Can laser therapy be the answer for radiodermatitis in anal cancer patients? Two case reports

Abstract

Background: Patients suffering from anal cancer have to undergo different anticancer therapies, including radiotherapy. Radiodermatitis represents a debilitating side effect of radiotherapy, often leading to painful lesions and a suspension of the radiotherapy treatment. No widely recognized treatment of radiodermatitis is currently available. Objective: The present report introduces an innovative technique based on the use of laser light to manage radiodermatitis of the anal region in a decisive fashion. Study design: Two cases of radiodermatitis are presented, the occurrence of which followed combined chemoradiotherapy for anal squamous cell carcinoma. Both patients complained about strong pain, severe itch and spontaneous bleeding from the lesions. In addition, they reported limitations in their daily life activities as well as a negative impact on their quality of life. Both patients received laser irradiation therapy by applying two wavelengths simultaneously (970±15 nm and 660±15 nm) for a total of six laser sessions. The chosen treatment parameters were as follows: peak power, 6 W, 50% duty cycle for 360 s; peak power, 6 W in continuous mode for another 120 s resulting in spatially averaged energy fluences of 67.5 J/cm² and 45 J/cm², respectively. Results: Complete healing of the lesions and symptoms was achieved within 2 weeks. Remission of the symptoms continued after 2 months with no documented side effects. Both patients managed to complete the radiotherapy sessions and reported maximum satisfaction with the treatment. Conclusions: These cases can prepare the ground to consider class-IV laser therapy, an innovative option to manage radiodermatitis with predictable effectiveness and a consequent improvement in the quality of life of the patients. Patients experiencing radiodermatitis suffer from pain accompanied by limited independence in daily activities, decreased life quality, and reduced self-esteem which often leads to depression. Resolution of radiodermatitis can result in fewer cases of radiotherapy suspension and a better outcome in the oncological treatment as well as an improved quality of life, usually very quickly.