Effects of photobiomodulation in the physical therapy treatment for radiodermatitis in breast cancer patients
DOI:
https://doi.org/10.62827/fb.v26i1.1045Keywords:
Radiodermatitis; Low-Level Light Therapy; Breast Neoplasms.Abstract
Introduction: Radiotherapy (RT) is a widely utilized treatment in cancer management. However, one of the most frequent adverse effects of this procedure is radiodermatitis (RD), which can result in pain, reduced quality of life, and, in severe cases, discontinuation of RT. Photobiomodulation (PBM) has emerged as a promising therapeutic approach capable of aiding in the management of this oncological condition. Objective: To evaluate the regenerative potential of physiotherapeutic treatment with PBM regarding pain, degree and severity of radiodermatitis, and quality of life in patients with breast cancer. Methods: A quasi-experimental quantitative study involving 9 breast cancer patients with RD following radiotherapy. The PBM protocol employed a cluster device with red LED (658 nm), infrared LED (858 nm), and red laser (660 nm), simultaneously irradiated with an energy density of 4 J/cm². The devices were applied perpendicularly to the affected areas twice a week for 3 weeks, totaling 6 sessions. Pain was assessed using the Numeric Pain Rating Scale (NRS), RD was evaluated using the Radiation Therapy Oncology Group (RTOG) acute morbidity scoring criteria and the Radiation-Induced Skin Reaction Assessment Scale (RISRAS), and dermatological quality of life was measured using the Skindex-16 questionnaire. Results: There was a significant improvement with a reduction in pain (p = 0.018), degree (p = 0.046) and severity of radiodermatitis (p = 0.028), in addition to an increase in dermatological quality of life (p = 0.038). Conclusion: FBM demonstrated to be a promising strategy to treat radiodermatitis, promoting tissue regeneration and symptom relief. However, additional studies with a larger number of participants are necessary to validate the results obtained.
References
Brasil. Ministério da Saúde. INCA estima 704 mil casos de câncer por ano no Brasil até 2025 [Internet]. Disponível em: https://www.gov.br/inca/pt-br/assuntos/noticias/2022/inca-estima-704-mil-casos-de-cancer-por-ano-no-brasil-ate2025.
Allali S, Kirova Y. Radiodermatitis and Fibrosis in the Context of Breast Radiation Therapy: A Critical Review. Cancers (Basel). 2021;13(23):5928. doi: 10.3390/cancers13235928.
Bontempo PSM, Rodrigues MM, Maia GNL, Silva NCL, Gomes IP, Vasques CI, et al. Acute radiodermatitis in cancer patients: incidence and severity estimates. Rev Esc Enferm USP. 2021;55:e03676. doi: 10.1590/S1980-220X2019021703676.
Robijns J, Lodewijckx J, Mebis J. Photobiomodulation therapy for acute radiodermatitis. Curr Opin Oncol. 2019;31(4):291–8. doi: 10.1097/CCO.0000000000000511.
Censabella S, Claes S, Robijns J, Bulens P, Mebis J. Photobiomodulation for the management of radiation dermatitis: the DERMIS trial, a pilot study of MLS(®) laser therapy in breast cancer patients. Support Care Cancer. 2016;24(9):3925–33. doi: 10.1007/s00520-016-3232-0
Park J-H, Byun HJ, Lee JH, Kim H, Noh JM, Kim CR, et al. Feasibility of photobiomodulation therapy for the prevention of radiodermatitis: a single-institution pilot study. Lasers Med Sci. 2020;35(5):1119–27. doi: 10.1007/s10103-019-02930-1.
Robijns J, Censabella S, Claes S, Pannekoeke L, Bussé L, Colson D, et al. Biophysical skin measurements to evaluate the effectiveness of photobiomodulation therapy in the prevention of acute radiation dermatitis in breast cancer patients. Support Care Cancer. 2019;27(4):1245–54. doi: 10.1007/s00520-018-4487-4.
Robijns J, Lodewijckx J, Claes S, Van Bever L, Pannekoeke L, Censabella S, et al. Photobiomodulation therapy for the prevention of acute radiation dermatitis in head and neck cancer patients (DERMISHEAD trial). Radiother Oncol. 2021;158:268–75. doi: 10.1016/j.radonc.2021.03.002.
Strouthos I, Chatzikonstantinou G, Tselis N, Bon D, Karagiannis E, Zoga E, et al. Photobiomodulation therapy for the management of radiation-induced dermatitis. Strahlenther Onkol. 2017;193(6):491–8. doi: 10.1007/s00066-017-1117-x.
Pivetta HMF, et al. Atenção fisioterapêutica à mulher climatérica: aspectos de incontinência urinária e oncologia mamária. Santa Maria (RS): Universidade Federal de Santa Maria; 2014. 71 p.
Nugent SM, Lovejoy TI, Shull S, Dobscha SK, Morasco BJ. Associations of pain numeric rating scale scores collected during usual care with research administered patient reported pain outcomes. Pain Med. 2021;22(10):2235–41. doi: 10.1093/pm/pnab110.
Ramos Rocha S, da Costa Ferreira SA, Ramalho A, Conceição Gouveia Santos VL, Cristina Nogueira P. Photobiomodulation Therapy in the Prevention and Treatment of Radiodermatitis in Breast Cancer Patients: Systematic Review. J Lasers Med Sci. 2022;13:e42. doi: 10.34172/jlms.2022.42.
Noble-Adams R. Radiation-induced skin reactions. 2: Development of a measurement tool. Br J Nurs. 1999;8(18):1208–11. doi: 10.12968/bjon.1999.8.18.6490.
Cárcano CBM, de Oliveira CZ, Paiva BSR, Paiva CE. The Brazilian version of Skindex16 is a valid and reliable instrument to assess the health-related quality of life of patients with skin diseases. PLoS One. 2018;13(3):e0194492. doi: 10.1371/journal.pone.0194492.
Aguiar BRL, Guerra ENS, Normando AGC, Martins CC, Reis PEDD, Ferreira EB. Effectiveness of photobiomodulation therapy in radiation dermatitis: A systematic review and meta-analysis. Crit Rev Oncol Hematol. 2021;162:103349. doi: 10.1016/j.critrevonc.2021.
Zhang WW, Wang XY, Chu YX, Wang YQ. Light-emitting diode phototherapy: pain relief and underlying mechanisms. Lasers Med Sci. 2022;37(5):2343–52. doi: 10.1007/s10103-022-03540-0.
Hali F, El Kissouni A, Chiheb S, Charkaoui M, Berreda Y, Benchakroune N, Sahraoui S. Light-emitting diode therapy for the management of radiodermatitis. Our Dermatol Online. 2023;14(2):127–30. doi: 10.7241/ourd.20232.2.
Schlosser A, Maestri E, Cristina de Oliveira M, Frizon G, Felipette Lima J, Santos Candido TF, et al. Fotomodulação no processo de cicatrização de queimaduras: uma revisão integrativa. Sci Electronic Arch. 2023;16(11). doi: 10.36560/161120231810.
Cavalcante LG, Domingues RAR, Junior BO, Fernandes MAR, Pessoa EC, Abbade LPF. Incidence of radiodermatitis and factors associated with its severity in women with breast cancer: a cohort study. An Bras Dermatol. 2024;99(1):57–65. doi: 10.1016/j.abd.2023.01.004.
Vieira LAC, Menêses AG, Bontempo PSM, Simino GPR, Ferreira EB, Guerra ENDS, Reis PEDD. Incidence of radiodermatitis in breast cancer patients during hypofractionated radiotherapy. Rev Esc Enferm USP. 2022;56:e20220173. doi:10.1590/1980-220X-REEUSP-2022-0173en.
Anoop TM, Joseph PR, Pn M, Kp P, Gopan G, Chacko S. Cutaneous Toxicities in Breast Cancer Patients Receiving Chemotherapy and Targeted Agents--An Observational Clinical Study. Clin Breast Cancer. 2021;21(4):e434–47. doi: 10.1016/j.clbc.2021.01.009.
Seité S, Bensadoun RJ, Mazer JM. Prevention and treatment of acute and chronic radiodermatitis. Breast Cancer (Dove Med Press). 2017;9:551–7. doi: 10.2147/BCTT.S149752.
McDermott PN. Surface dose and acute skin reactions in external beam breast radiotherapy. Med Dosim. 2020;45(2):153–8. doi: 10.1016/j.meddos.2019.09.001.
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