LED Photomodulation Reduces Skin Damage From Radiation Therapy in Breast Cancer Patients

Dr. Maitland DeLand, a radiation oncologist at LSU School of Medicine, New Orleans, and president of OncoLogics, Inc, in Lafayette, La, has found that following radiotherapy for breast cancer, exposing women to low-energy nonthermal light-emitting diode (LED) photomodulation can significantly reduce painful, treatment-interrupting skin reactions.

DeLand performed a study treating 19 breast cancer patients with radiation therapy followed by LED photomodulation and 28 with only radiation. Of the 19 women treated with LED photomodulation, 18 had mild or no dermatitis, while all 28 patients treated only with radiation had some degree of skin reaction. All of the women who participated in the study had stage I or II breast cancer and received intensity-modulated radiation therapy following a lumpectomy. Some had received chemotherapy prior to radiotherapy.

Reduces Treatment Interruptions

"Radiation dermatitis is an adverse condition that can affect regimen schedules," said Dr. DeLand. "Using LED photomodulation reduces the need for treatment interruptions allowing the patient to complete radiation in the most timely and effective way possible."

The 19 women who received daily radiation therapy followed by LED treatment, in which 100 pulses of light at 0.15 joules/cm² for 250 ms each are delivered to the irradiated breast, used only a dry skin ointment after their daily sessions. The 28 women who underwent the same radiation therapy protocol but had no LED photomodulation were also allowed to use a dry skin ointment. All patients had a weekly evaluation of the irradiated skin.

Dr. DeLand found that 7 of the women who had received LED photomodulation had no skin reactions, 11 had only mild (grade 1) reactions, and one had moderate (grade 2) radiation-induced dermatitis. In addition, none of the patients who underwent photomodulation experienced moist skin reactions, although one patient in this group had inflammation severe enough to require interruption of radiotherapy.

All 28 patients not receiving LED photomodulation had some type of skin reaction following radiation therapy: 4 had mild radiation dermatitis, 18 had moderate dermatitis, and 6 had serious skin reactions. Of these 28 patients, 19 required temporary interruption of treatment because of erythematous reactions and moist desquamation.

New Concept in Cancer Therapy

LED photomodulation is widely used in cosmetic dermatology for improving skin healing and appearance. The apparatus consists of light-emitting diodes in a specific array that emit a nonthermal, low-energy light at a pulsating frequency. Using photomodulation for skin repair with cancer patients is a new concept.

"The pulses stimulate at the cellular level skin cells such as fibroblasts to repair themselves to build up the collagen," explained Dr. DeLand. "After speaking with my dermatologist colleagues, I realized that the positive results they had with LED photomodulation could also be attained in treating my patients suffering with painful skin reactions from radiation therapy," she said.

"My patients have been through surgery and chemotherapy. If a taxane or an Adriamycin [doxorubicin]-based drug is used, it photosensitizes the skin. So, when I begin radiation, the skin reaction is typically worse. These moist skin reactions are extremely painful. Experimenting with LED photomodulation has allowed me to find a safe way to eliminate an extremely high level of discomfort for my patients," Dr. DeLand said.

Comparison at Follow-up

Six of the women in the LED treatment group were available for follow-up at 3 months, and five were available at 6 months posttherapy. In all of these patients, the surgical scar was barely visible, skin texture and pigment were excellent, and the breast tissue was smooth and supple, without dryness.

At 3 months after therapy, women who did not receive LED photomodulation had typical late radiation effects, including atrophy, telangiectasias, and hyperor hypopigmentation. Some women also had radiation-induced fibrosis, with long-term induration, edema, and dermal thickening.

"My studies have shown that using LED photomodulation followed by a dry skin ointment provides a new, quick, and painless solution to combat the skin reactions that may interrupt and compromise treatment," said DeLand.