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Supportive Care in Cancer

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01-09-2016 | Original Article

Photobiomodulation for the management of radiation dermatitis: the DERMIS trial, a pilot study of MLS^® laser therapy in breast cancer patients

Authors: Sandrine Censabella, Stefan Claes, Jolien Robijns, Paul Bulens, Jeroen Mebis

Published in: Supportive Care in Cancer | Issue 9/2016

Abstract

Purpose

The aim of this study was to assess the effectiveness and acceptability of photobiomodulation using MLS^® laser therapy (LT) in the management of acute radiation dermatitis (RD).

Methods

We compared two successive groups of breast cancer patients undergoing identical radiotherapy regimens post-lumpectomy. Both groups received our standard skin care but the second group received six additional LT sessions (beam area 19.635 cm², 0.168 W/cm², 4 J/cm²), starting at fraction 20 of radiotherapy (control and LT group, N = 41 and 38, respectively). The clinical outcomes were the severity of RD (using the Radiation Therapy Oncology Group [RTOG] criteria and the Radiotherapy-Induced Skin Reaction Assessment Scale [RISRAS]) and dermatology-specific quality of life (Skindex-16) before the start of LT and at the end of radiotherapy. Secondary outcomes were patients’ ratings of skin care or LT (pleasantness, soothing effect, and global satisfaction).

Results

Skin toxicity was equivalent between the groups before the start of LT but significantly differed at the end of radiotherapy, with an aggravation in the control but not in the LT group (e.g., 29 versus 3 % of RTOG grade 2 RD, respectively, P < 0.005). We found no significant group differences with respect to quality of life. However, the RISRAS subjective score decreased in the LT group only, implying a decreased impact of RD on patients’ quality of life. Finally, patients’ ratings were significantly higher for LT than for standard care.

Conclusions

These findings suggest that LT might be effective to manage acute RD and warrant further research.

Trial registration

Clinical trial number: NCT01932073. https://clinicaltrials.gov/ct2/show/NCT01932073.

The MLS^® combines a laser diode emitting at 808 nm in continuous mode with a laser emitting at 905 nm in pulsed mode. Continuous laser emissions act on inflammation, stimulates blood and lymphatic circulation, and induces fast re-absorption of fluid build-ups; while pulsed laser emissions have an immediate effect on pain, since they are able to induce analgesia interfering with the very transmission of the pain impulse to the higher brain centers. Thanks to this combination, these various therapeutic effects not only take place at the same time but also reciprocally reinforce each other, resulting in rapid physiological effects and symptoms relief. Moreover, both wavelengths fall into the so-called optical window where the effective tissue penetration of light is maximized [24]. LT using synchronized wavelengths of 808 and 905 nm will reach both the epidermal and dermal layers and will be able to stimulate the self-renewing property of the epidermis and the production of collagen tissue by the dermal fibroblasts.

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Title: Photobiomodulation for the management of radiation dermatitis: the DERMIS trial, a pilot study of MLS® laser therapy in breast cancer patients
Authors: Sandrine Censabella
Stefan Claes
Jolien Robijns
Paul Bulens
Jeroen Mebis
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 9/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-016-3232-0

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Abstract

Purpose

Methods

Results

Conclusions

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