Severe Skin Toxicity During Whole-Brain Radiotherapy, Targeted Therapy, and Additional Drug Intake Including St. John's Wort Skin Oil

    January 2021 in “ Strahlentherapie und Onkologie ”
    Tanja Eichkorn, Fabian Schunn, Sebastian Regnery, Rami A. El Shafie, Juliane Hörner‐Rieber, Sebastian Adeberg, Klaus Herfarth, Jürgen Debus, Laila König
    TLDR St. John's wort skin oil may increase skin damage risk during radiotherapy.
    A case report highlighted the potential interaction between St. John's wort skin oil and radiotherapy in a 63-year-old female patient with stage IV non-small cell lung cancer (NSCLC). The patient, undergoing whole-brain radiotherapy and bone irradiation, developed severe folliculitis capitis after using the herbal oil on her scalp. This reaction occurred despite similar radiation doses to other body areas, where no skin issues were observed. The condition improved after discontinuing the oil and administering antibiotics, suggesting that St. John's wort may act as a radiosensitizer, increasing skin toxicity risk during photon radiotherapy. This finding was significant as St. John's wort is commonly used by cancer patients for its antidepressant and pain-relieving properties, yet literature on its interaction with radiotherapy was scarce.
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