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Meta-Analysis
. 2023 Mar 23;31(4):227.
doi: 10.1007/s00520-023-07673-y.

Photobiomodulation therapy for the prevention of acute radiation dermatitis: a systematic review and meta-analysis

Margherita Gobbo  1 , Victoria Rico  2 , Gustavo Nader Marta  3 , Saverio Caini  4 , Julie Ryan Wolf  5 , Corina van den Hurk  6 , Mara Beveridge  7 , Henry Lam  8 , Pierluigi Bonomo  9 , Edward Chow  10 , Tara Behroozian  11
Affiliations
Meta-Analysis

Photobiomodulation therapy for the prevention of acute radiation dermatitis: a systematic review and meta-analysis

Margherita Gobbo et al. Support Care Cancer. .

Abstract

Purpose: Approximately 95% of patients undergoing radiotherapy (RT) experience radiation dermatitis (RD). Evidence has suggested that photobiomodulation therapy (PBMT) can stimulate skin renewal and minimize RD. The aim of the present paper was to investigate the efficacy of PBMT in RD prevention through a comprehensive literature review.

Methods: A literature search of Ovid MEDLINE, Embase, and Cochrane databases was conducted from 1980 to March 2021 to identify RCT on the use of PBMT for RD prevention. Forest plots were developed using RevMan software to quantitatively compare data between studies.

Results: Five papers were identified: four in breast and one in head and neck cancer patients. Patients receiving PBMT experienced less severe RD than the control groups after 40 Gray (Gy) of RT (grade 3 toxicity: Odds Ratio (OR): 0.57, 95% CI 0.14-2.22, p = 0.42) and at the end of RT (grade 0 + 1 vs. 2 + 3 toxicity: OR: 0.28, 95% CI 0.15-0.53, p < 0.0001). RT interruptions due to RD severity were more frequent in the control group (OR: 0.81, 95% CI 0.10-6.58, p = 0.85).

Conclusion: Preventive PBMT may be protective against the development of severe grades of RD and reduce the frequency of RT interruptions. Larger sample sizes and other cancer sites at-risk of RD should be evaluated in future studies to confirm the true efficacy of PBMT, also in preventing the onset of RD and to finalize a standardized protocol to optimize the technique. At present, starting PBMT when RT starts is recommendable, as well as performing 2 to 3 laser sessions weekly.

Keywords: Acute radiation dermatitis; Laser therapy; Photobiomodulation therapy; Prevention; Radiotherapy.

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Conflict of interest statement

The authors declare no competing interests.

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Prisma diagram
Fig. 2
Fig. 2
Forest plots showing comparison for all grades of RD at 40 Gys and at the end of RT. A Grade 0,1,2,3 after 40 Gys including all cancer sites. B Grade 0,1,2,3 after 40 Gys considering only Breast Cancer patients. C Grade 0,1,2,3 at the end of RT including all cancer sites. D Grade 0,1,2,3 at the end of RT considering only Breast Cancer patients
Fig. 3
Fig. 3
Forest plots showing comparison for lower grades (0–1) versus higher grades (2–3) at the end of RT. A Grade 0,1 at the end of RT considering all cancer sites. B Grade 0,1 at the end of RT considering only Breast Cancer patients. C Grade 2,3 at the end of RT considering all cancer sites. D Grade 2,3 at the end of RT considering only Breast Cancer patients
See this image and copyright information in PMC

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