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Updated: Jan 27, 2026

Diffuse Optical Spectroscopy for the Quantitative Assessment of Acute Ionizing Radiation Induced Skin Toxicity Using a Mouse Model
Published on: May 27, 2016
Subdermal injection of hyaluronic acid to decrease skin toxicity from radiation delivered with low-dose-rate
Yuan Yuan1, Zhang Ying1, Dai Jianjian1
1Cancer Therapy and Research Center, Shandong Provincial Hospital affiliated to Shandong University, Shandong University, Jinan, P. R China.
Purpose:
To study the feasibility of hyaluronic acid (HA) injection to increase the distance between skin and radioactive sources, and dose reduction of skin during low-dose-rate (LDR) brachytherapy.Material and methods: A total of 11 patients with subdermal malignant tumors were enrolled in this study. HA was injected after I-125 seed implantation, and dosimetric parameters were calculated by a brachytherapy treatment planning system (BTPS). The distance of the new space between radioactive sources and skin was measured on computed tomography (CT) and magnetic resonance imaging (MRI). Clinical signs were observed and followed up for every patient.
Results:
After HA injection, the average of newly generated maximum distance was 1.0 cm along the entire length of the tumor. The D90 and V100 did not significantly change for tumors before or after injection (p = 0.39, p = 0.50, respectively). The maximum dose to a relatively small volume (0.1 cc) of the skin (OAR-Max) decreased from 100.66 Gy to 61.20 Gy (p < 0.05), and the mean skin dose (OAR-Mean) decreased from 49.20 Gy to 17.27 Gy (p < 0.05) after injection. On follow-up CT and MRI, HA was quite stable in shape and position for nearly 6 months.
Conclusions:
Our study results showed that an additional 1.0 cm distance between the radioactive source and skin could be induced by HA injection in patients with subdermal tumor, and this distance could significantly decrease the skin dose in LDR brachytherapy. In addition, no obvious toxicity and side effects were produced by HA injection. Therefore, hyaluronic acid injection is a safe and effective technique.
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