Photobiomodulation therapy for the prevention of acute radiation dermatitis in head and neck cancer patients (DERMISHEAD trial)

Abstract

Background and purpose: The purpose of this study was to investigate the effectiveness of photobiomodulation therapy (PBMT) for the prevention of acute radiation dermatitis (ARD) in head and neck cancer (HNC) patients. Materials and methods: A randomised, placebo-controlled trial (RCT) with 46 HNC patients who underwent radiotherapy (RT) with or without concomitant chemotherapy was set up (DERMISHEAD trial). Patients were randomised to receive PBM or placebo treatments from the first day of RT (2Â/week) alongside the institutional skincare. The severity of skin reactions was assessed by the National Cancer Institute-Common Terminology Criteria for Adverse Events version 4.03 (NCI-CTCAE v4.03) and the Radiotherapy-Induced Skin Reaction Assessment Scale (RISRAS). Quality of life (QoL) was evaluated using the Skindex-16 questionnaire. Results: PBMT significantly reduced NCI-CTCAE grade 2-3 ARD with 49% at the end of RT. Conclusion:The results of the first RCT in HNC patients showed that PBMT is an effective method to prevent the development of severe ARD. These results support the implementation of PBM in the clinical oncology -radiotherapy practice.

Photobiomodulation as a treatment for dermatitis caused by chemoradiotherapy for squamous cell anal carcinoma: case report and literature review

“…Literature has shown effectiveness to mitigate radiodermatitis grade in breast cancer [28]. Robijins et al [29] demonstrated that PBM can prevent acute radiodermatitis in patients with breast cancer submitted to RT. Additionally, that study, demonstrated that 12% of the patients in the treatment group had radiodermatitis grade 2, while 44.4% of the patients in the control group had radiodermatitis grade 2 or greater grades, concluding that the severity of skin reactions were significantly less in the group which PBM was performed, which means that this is an effective tool for preventing acute radiodermatitis, thus improving the quality of life of the patients.…”

Photobiomodulation Therapy in the Prevention and Treatment of Radiodermatitis in Breast Cancer Patients: Systematic Review

“…40 A recent clinical trial (DERMISHEAD trial) performed with 46 participants with head and neck cancer patients undergoing RT, controlled by the application of a placebo laser, demonstrated a significant reduction in severe RD (RTOG ≥ 2) in the group receiving MLS® laser (25 W + 1.1 W, 808 + 905 nm, 168 mW/cm 2 , 4 J/cm 2 , twice a week). 41 There is a wide variation in the parameters of application and treatment; however, current evidence shows that PBMT in the red or near-infrared spectrum (630-905 nm) is safe and efficient in the management of various complications of oncological therapy and can be applied throughout radiotherapy and/or up to 30 days after. 22,26,42 A correct choice of dosimetry is crucial for the efficacy of this therapy and is determined by radiation parameters, which include the wavelength, power, fluence or energy density, and pulse structure, and treatment parameters, which include the dose or energy per point, time, treatment schedule, and anatomic site.…”

Deep Learning-Based Automatic Assessment of Radiation Dermatitis in Patients With Nasopharyngeal Carcinoma

“…The final output would be one of the four RD categories: Grade 0, Grade 1, Grade 2, and Above Grade 2. For further analysis and discussion, Grade 0 and Grade 1 were grouped as "mild" cases, and Grade 2 and above Grade 2 were grouped as "severe" cases 24 . According to the photo-taken directions, all images were divided into two subgroups, front view and side view (left and right views).…”