wounds is chemotactic for macrophages and increases the IL-1\/IL-6 ratio","volume":"10","author":"Coulomb","year":"1997","journal-title":"Skin Pharmacol."},{"key":"2020071622255149800_b17-0701025","volume-title":"Biafine topical emulsion package insert","year":"2009"},{"key":"2020071622255149800_b18-0701025","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1016\/S0360-3016(00)00782-3","article-title":"Randomized phase III study comparing best supportive care to Biafine as a prophylactic agent for radiation-induced skin toxicity for women undergoing breast irradiation: Radiation Therapy Oncology Group (RTOG) 97\u2013113","volume":"48","author":"Fisher","year":"2000","journal-title":"Int J Radiat Oncol Biol Phys."},{"key":"2020071622255149800_b19-0701025","first-page":"305","article-title":"Topical Biafine and Lipiderm for the prevention of radiation dermatitis: a randomized prospective trial","volume":"8","author":"Fenig","year":"2001","journal-title":"Oncol Rep."},{"key":"2020071622255149800_b20-0701025","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1038\/193293a0","article-title":"Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig","volume":"193","author":"Winter","year":"1962","journal-title":"Nature."},{"key":"2020071622255149800_b21-0701025","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/S0194-5998(99)70062-8","article-title":"Choosing the optimal wound dressing for irradiated soft tissue wounds","volume":"121","author":"Hom","year":"1999","journal-title":"Otolaryngol Head Neck Surg."},{"key":"2020071622255149800_b22-0701025","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1345\/aph.1E186","article-title":"Role of pentoxifylline and vitamin E in attenuation of radiation-induced fibrosis","volume":"39","author":"Chiao","year":"2005","journal-title":"Ann Pharmacother."},{"issue":"suppl 1","key":"2020071622255149800_b23-0701025","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.6004\/jnccn.2008.2001","article-title":"NCCN task force report: prevention and management of mucositis in cancer care","volume":"6","author":"Bensinger","year":"2008","journal-title":"J Natl Compr Canc Netw."},{"issue":"suppl 9","key":"2020071622255149800_b24-0701025","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1002\/cncr.20162","article-title":"Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients","volume":"100","author":"Sonis","year":"2004","journal-title":"Cancer."},{"key":"2020071622255149800_b25-0701025","first-page":"23","article-title":"Management of radiation-induced head and neck injury","volume-title":"Radiation toxicity: a practical guide","author":"Blanco","year":"2006"},{"key":"2020071622255149800_b26-0701025","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.semradonc.2008.09.006","article-title":"Strategies for managing radiation-induced mucositis in head and neck cancer","volume":"19","author":"Rosenthal","year":"2009","journal-title":"Semin Radiat Oncol."},{"key":"2020071622255149800_b27-0701025","first-page":"16","volume-title":"WHO handbook for reporting results of cancer treatment","year":"1979"},{"issue":"suppl 9","key":"2020071622255149800_b28-0701025","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.1002\/cncr.20163","article-title":"Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis","volume":"100","author":"Rubenstein","year":"2004","journal-title":"Cancer."},{"key":"2020071622255149800_b29-0701025","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1002\/cncr.22484","article-title":"Updated clinical practice guidelines for the prevention and treatment of mucositis","volume":"109","author":"Keefe","year":"2007","journal-title":"Cancer."},{"issue":"suppl 6","key":"2020071622255149800_b30-0701025","doi-asserted-by":"crossref","first-page":"vi78","DOI":"10.1093\/annonc\/mdr391","article-title":"Management of oral and gastrointestinal mucositis: ESMO clinical practice guidelines","volume":"22","author":"Peterson","year":"2011","journal-title":"Ann Oncol."},{"key":"2020071622255149800_b31-0701025","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1188\/08.CJON.141-152","article-title":"Putting evidence into practice: evidence-based interventions for the management of oral mucositis","volume":"12","author":"Harris","year":"2008","journal-title":"Clin J Oncol Nurs."},{"key":"2020071622255149800_b32-0701025","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/00000421-198604000-00006","article-title":"Benzydamine HCl, a new agent for the treatment of radiation mucositis of the oropharynx","volume":"9","author":"Kim","year":"1986","journal-title":"Am J Clin Oncol."},{"key":"2020071622255149800_b33-0701025","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1002\/1097-0142(20010815)92:4<875::AID-CNCR1396>3.0.CO;2-1","article-title":"Benzydamine HCl for prophylaxis of radiation-induced oral mucositis: results from a multicenter, randomized, double-blind, placebo-controlled clinical trial","volume":"92","author":"Epstein","year":"2001","journal-title":"Cancer."},{"key":"2020071622255149800_b34-0701025","doi-asserted-by":"crossref","first-page":"2590","DOI":"10.1056\/NEJMoa040125","article-title":"Palifermin for oral mucositis after intensive therapy for hematologic cancers. 1","volume":"351","author":"Spielberger","year":"2004","journal-title":"N Engl J Med."},{"key":"2020071622255149800_b35-0701025","doi-asserted-by":"crossref","first-page":"2808","DOI":"10.1200\/JCO.2010.32.4095","article-title":"Palifermin reduces severe mucositis in definitive chemoradiotherapy of locally advanced head and neck cancer: a randomized, placebo-controlled study","volume":"29","author":"Le","year":"2011","journal-title":"J Clin Oncol."},{"key":"2020071622255149800_b36-0701025","doi-asserted-by":"crossref","first-page":"2815","DOI":"10.1200\/JCO.2010.32.4103","article-title":"Palifermin decreases severe oral mucositis of patients undergoing postoperative radio-chemotherapy for head and neck cancer: a randomized, placebo-controlled trial","volume":"29","author":"Henke","year":"2011","journal-title":"J Clin Oncol."},{"key":"2020071622255149800_b37-0701025","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1191\/1078155205jp166oa","article-title":"Survey of topical oral solutions for the treatment of chemo-induced oral mucositis","volume":"11","author":"Chan","year":"2005","journal-title":"J Oncol Pharm Pract."},{"key":"2020071622255149800_b38-0701025","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1067\/moe.2000.105713","article-title":"Randomized clinical trial of the effectiveness of 3 commonly used mouthwashes to treat chemotherapy-induced mucositis","volume":"90","author":"Dodd","year":"2000","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod."},{"key":"2020071622255149800_b39-0701025","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1002\/cncr.22302","article-title":"Radiation-induced xerostomia in patients with head and neck cancer: a literature review","volume":"107","author":"Dirix","year":"2006","journal-title":"Cancer."},{"key":"2020071622255149800_b40-0701025","first-page":"191","article-title":"Pathophysiology and management of radiation-induced xerostomia","volume":"3","author":"Berk","year":"2005","journal-title":"J Support Oncol."},{"key":"2020071622255149800_b41-0701025","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.clon.2009.09.002","article-title":"Radiation-induced xerostomia: pathophysiology, prevention and treatment","volume":"21","author":"Bhide","year":"2009","journal-title":"Clin Oncol (R Coll Radiol)."},{"key":"2020071622255149800_b42-0701025","volume-title":"Amifostine package insert","year":"2009"},{"key":"2020071622255149800_b43-0701025","doi-asserted-by":"crossref","first-page":"3339","DOI":"10.1200\/JCO.2000.18.19.3339","article-title":"Phase III randomized trial of amifostine as a radioprotector in head and neck cancer","volume":"18","author":"Brizel","year":"2000","journal-title":"J Clin Oncol."},{"key":"2020071622255149800_b44-0701025","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1200\/JCO.2008.17.2627","article-title":"American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants","volume":"27","author":"Hensley","year":"2009","journal-title":"J Clin Oncol."},{"key":"2020071622255149800_b45-0701025","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1002\/hed.20456","article-title":"Radiation-induced xerostomia","volume":"29","author":"Chambers","year":"2007","journal-title":"Head Neck."},{"key":"2020071622255149800_b46-0701025","volume-title":"Pilocarpine hydrochloride package insert","year":"2010"},{"key":"2020071622255149800_b47-0701025","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1056\/NEJM199308053290603","article-title":"Oral pilocarpine for post-irradiation xerostomia in patients with head and neck cancer","volume":"329","author":"Johnson","year":"1993","journal-title":"N Engl J Med."},{"key":"2020071622255149800_b48-0701025","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1200\/JCO.1993.11.6.1124","article-title":"A multicenter, randomized, double-blind, placebo-controlled, dose-titration study of oral pilocarpine for treatment of radiation-induced xerostomia in head and neck cancer patients","volume":"11","author":"LeVeque","year":"1993","journal-title":"J Clin Oncol."},{"key":"2020071622255149800_b49-0701025","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/0360-3016(94)00361-N","article-title":"Oral pilocarpine for radiation-induced xerostomia: integrated efficacy and safety results from two prospective randomized clinical trials","volume":"31","author":"Rieke","year":"1995","journal-title":"Int J Radiat Oncol Biol Phys."},{"key":"2020071622255149800_b50-0701025","volume-title":"Evoxac (cevimeline) package insert","year":"2011"},{"key":"2020071622255149800_b51-0701025","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/j.ijrobp.2007.01.019","article-title":"Cevimeline for the treatment of postirradiation xerostomia in patients with head and neck cancer","volume":"68","author":"Chambers","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys."},{"key":"2020071622255149800_b52-0701025","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1002\/hed.21894","article-title":"Effectiveness of cevimeline to improve oral health in patients with postradiation xerostomia","volume":"34","author":"Witsell","year":"2012","journal-title":"Head Neck."}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ajhp\/article-pdf\/70\/12\/1025\/28363959\/ajhp1025.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ajhp\/article-pdf\/70\/12\/1025\/28363959\/ajhp1025.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T06:43:22Z","timestamp":1594968202000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/70\/12\/1025\/5112266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,15]]},"references-count":52,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2013,6,15]]}},"URL":"https:\/\/doi.org\/10.2146\/ajhp120467","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2013,6,15]]},"published":{"date-parts":[[2013,6,15]]}}}