**6. Prevention of radiation-induced skin reactions**

### **6.1 Modern radiation therapy**

To reduce complications on the skin, some modern techniques have been applied and gave promising results, such as IMRT and volumetric-modulated arc therapy (VMAT) [41, 42]. These techniques will deliver radiation doses conformally targeting tumor cells rather than surrounding normal cells, thus, minimizing skin injuries. A hypofractionated regimen, which reduces the period of time to exposure to radiation, also could prevent patients from suffering from skin injuries [43].

## **6.2 Topical corticosteroids**

Topical corticosteroids possess anti-inflammatory properties that inhibit proinflammatory cytokines initiating the early stage of skin reactions [44, 45]. Mometasone furoate, a highly potent corticosteroid, was daily during RT and shown its benefits to prevent skin toxicity compared to placebo [46]. Other topical corticosteroids, namely methylprednisolone and betamethasone, revealed similar effects delaying the onset of RT-induced skin dermatitis [47, 48].

## **6.3 Skincare**

After RT, the protection of the skin from adverse agents should be also paid attention to. These measures include protecting skin from the sun (i.g. by applying sunscreen or wearing a long-sleeve shirt), and daily cleaning irradiated skin with mild soap and water. It should be avoided to use an electric razor, tape, and adhesive on irradiated skin areas to minimize irritation or friction.
