Skip to main content
Top
Published in: Trials 1/2014

Open Access 01-12-2014 | Study protocol

Phototherapy 660 nm for the prevention of radiodermatitis in breast cancer patients receiving radiation therapy: study protocol for a randomized controlled trial

Authors: Marina Moreira Costa, Sidney Benedito Silva, Ana Luiza Pereira Quinto, Priscilla Furtado Souza Pasquinelli, Vanessa de Queiroz dos Santos, Gabriela de Cássia Santos, Daniela Francescato Veiga

Published in: Trials | Issue 1/2014

Login to get access

Abstract

Background

Breast neoplasms are the second most common type of cancer worldwide, and radiation therapy is a key component of their treatment. Acute skin reactions are one of the most common side effects of radiation therapy, and prevention of this adverse event has been investigated in several studies. However, a clinically applicable, preventative treatment remains unavailable. It has been demonstrated that application of a low-power laser can promote tissue repair. Therefore, the aim of this trial is to evaluate the effectiveness of an indium gallium aluminum phosphorus (InGaAIP) laser operated at 660 nm in preventing radiodermatitis in women undergoing adjuvant radiotherapy for breast cancer.

Methods/Design

This is a two-arm, randomized controlled trial. A total of 52 patients undergoing radiotherapy for breast cancer (stages I to III) will be enrolled. Patients will be randomly assigned to an intervention group to receive laser therapy (n = 26) or a control group to receive a placebo (n = 26). The laser or placebo will be applied five days a week, immediately before each radiotherapy session. Skin reactions will then be graded weekly by a nurse, a radiotherapist, and an oncologist (all of whom will be blinded) using the Common Toxicity Criteria (CTC) developed by the National Cancer Institute and the Acute Radiation Morbidity Scoring Criteria developed by the Radiation Therapy Oncology Group. Patients will also answer a modified visual analogue scale for pain (a self-evaluation questionnaire). Primary and secondary outcomes will be the prevention of radiodermatitis and pain secondary to radiodermatitis, respectively.

Discussion

The ideal tool for preventing radiodermatitis is an agent that mediates DNA repair or promotes cell proliferation. Application of a low-power laser has been shown to promote tissue repair by reducing inflammation and inducing collagen synthesis. Moreover, this treatment approach has not been associated with adverse events and is cost-effective. Thus, the results of this ongoing trial may establish whether use of a low-power laser represents an ideal treatment option for the prevention of radiodermatitis.

Trial registration

ClinicalTrials.gov identifier: NCT02003599. Registered on 2 December 2013.
Appendix
Available only for authorised users
Literature
1.
go back to reference Aistars J: The validity of skin care protocols followed by women with breast cancer receiving external radiation. Clin J Oncol Nurs. 2006, 10: 487-492.CrossRefPubMed Aistars J: The validity of skin care protocols followed by women with breast cancer receiving external radiation. Clin J Oncol Nurs. 2006, 10: 487-492.CrossRefPubMed
2.
go back to reference Pommier P, Gomez F, Sunyach MP, D’Hombres A, Carrie C, Montbarbon X: Phase III randomized trial of Calendula oficcinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol. 2004, 22: 1447-1453.CrossRefPubMed Pommier P, Gomez F, Sunyach MP, D’Hombres A, Carrie C, Montbarbon X: Phase III randomized trial of Calendula oficcinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol. 2004, 22: 1447-1453.CrossRefPubMed
3.
go back to reference Zhang Y, Zhang S, Shao X: Topical agent therapy for prevention and treatment of radiodermatitis: a meta-analysis. Support Care Cancer. 2013, 21: 1025-1031.CrossRefPubMed Zhang Y, Zhang S, Shao X: Topical agent therapy for prevention and treatment of radiodermatitis: a meta-analysis. Support Care Cancer. 2013, 21: 1025-1031.CrossRefPubMed
4.
go back to reference Perez CA, Brady LW: Principles and Practice of Radiation Oncology. 2008, Philadelphia: Lippincott-Raven Press, 5 Perez CA, Brady LW: Principles and Practice of Radiation Oncology. 2008, Philadelphia: Lippincott-Raven Press, 5
6.
go back to reference Porock D, Kristjanson L, Nikoletti S, Cameron F, Pedler P: Predicting the severity of radiation skin reactions in women with breast cancer. Oncol Nurs Forum. 1998, 25: 1019-1029.PubMed Porock D, Kristjanson L, Nikoletti S, Cameron F, Pedler P: Predicting the severity of radiation skin reactions in women with breast cancer. Oncol Nurs Forum. 1998, 25: 1019-1029.PubMed
7.
go back to reference Bolderston A, Lloyd NS, Wong RK, Holden L, Robb-Blenderman L, Supportive Care Guidelines Group of Cancer Care Ontario Program in Evidence-Based Care: The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer. 2006, 14: 802-817.CrossRefPubMed Bolderston A, Lloyd NS, Wong RK, Holden L, Robb-Blenderman L, Supportive Care Guidelines Group of Cancer Care Ontario Program in Evidence-Based Care: The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer. 2006, 14: 802-817.CrossRefPubMed
8.
go back to reference Salvo N, Barnes E, van Draanen J, Stacey E, Mitera G, Breen D, Giotis A, Czarnota G, Pang J, De Angelis C: Prophylaxis and management of acute radiation- induced skin reactions: a systematic review of the literature. Curr Oncol. 2010, 17: 94-112.PubMedPubMedCentral Salvo N, Barnes E, van Draanen J, Stacey E, Mitera G, Breen D, Giotis A, Czarnota G, Pang J, De Angelis C: Prophylaxis and management of acute radiation- induced skin reactions: a systematic review of the literature. Curr Oncol. 2010, 17: 94-112.PubMedPubMedCentral
9.
go back to reference Dirier A, Akmansu M, Bora H, Gurer M: The effect of vitamin E on acute skin reaction caused by radiotherapy. Clin Exp Dermatol. 2007, 32: 571-573.CrossRefPubMed Dirier A, Akmansu M, Bora H, Gurer M: The effect of vitamin E on acute skin reaction caused by radiotherapy. Clin Exp Dermatol. 2007, 32: 571-573.CrossRefPubMed
10.
go back to reference Hawkins D, Abrahamse H: Effect of multiple exposures of low-level laser therapy on the cellular responses of wounded human fibroblasts. Photomed Laser Sur. 2006, 24: 705-714.CrossRef Hawkins D, Abrahamse H: Effect of multiple exposures of low-level laser therapy on the cellular responses of wounded human fibroblasts. Photomed Laser Sur. 2006, 24: 705-714.CrossRef
11.
go back to reference Rampini MP, Ferreira EMS, Ferreira CG, Antunes HS: Utilização da terapia com laser de baixa potência para prevenção de mucosite oral: revisão de literatura. Rev Bras Cancerologia. 2009, 55: 59-68. Rampini MP, Ferreira EMS, Ferreira CG, Antunes HS: Utilização da terapia com laser de baixa potência para prevenção de mucosite oral: revisão de literatura. Rev Bras Cancerologia. 2009, 55: 59-68.
12.
go back to reference Arun Maiya G, Sagar MS, Fernandes D: Effect of low level helium-neon (He-Ne) laser therapy in the prevention & treatment of radiation induced mucositis in head & neck cancer patients. Indian J Med Res. 2006, 124: 339-402. Arun Maiya G, Sagar MS, Fernandes D: Effect of low level helium-neon (He-Ne) laser therapy in the prevention & treatment of radiation induced mucositis in head & neck cancer patients. Indian J Med Res. 2006, 124: 339-402.
13.
go back to reference Arora H, Pai KM, Maiya A, Vidyasagar MS, Rajeev A: Efficacy of He-Ne Laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients. Oral Surg Med Oral Pathol Radiol Endod. 2008, 105: 180-186.CrossRef Arora H, Pai KM, Maiya A, Vidyasagar MS, Rajeev A: Efficacy of He-Ne Laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients. Oral Surg Med Oral Pathol Radiol Endod. 2008, 105: 180-186.CrossRef
14.
go back to reference Bensadoun RJ, Nair RG: Low-level laser therapy in the prevention and treatment of cancer therapy-induced mucositis: 2012 state of the art based on literature review and meta-analysis. Curr Opin Oncol. 2012, 24: 363-370.CrossRefPubMed Bensadoun RJ, Nair RG: Low-level laser therapy in the prevention and treatment of cancer therapy-induced mucositis: 2012 state of the art based on literature review and meta-analysis. Curr Opin Oncol. 2012, 24: 363-370.CrossRefPubMed
15.
go back to reference Bjordal JM, Bensadoun RJ, Tunèr J, Frigo L, Gierde K, Lopes-Martins RA: A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis. Support Care Cancer. 2011, 19: 1069-1077.CrossRefPubMed Bjordal JM, Bensadoun RJ, Tunèr J, Frigo L, Gierde K, Lopes-Martins RA: A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis. Support Care Cancer. 2011, 19: 1069-1077.CrossRefPubMed
16.
go back to reference Zimin AA, Samoilova KA, Zhevago NA: Proliferation of normal and tumor cells in presence of sérum of patients with breast carcinoma after phototherapy with visible and near infrared light. Cell Tissue Biol. 2010, 52: 785-792. Zimin AA, Samoilova KA, Zhevago NA: Proliferation of normal and tumor cells in presence of sérum of patients with breast carcinoma after phototherapy with visible and near infrared light. Cell Tissue Biol. 2010, 52: 785-792.
17.
go back to reference Omar MT, Shaheen AA, Zafar H: A systematic review of the effect of low- level laser therapy in the management of breast cancer-related lymphedema. Support Care Cancer. 2012, 20: 2977-2984.CrossRefPubMed Omar MT, Shaheen AA, Zafar H: A systematic review of the effect of low- level laser therapy in the management of breast cancer-related lymphedema. Support Care Cancer. 2012, 20: 2977-2984.CrossRefPubMed
18.
go back to reference Dirican A, Andacoglu O, Johnson R, McGuire K, Mager L, Soran A: The short-term effects of low-level laser therapy in the management of breast-cancer-related lymphedema. Support Care Cancer. 2011, 19: 685-690.CrossRefPubMed Dirican A, Andacoglu O, Johnson R, McGuire K, Mager L, Soran A: The short-term effects of low-level laser therapy in the management of breast-cancer-related lymphedema. Support Care Cancer. 2011, 19: 685-690.CrossRefPubMed
19.
go back to reference Lau RW, Cheing GL: Managing postmastectomy lymphedema with low-level laser therapy. Photomed Laser Surg. 2009, 27: 763-769.CrossRefPubMed Lau RW, Cheing GL: Managing postmastectomy lymphedema with low-level laser therapy. Photomed Laser Surg. 2009, 27: 763-769.CrossRefPubMed
20.
go back to reference Carati CJ, Anderson SN, Gannon BJ, Piller NB: Treatment of postmastectomy lymphedema with low-level laser therapy: a double blind, placebo-controlled trial. Cancer. 2003, 98: 1114-1122.CrossRefPubMed Carati CJ, Anderson SN, Gannon BJ, Piller NB: Treatment of postmastectomy lymphedema with low-level laser therapy: a double blind, placebo-controlled trial. Cancer. 2003, 98: 1114-1122.CrossRefPubMed
21.
go back to reference DeLand MM, Weiss RA, McDaniel DH, Geronemus RG: Treatment of radiation-induced dermatitis with light-emitting diode (LED) photomodulation. Lasers Surg Med. 2007, 39: 164-168.CrossRefPubMed DeLand MM, Weiss RA, McDaniel DH, Geronemus RG: Treatment of radiation-induced dermatitis with light-emitting diode (LED) photomodulation. Lasers Surg Med. 2007, 39: 164-168.CrossRefPubMed
22.
go back to reference Bensadoun RJ, Franquin JC, Ciais G, Darcour V, Schubert MM, Viot M, Dejou J, Tardieu C, Benezery K, Nguyen TD, Laudoyer Y, Dassonville O, Poissonnet G, Vallicioni J, Thyss A, Hamdi M, Chauvel P, Demard F: Low energy He/Ne laser in the prevention of radiation-induced mucositis: a multicenter phase III randomized study in patients with head and neck cancer. Support Care Cancer. 1999, 7: 244-252.CrossRefPubMed Bensadoun RJ, Franquin JC, Ciais G, Darcour V, Schubert MM, Viot M, Dejou J, Tardieu C, Benezery K, Nguyen TD, Laudoyer Y, Dassonville O, Poissonnet G, Vallicioni J, Thyss A, Hamdi M, Chauvel P, Demard F: Low energy He/Ne laser in the prevention of radiation-induced mucositis: a multicenter phase III randomized study in patients with head and neck cancer. Support Care Cancer. 1999, 7: 244-252.CrossRefPubMed
23.
go back to reference Ferraz MB, Quaresma MR, Aquino LR, Atra E, Tugwell P, Goldsmith CH: Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol. 1990, 17: 1022-1024.PubMed Ferraz MB, Quaresma MR, Aquino LR, Atra E, Tugwell P, Goldsmith CH: Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol. 1990, 17: 1022-1024.PubMed
26.
go back to reference Benomar S, Boutayeb S, Laiva I, Errihani H, Hassam B, El Gueddari BK: Treatment and prevention of acute radiation dermatitis. Cancer Radiother. 2010, 14: 213-216.CrossRefPubMed Benomar S, Boutayeb S, Laiva I, Errihani H, Hassam B, El Gueddari BK: Treatment and prevention of acute radiation dermatitis. Cancer Radiother. 2010, 14: 213-216.CrossRefPubMed
Metadata
Title
Phototherapy 660 nm for the prevention of radiodermatitis in breast cancer patients receiving radiation therapy: study protocol for a randomized controlled trial
Authors
Marina Moreira Costa
Sidney Benedito Silva
Ana Luiza Pereira Quinto
Priscilla Furtado Souza Pasquinelli
Vanessa de Queiroz dos Santos
Gabriela de Cássia Santos
Daniela Francescato Veiga
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Trials / Issue 1/2014
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-15-330

Other articles of this Issue 1/2014

Trials 1/2014 Go to the issue