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In fact, incorporation of brachytherapy remains one of the most robust independent predictors of long-term survival, with reported local control rates exceeding 8090% in many series when combined with concurrent chemoradiation [92, 93]

Minelli C, Granell R, Newson R, et al

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Glutathione exerts its hypopigmentary effect by several mechanisms namely direct (by binding with the copper-containing active sites) and indirect (via antioxidant effect leading to exhaustion of free radicals and peroxides) inhibition of tyrosinase enzyme (the key enzyme for melanogenesis).[] It also switches the production of eumelanin to pheomelanin by the formation of sulfhydryl-dopa conjugates.[] Additionally glutathione has been shown to scavenge UV radiation-induced reactive oxygen species generated in epidermal cells.[] Its antioxidative action also helps to lighten melasma, as several studies have confirmed the role of oxidative stress in melasma.[] Glutathione may be used orally (2040 mg/kg/day in two divided doses) or intravenously (6001200 mg)