ABSTRACT
The chapter provides a comprehensive review of available models for prediction of the risk for skin side effects. The two main layers of the skin are the epidermis, which is the outer shell, and the dermis, the inner one. The subcutaneous tissue contains predominantly fat cells, but also a network of arteries, veins, and lymphatics. The chapter reviews the models currently available for the estimation of Normal Tissue Complication Probability for adverse skin reactions and propose new dose response models based on published data on the incidence of adverse skin effects on patients treated with megavoltage photon radiation therapy for breast cancer. Radiation reactions in the skin can be divided into early or acute changes and delayed or chronic changes. The skin is the most studied organ in terms of response to radiation, as the risk for acute side effects and its dependence on fractionation schedule, overall treatment time, and irradiated surface/volume are well established.
