Use of LED in the prevention of radiodermatitis in breast cancer: a randomized clinical trial
DOI:
https://doi.org/10.55892/jrg.v8i19.2356Keywords:
Breast Cancer, Radiotherapy, Radiodermatitis, Low-Intensity TherapyAbstract
INTRODUCTION: Radiotherapy is a common treatment for breast cancer, but one of its frequent adverse effects is radiodermatitis, a skin toxicity. Photobiomodulation (PBM) has been proposed as an approach to prevent or minimize these changes in irradiated skin by acting on inflammatory processes. OBJECTIVE: To evaluate the applicability of PBM through LED therapy in preventing radiodermatitis in breast cancer compared to standard local care. METHODS: This is a single-blind, randomized clinical trial conducted with women diagnosed with breast cancer and undergoing three-dimensional conformal radiotherapy (3D-CRT) between March and September 2024 at the Radiotherapy Outpatient Clinic of Hospital de Base IGESDF. Participants were divided into two groups: (1) Control Group, which received standard skin care with the device turned off, and (2) PBM Group, treated with LED panels applied to the breast and axillary regions at a dose of 4.8 Joules for 10 minutes, twice a week after radiotherapy. RESULTS: The results showed that 16 patients were included (control = 9 and treatment = 7). Radiodermatitis in the breast area was less frequent in the PBM group compared to the control group (12.6% vs. 50% - p=0.015). CONCLUSION: These data suggest that photobiomodulation may be effective in preventing acute radiodermatitis in breast cancer patients, and further research is needed to confirm these findings.
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References
Arnold, M., Leitzmann, M., Freisling, H., Bray, F., Romieu, I., Renehan, A., et al. (2016). Obesity and cancer: An update of the global impact. Cancer Epidemiology, 41, 8–15.
Bensadoun, R.-J. (2018). Photobiomodulation or low-level laser therapy in the management of cancer therapy-induced mucositis, dermatitis and lymphedema. Current Opinion in Oncology, 30, 226–232.
Brewer, H. R., Jones, M. E., Schoemaker, M. J., Ashworth, A., & Swerdlow, A. J. (2017). Family history and risk of breast cancer: An analysis accounting for family structure. Breast Cancer Research and Treatment, 165(1), 193–200.
Censabella, S., Claes, S., Robijns, J., Bulens, P., & Mebis, J. (2016). Photobiomodulation for the management of radiation dermatitis: The DERMIS trial, a pilot study of MLS® laser therapy in breast cancer patients. Supportive Care in Cancer, 24(9), 3925–3933.
Costa, L. D., Rett, M. T., Mendonça, A. C. R., Silva Junior, W. M. da, & Santana, J. M. de. (2012). Comparação da qualidade de vida após a cirurgia para câncer de mama associada ou não à radioterapia adjuvante. Revista Brasileira de Qualidade de Vida, 4(1).
Cox, J. D., Stetz, J., & Pajak, T. F. (1995). Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). International Journal of Radiation Oncology, Biology, Physics.
DeLand, M. M., Weiss, R. A., McDaniel, D. H., & Geronemus, R. G. (2007). Treatment of radiation-induced dermatitis with light-emitting diode (LED) photomodulation. Lasers in Surgery and Medicine, 39(2), 164–168.
Drumond, A. S. (2006). Exploração do Disabilities of the Arm, Shoulder and Hand (DASH) através da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) e da análise Rasch [Dissertação de mestrado, Universidade Federal de Minas Gerais]. Escola de Educação Física, Fisioterapia e Terapia Ocupacional, UFMG.
Fife, D., Rayhan, D. J., Behnam, S., Ortiz, A., Elkeeb, L., Aquino, L., et al. (2010). A randomized, controlled, double-blind study of light-emitting diode photomodulation for the prevention of radiation dermatitis in patients with breast cancer. Dermatologic Surgery, 36(12), 1921–1927.
Fischer-Sgrott, F. de O. (2022). Fotobiomodulação na radiodermite no câncer de mama. São Paulo.
Instituto Nacional de Câncer José Alencar Gomes da Silva. (2022). Estimativa 2023: Incidência de câncer no Brasil. INCA. Recuperado em 5 de maio de 2023, de https://www.gov.br/inca/pt-br/assuntos/cancer/numeros/estimativa
Kolak, A., Kamińska, M., Sygit, K., Budny, A, Surdyka, D., Kukiełka-Budny, B., et al. (2017). Primary and secondary prevention of breast cancer. Annals of Agricultural and Environmental Medicine, 24(4), 549–553.
Kraus-Tiefenbacher, U., Sfintizky, A., Welzel, G., Simeonova, A., Sperk, E., Siebenlist, K., et al. (2012). Factors of influence on acute skin toxicity of breast cancer patients treated with standard three-dimensional conformal radiotherapy (3D-CRT) after breast-conserving surgery (BCS). Radiation Oncology, 7, 217. http://www.ro-journal.com/content/7/1/217
Lauby-Secretan, B., Scoccianti, C., Loomis, D., Grosse, Y., Bianchini, F., & Straif, K. (2016). Body fatness and cancer—Viewpoint of the IARC Working Group. The New England Journal of Medicine, 375(8), 794–798.
Leventhal, J. B., & Young, M. R. (2017). Radiation dermatitis: Recognition, prevention, and management. Cancer Network. https://www.cancernetwork.com/view/radiation-dermatitis-recognition-prevention-and-management
Malta, D. C., & Silva Junior, J. B. da. (2014). Plano de ações estratégicas para o enfrentamento das doenças crônicas não transmissíveis no Brasil após três anos de implantação, 2011–2013. Epidemiologia e Serviços de Saúde, 23(3), 389–398.
Nações Unidas. (2022). Mês da conscientização do câncer de mama alerta para prevenção. ONU News. Recuperado em 10 de dezembro de 2024, de https://news.un.org/pt/story/2022/10/1804227
Orfale, A. G., Araújo, P. M. P., Ferraz, M. B., & Natour, J. (2005). Translation into Brazilian Portuguese, cultural adaptation and evaluation of the reliability of the Disabilities of the Arm, Shoulder and Hand Questionnaire. Brazilian Journal of Medical and Biological Research, 38.
Robijns, J., Censabella, S., Claes, S., Pannekoeke, L., Bussé, L., Colson, D., et al. (2018). Prevention of acute radiodermatitis by photobiomodulation: A randomized, placebo-controlled trial in breast cancer patients (TRANSDERMIS trial). Lasers in Surgery and Medicine, 50(7), 763–771.
Robijns, J., Censabella, S., Claes, S., Van Bever, L., Pannekoeke, L., Censabella, S., et al. (2019). Biophysical skin measurements to evaluate the effectiveness of photobiomodulation therapy in the prevention of acute radiation dermatitis in breast cancer patients. Supportive Care in Cancer, 27(4), 1245–1254.
Robijns, J., Lodewijckx, J., Bensadoun, R.-J., & Mebis, J. (2020). A narrative review on the use of photobiomodulation therapy for the prevention and management of acute radiodermatitis: Proposed mechanisms, current clinical outcomes, and preliminary guidance for clinical studies. Photobiomodulation, Photomedicine, and Laser Surgery, 38, 332–339.
Robijns, J., Lodewijckx, J., Claes, S., Van Bever, L., Pannekoeke, L., Censabella, S., et al. (2021). Photobiomodulation therapy for the prevention of acute radiation dermatitis in head and neck cancer patients (DERMISHEAD trial). Radiotherapy and Oncology, 158, 268–275.
Sun, Y.-S., Zhao, Z., Yang, Z.-N., Xu, F., Lu, H.-J., Zhu, Z.-Y., et al. (2017). Risk factors and preventions of breast cancer. International Journal of Biological Sciences, 13, 1387–1397.
Vieira, R. A. C., Silva, F. C. B., Biller, G., Silva, J. J., Paiva, C. E., & Sarri, A. J. (2016). Instrumentos de avaliação quantitativa e qualitativa das sequelas relacionadas ao tratamento do câncer de mama. Revista Brasileira de Mastologia, 26(3), 126–132. http://www.rbmastologia.com.br/wp-content/uploads/2016/06/MAS_v26n3_126-132.pdf
Wright, J. L., Takita, C., Reis, I. M., Zhao, W., Lee, E., Nelson, O. L., et al. (2016). Prospective evaluation of radiation-induced skin toxicity in a race/ethnically diverse breast cancer population. Cancer Medicine, 5(3), 454–464.
