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Objective: To determine the protective efficacy of vitamin B12 combined with far-infrared radiation on radiation-induced skin damage in the treatment of acute and chronic pelvic tumours. Methods: One hundred patients requiring radiation therapy were randomly assigned to one of two groups: 50 patients were assigned to the control group and received usual care; the 50 patients assigned to the experimental group were, in addition to usual care, given vitamin B12 (0.25 mg/mL) injections to radiation-sensitive perineal skin and subsequently treated with far-infrared radiation beginning the first day of radiotherapy. Far-infrared radiation treatment was performed at a light distance of 40 cm at a temperature of 28°C to 32°C for 25 min twice per day. Results: The incidence of acute skin reactions in the two groups was statistically different (P<0.05). The incidences of grades I, II, III and IV radiation-induced skin damage in the experimental group were 60.0%, 30.0%, 10.0% and 0%, respectively; in contrast, the incidences in the control group were 26.0%, 54.0%, 18.0% and 2.0%, respectively. Grades II to IV skin reactions in the experimental group were remarkably less severe than those of the control group. When a radiation treatment dose of <40 Gy was used, the incidences of acute radiation-induced dermatitis in the control and experimental groups were 66% and 34%, respectively (P<0.05). Conclusion: Vitamin B12 combined with far-infrared radiation had a markedly protective effect on acute radiation-induced skin damage in the treament of pelvic cancers. Moreover, the treatment improved patient quality of life and was clinically valuable.