Lin YT et al. - Photobiomodulation in the prevention and treatment of radiation dermatitis in cancer patients

A meta-analysis published in 2024 in *Radiotherapy and Oncology* reports a significantly lower incidence of grade 2 and 3 acute radiodermatitis in patients treated with photobiomodulation, with a risk difference of -0.36 (95% CI -0.53 to -0.19). The authors highlight a very high degree of heterogeneity among the studies and urge caution in interpreting this result.

What this study measured

The objective was to examine the efficacy of photobiomodulation in treating acute radiodermatitis in cancer patients. Acute radiodermatitis is a skin reaction associated with radiation therapy, and its management is part of supportive care rather than tumor treatment.

The authors searched PubMed, Embase, the Cochrane Library, and CINAHL from the databases’ inception through July 2024. The review included randomized controlled trials and non-randomized studies evaluating photobiomodulation for radiodermatitis. Meta-analyses and sensitivity analyses were conducted using a random-effects model. Subgroup analyses were performed based on cancer type and the purpose of photobiomodulation (prevention or treatment), with stratification by degree of radiation dermatitis.

Key Findings

The data reported by the authors are as follows.

• Eight studies were included: five randomized controlled trials and three non-randomized studies.
• Radiodermites de grade 2 et 3 : différence de risque de -0,36 en faveur du groupe photobiomodulation, IC 95 % de -0,53 à -0,19, p < 0,00001.
• Heterogeneity among studies: I² = 85%.
• Subgroup analyses: a significant effect was observed in both breast cancer and head and neck cancers.
• Photobiomodulation significantly reduces the incidence of grade 2 and 3 radiation dermatitis in both the prevention and treatment subgroups.

How photobiomodulation works for this indication

Photobiomodulation involves applying low-intensity light to irradiated skin, without causing any thermal effects. In this meta-analysis, it is evaluated according to two distinct uses: as a preventive measure, before or during radiation therapy, and as a treatment for an existing skin reaction. Both subgroups show a significant effect on grades 2 and 3.

The abstract does not provide details on the biological mechanisms or the dosimetry parameters used in the included studies. The observed benefit pertains to high-grade radiodermatitis, that is, the most severe forms.

Limits You Should Know

The authors explicitly point out the main limitation: there is a high degree of heterogeneity among the included studies, with an I² of 85%. They conclude that the results should be interpreted with caution.

Furthermore, the body of evidence remains limited: only eight studies, three of which are non-randomized, which poses a risk of bias. This is a synthesis of real-world data, which has a lower level of control than a single large-scale trial. The authors use cautious language: photobiomodulation may have beneficial effects, but its efficacy is not considered definitively established.

What This Means in Practice

This meta-analysis reinforces the value of photobiomodulation as an adjunctive therapy in radiation therapy, particularly for reducing severe radiation dermatitis in breast cancer and head and neck cancers. It does not alter the oncological management itself: photobiomodulation is not a cancer treatment and does not replace radiation therapy. Any implementation requires a shared decision with the radiation oncology team, which determines the parameters and schedule of the sessions.

Frequently Asked Questions

Can photobiomodulation replace cancer treatment?

No. This meta-analysis focuses exclusively on a skin-related adverse effect of radiation therapy. Photobiomodulation is used here as supportive care and has no documented role in treating the tumor. It is not a substitute for any prescribed treatment.

Is it better to use photobiomodulation as a preventive measure or after radiodermatitis has developed?

Subgroup analyses show a significant effect on grades 2 and 3 in both cases—for prevention and treatment. The abstract does not allow for a comparison between the two strategies. The choice is up to the healthcare team.

Do these findings apply to all types of cancer?

The subgroups analyzed included breast cancer and head and neck cancers, with a significant effect observed in both. The abstract does not report results for other sites. It is not possible to extrapolate beyond these populations.

Reference

Lin YT, Tung KM, Chiou JF, Chen YC, Hou WH. Effects of photobiomodulation therapy for acute radiation dermatitis in cancer patients: A systematic review and meta-analysis of real-world evidence. Radiotherapy and Oncology, 2024. PMID 39426526. https://pubmed.ncbi.nlm.nih.gov/39426526/

This summary is provided for informational purposes only and does not constitute medical advice. Photobiomodulation is not a substitute for prescribed treatment. Consult a healthcare professional.