Low Level Laser Therapy

Low Level Laser Therapy

PEP Topic 
Radiodermatitis
Description 

Low-level laser therapy (LLLT) involves the use of a hand-held infrared laser in an attempt to affect cells and physical symptoms often related to inflammation. The therapy has been approved by the Food and Drug Administration for treatment of post-mastectomy lymphedema. LLLT has also been evaluated for prevention and treatment of mucositis.

Effectiveness Not Established

Research Evidence Summaries

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, 3925–3933. 

doi: 10.1007/s00520-016-3232-0
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Study Purpose:

To assess the effects of Multiwave Lock System low-level laser therapy in the management of acute radiation dermatitis

Intervention Characteristics/Basic Study Process:

All patients received standard skin care including hydroactive colloid gel thre times daily throughout radiation therapy and self-adhesive silicone foam dressing for dry or moist desquamation. Those in the laser therapy group also received six sessions twice a week starting from fraction 20 of radiation. Results from the laser group were compared to that of a historical control group who had only usual care.

Sample Characteristics:

  • N = 79   
  • MEAN AGE = 55 years
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: Patients with breast cancer; most had stage I–II disease; slightly more than one-third had chemotherapy prior to radiotherapy.

Setting:

  • SITE: Single site   
  • SETTING TYPE: Outpatient    
  • LOCATION: Belgium

Phase of Care and Clinical Applications:

PHASE OF CARE: Active antitumor treatment

Study Design:

Prospective, quasiexperimental with historical control comparison

Measurement Instruments/Methods:

  • Radiation Therapy Oncology Group (RTOG) grading
  • Radiotherapy-Induced Skin Reaction Assessment Scale (RISRA)
  • Skindex-16

Results:

RTOG scores in the control group increased over time but remained stable in the laser group. The difference between groups was significant (p < 0.005). There were no cases of greater than grade 2 skin toxicity. Analysis of change in RISRA scores showed improvement in subjective scores in the laser group (p = 0.023) and less score increase overall in the laser group (p < 0.03).

Conclusions:

This type of low-level laser therapy was shown to be beneficial in reducing the severity of radiodermatitis among women being treated for breast cancer.

Limitations:

  • Small sample (< 100)
  • Risk of bias (no blinding)
  • Risk of bias (no random assignment)
  • Risk of bias (no appropriate attentional control condition)
 

Nursing Implications:

The use of low-level laser therapy may have some benefit for the management of radiodermatitis. The promising findings from this study warrant additional well designed research.

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