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Biophysical skin measurements to evaluate the effectiveness of photobiomodulation therapy in the prevention of acute radiation dermatitis in breast cancer patients

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Abstract

Purpose

The purpose of this study was to evaluate objectively the effectiveness of photobiomodulation therapy (PBMT) for the prevention of acute radiation dermatitis (ARD) by using biophysical skin measurements.

Methods

A randomized, placebo-controlled trial with 120 breast cancer patients who underwent an identical radiotherapy (RT) regimen post-lumpectomy was performed (TRANSDERMIS trial). Patients were randomized to receive PBM (808 nm CW/905 nm pulsed, 168 mW/cm2, spot size 19.6 cm2, fluence 4 J/cm2) or placebo treatments from the first day of RT (2×/week). Biophysical skin measurements were collected to assess the skin pigmentation and barrier function. Measurements were collected at the first day of RT, a RT dose of 40 Gray (Gy), and the end of RT (66 Gy).

Results

The incidence of moist desquamation was significantly higher in the control than in the PBMT group at the end of RT (30 vs. 7%, respectively, odds ratio = 6, p = 0.004). The biophysical skin measures showed that the mean percentage change from the baseline transepidermal water loss (TEWL), erythema, and melanin values was significantly higher in the control than in the PBMT group at the end of RT (ps < 0.05). Logistic regression analysis revealed that the risk on moist desquamation was significantly increased for patients with a large (> 800 cc) breast volume (odds ratio = 4, p = 0.017).

Conclusions

This is the first randomized controlled trial demonstrating by objective measurements that PBMT is effective in reducing the incidence of moist desquamation in breast cancer patients undergoing RT. Additionally, a large breast volume is an important risk factor for the development of moist desquamation.

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Notes

  1. DIBH was used when the patients matched the following criteria: bilateral breast cancer; left-sided breast cancer and lymph node metastases under the age of 70 years; left-sided breast cancer and lymph node metastases above the age of 70 years and undergoing chemotherapy; left-sided breast cancer without lymph node metastasis but with a MHD ≥ 35 Gy. DIBH was applied using the Varian Real-Time Position Management (RPM) gating system (Varian Medical System, Palo Alto, CA).

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Acknowledgments

The corresponding author, Mrs. Jolien Robijns, received the Young Investigator Award of the MASCC for her scientific abstract.

Funding

This research is part of the Limburg Clinical Research Program (LCRP) UHasselt-ZOL-Jessa, financially supported by the foundation Limburg Sterk Merk, province of Limburg, Flemish government, Hasselt University, Ziekenhuis Oost-Limburg, and Jessa Hospital. Additionally, this research is supported by Kom op Tegen Kanker, Limburgs Kankerfonds, and ASA Srl.

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Authors and Affiliations

  1. Faculty of Medicine & Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium

    Jolien Robijns, Lore Bussé, Dora Colson, Iris Kaminski, Joy Lodewijckx, Ivo Lambrichts, Veerle Somers & Jeroen Mebis

  2. Department of Medical Oncology, Jessa Hospital, Stadsomvaart 11, Hasselt, Belgium

    Sandrine Censabella, Paul Bulens, Annelies Maes, Leen Noé, Marc Brosens & Jeroen Mebis

  3. Limburg Oncology Centre, Jessa Hospital, Stadsomvaart 11, Hasselt, Belgium

    Stefan Claes, Luc Pannekoeke, Paul Bulens, Annelies Maes, Leen Noé, Marc Brosens & Jeroen Mebis

  4. Department of Dermatology, Jessa Hospital, Stadsomvaart 11, Hasselt, Belgium

    An Timmermans

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  1. Jolien Robijns
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  2. Sandrine Censabella
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Correspondence to Jolien Robijns.

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The authors declare that they have no competing interests.

Ethical approval

The ethics committees of the Jessa Hospital and the University of Hasselt approved the study (B243201524443). All procedures performed in the study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Robijns, J., Censabella, S., Claes, S. 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 27, 1245–1254 (2019). https://doi.org/10.1007/s00520-018-4487-4

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