HIGH-DOSE oral vitamin D may offer a safe, rapid treatment option for chemotherapy- and radiation-induced skin toxicities, according to a multicentre study.
Researchers evaluated 33 patients treated for toxic erythema of chemotherapy (TEC) or acute radiation dermatitis (ARD) at three academic medical centres between December 2021 and January 2024. Participants received one or two oral doses of 100,000 IU of cholecalciferol or ergocalciferol and were followed for at least 10 days.
Among the study population, 28 patients had TEC and five had ARD. Overall, 26 of 30 evaluable patients (87%) reported symptom relief within 10 days of treatment. The median time to improvement was five days, falling to three days among hospitalised patients. Clinician-assessed erythema also improved substantially, with mean Likert scores decreasing from 4.36 at baseline to 2.21 by day 10.
Safety Profile Supports Further Investigation
The most rapid responses were observed in patients with neutrophilic eccrine hidradenitis and Stevens–Johnson syndrome/toxic epidermal necrolysis-like presentations. Importantly, investigators reported no treatment-related adverse events and no clinically meaningful changes in serum calcium levels following high-dose vitamin D administration, addressing a key safety concern associated with vitamin D therapy.
Treatment continuity was another notable finding. Nearly three-quarters of patients (73%) were able to continue their anticancer therapy without interruption after receiving vitamin D, suggesting the intervention could help minimise disruptions caused by severe cutaneous adverse effects.
Although chemotherapy- and radiation-related skin toxicities can significantly impair quality of life and necessitate treatment delays, effective therapeutic options remain limited. The authors note that high-dose vitamin D has previously demonstrated immunomodulatory effects in preclinical studies and small clinical investigations, but evidence in oncology populations has been scarce.
Clinical Potential Requires Further Validation
While the retrospective design and small sample size limit definitive conclusions, the findings suggest that high-dose oral vitamin D may represent a promising supportive care strategy for managing TEC and ARD. Larger prospective, controlled studies are now warranted to confirm its efficacy, establish optimal dosing, and further evaluate long-term safety in patients undergoing cancer treatment.
Reference
Patil MK et al. High-dose oral vitamin D for toxic effects of the skin associated with chemotherapy and radiation. JAMA Dermatol. 2026;DOI: 10.1001/jamadermatol.2026.2267.
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