Abstract
The increased precision, efficacy, and safety of radiation brachytherapy has tremendously improved its popularity in cancer care. However, an unfortunate side effect of this therapy involves localized skin damage and breakdown that are managed palliatively currently. This study was motivated by prior reports on the efficacy of photobiomodulation (PBM) therapy in improving tissue resilience and wound healing. We evaluated the efficacy of PBM therapy on 36 athymic mice with 125I seed (0.42 mCi) implantation over 60 days. PBM treatments were performed with either red (660 nm) or near-infrared (880 nm, NIR) LEDs irradiance of 40 mW/cm2, continuous wave, fluence of 20 J/cm2 once per week. Animals were evaluated every 7 days with digital imaging, laser Doppler flowmetry, thermal imaging, µPET-CT imaging using 18F-FDG, and histology. We observed that both PBM treatments—red and NIR—demonstrated significantly less incidence and severity and improved healing with skin radionecrosis. Radiation exposed tissues had improved functional parameters such as vascular perfusion, reduced inflammation, and metabolic derangement following PBM therapy. Histological analysis confirmed these observations with minimal damage and resolution in tissues exposed to radiation. To our knowledge, this is the first report on the successful use of PBM therapy for brachytherapy. The results from this study support future mechanistic lab studies and controlled human clinical studies to utilize this innovative therapy in managing side effects from radiation cancer treatments.
Highlights
Cancer incidence has increased significantly in recent years due to continuous population growth and aging
With the advancement in biology and technologies, current cancer treatment usually consists of individual chemotherapy or combined use of chemotherapy, surgery, radiotherapy, and immunotherapy depending on the etiology of the tumor [1,2]
Radiotherapy is delivered through two methods—an external ionizing radiation beam or by an implantable internal source [3]
Summary
Cancer incidence has increased significantly in recent years due to continuous population growth and aging. An ionizing radiation beam must be transmitted through upper layers of adjacent healthy tissues before the target tumor cells receive the appropriate radiation dose. This results in normal superficial tissues receiving high radiation doses. Brachytherapy delivers ionizing radiation from sealed metallic cylinders (commonly termed as seeds) containing radioactive isotopes implanted within the cancer tissue. The shorter half-life (16.96 days) of 103 Pd enables a faster dose rate, compared with 125 I, whose half-life is 59.408 days Utilizing these differences in dose rates, an isotope is chosen based on specific tumor characteristics; for example, slow-growing, initial tumors are treated with 125 I, while faster-growing, more aggressive tumors are treated with 103 Pd [6]
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