BOSTON — A light-based therapy commonly used in cosmetic dermatology minimizes the occurrence and symptom intensity of radiation-induced dermatitis in breast cancer patients undergoing radiation treatment, according to the results of a recent investigation. The preventive therapy not only minimizes patient discomfort, but also prevents treatment interruptions necessitated by severe skin reactions, said Dr. M. Maitland DeLand at the annual meeting of the American Society for Laser Medicine and Surgery.
Postradiation dermatitis can include reactions ranging from mild to moderate dryness and peeling to significant erythema, hyperemia, and moist desquamation with loss of epidermal barrier, said Dr. DeLand, a radiation oncologist in Lafayette, La. The investigators hypothesized that targeting these areas with pulses of nonthermal low-energy light via arrays of light-emitting diodes (LED) would interrupt the postradiation inflammatory process and stimulate collagen synthesis, and by so doing strengthen the skin's defenses, she said.
In the pilot study, 18 of 19 women who received LED photomodulation therapy following radiotherapy for breast cancer had little to no radiation dermatitis, whereas all 28 matched controls who did not receive the light therapy had some degree of skin reaction, Dr. DeLand said.
The women in the study were 35–80 years old. Prior to radiation therapy, all had undergone single lymph node sampling or axillary dissection; some had chemotherapy. The women in the photomodulation group received the LED treatment immediately after their daily radiation therapy, and were allowed to use a neutral pH ointment for dry skin after each session. The women in the control group followed the same radiation therapy protocol without the LED follow-up, and were also allowed to use the ointment.
Of the 19 women in the treatment group, 7 had no skin reactions, 11 had grade 1 reactions, and 1 patient had a grade 2 reaction. In contrast, 4 of the control patients had grade 1 reactions, 18 had grade 2 reactions, and 6 had grade 3 reactions. In the control group, the skin reactions—specifically severe erythema and moist desquamation—led to treatment interruptions in 19 patients.
“Only one patient in the [treatment group] had a reaction severe enough to interrupt therapy,” Dr. DeLand said. “This is an important finding, because the efficacy of radiation therapy is based on a dose/time relationship. You really want to avoid treatment disruptions” to achieve the best biologic response, she said.
The LED therapy also appeared to provide long-lasting skin benefits. At 3 and 6 months post therapy, the skin texture and pigment of irradiated areas in the women in the treatment group were “excellent,” the breast tissue was smooth and supple, and the surgical scars were “barely visible,” Dr. DeLand said. In contrast, the women in the control group showed typical signs of late radiation effects, including some atrophy and pigmentary changes and, in some cases, radiation-induced fibrosis, edema, and dermal thickening.
LED therapy should be made available to all women undergoing breast irradiation, Dr. DeLand concluded.
Dr. DeLand reported that she received free use of the photomodulation device for the investigation but has no financial interest in the manufacturer.