Application of Natural Products in Radiotherapy-Induced Dermatitis: A Comprehensive Review ‎

Radiodermatitis (RD) is experienced by many cancer patients ‎receiving radiotherapy. An increasing number of these patients demand alternative natural therapies. This study aimed to review the natural products application in cancer patients who experience RD.‎ A search of studies published from 1990 to ‎‎2020 in the ‎databases including PubMed, Scopus, and Google Scholar was performed with the keywords relevant to “Radiotherapy” “Dermatitis” and “Natural Products”. Out of 73 papers obtained, 40 papers were excluded which described only protocols or were non-clinical, non-English language, or without full text. The obtained studies were ‎discussed in detail according to the outcomes and potential mechanisms of action for each natural ‎product.‎ Clinically studied natural products were found to show several outcomes from non-effective to effective in diminishing various items of RD. Outcomes on the effectiveness of Aloe vera were diverse. Some trials suggest that Silybum marianum, Boswellia, Nigella sativa, olive oil, Lianbai, and Hypericum perforatum as well as some multi-ingredient products might be effective prophylactic treatments for RD. Potential mechanisms of these natural products included topical hydrating, anti-inflammatory, antioxidant, and wound ‎healing activities. Results from this review shows that there are some promising natural product options for the prevention and treatment of RD via their multifactorial bioactivities. However, additional research is needed before any definitive conclusions. A larger sample size, optimum doses and duration of intervention as well as investigation of treatment effects in diverse populations and comorbid complications would also be essential in future studies.