Low-level laser therapy as a tool for the management of radiodermatitis: a pilot study in breast cancer patients

Abstract

Introduction Radiodermatitis (RD) is a common and distressing side effect of radiotherapy. Objective Investigate the efficacy of low-level laser therapy (LLLT) as a treatment for RD in breast cancer patients. Methods For this prospective study two successive groups of breast cancer patients undergoing identical radiotherapy regime post-lumpectomy were compared. The control group (CTRL group, N=41) received the institutional skin care protocol, while the experimental group (LLLT group, N=38) was treated with this protocol plus biweekly with LLLT (6 sessions) starting at fraction 20 of radiotherapy. LLLT was delivered to the patients by a diode laser in the infrared range (808-905 nm) with a fixed energy density (4 J/cm2). There were no significant differences between the two groups with respect to patients’ and treatment-related characteristics. The severity of RD was evaluated by trained nurses before the start of LLLT and at the end of radiotherapy according to the criteria of the Radiation Therapy Oncology Group (RTOG). Additionally, the patients were asked to rate their global treatment satisfaction, through a numerical rating scale (0, “not at all” - 10, “very much”) at the end of radiotherapy.

Results Before the start of LLLT (i.e. at fraction 20) the distribution of the RTOG grades was comparable between both groups (p= 0.352), with most of the patients presenting RTOG grade 1. At the end of radiotherapy, the severity of RD significantly differed between the two groups (p= 0.002), with a greater proportion of patients with grade 2 RD in the control group (29.3% vs. 2.6%, for the control and LLLT group, resp.): There was an intensification of the skin reactions in the CTRL group (p= 0.004), while it remained stable (p= 0.222) in the LLLT group. Furthermore, the patients’ global satisfaction with LLLT was significantly higher than with the standard skin care (p= 0.001). Conclusion These results show that LLLT has a beneficial effect on RD by preventing the aggravation of the skin reactions. Moreover, the patients’ were more satisfied with LLLT than with the standard skin care. Further research is needed to investigate the efficacy of LLLT on the prevention and management of RD.