Breast Cancer Treatment Breakthrough; Dr. Maitland DeLand, of OncoLogics, Pioneers Using LED Photomodulation to Reduce Skin Damage From Radiation Therapy.

LAFAYETTE, La. -- Dr. Maitland DeLand, a radiation oncologist and president of OncoLogics, Inc. in Lafayette, LA, has found that following radiotherapy for breast cancer, exposing women to low energy non-thermal 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. 18 of the 19 women treated with the LED photomodulation 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.

"Radiation dermatitis is an adverse condition that can affect regimen schedules," said 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 seven 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 had inflammation severe enough to require interruption of radiotherapy.

All 28 not receiving LED photomodulation had some type of skin reaction following radiation. Four patients had mild radiation dermatitis, 18 had moderate dermatitis and six had serious skin reactions. 19 of the 28 patients who did not receive LED photomodulation required temporary interruption of therapy because of erythematous reactions and moist desquamation.

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 non-thermal, low energy light at a pulsating frequency.

"The pulses stimulate at the cellular level skins cells such as fibroblasts to repair themselves to build up the collagen," explained 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."

Using photomodulation for skin-repair with cancer patients is a new concept.

"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 phpotomodulation has allowed me to find a safe way to eliminate an extremely high level of discomfort for my patients," Dr. DeLand said.

Six of the women in the LED treatment group were available for follow-up at three months, and five were available at six months post therapy. 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 three months after therapy, women who did not receive LED photomodulation had typical late radiation effects, including atrophy, telangiectasias, and hyper- or hypo-pigmentation. 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.

Dr. Maitland DeLand is a clinical faculty member of the LSU School of Medicine and is specialist in the treatment of breast cancer and breast preservation with lumpectomy radiation therapy.