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

Background: Patients suffering from anal cancer have to undergo different anticancer therapies, including radio- therapy. 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 radio- dermatitis of the anal region in a decisive fashion. Study design: Two cases of radiodermatitis are presented, the occurrence of which followed combined chemoradio- therapy for anal squamous cell carcinoma. Both patients complained about strong pain, severe itch and spontane- ous bleeding from the lesions. In addition, they reported limitations in their daily life activities as well as a nega- tive 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 symp- toms continued after 2 months with no documented side effects. Both patients managed to complete the radiother- apy 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 suf- fer 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.