Low level Laser therapy in radiation-induced vaginal stenosis after cervical cancer treatment: Case Report/ Terapia a laser de baixa potência na estenose vaginal induzida por radiação após tratamento do câncer cervical: relato de caso

Authors

  • Mirella Dias
  • Suellen Cristina Roussenq
  • Laura Ferreira de Rezende
  • Juliana Lenzi

DOI:

https://doi.org/10.34117/bjdv7n4-133

Keywords:

low level laser therapy, pelvic radiotherapy, vaginal stenosis, oncology, case report.

Abstract

Background and objective: Low Level Laser Therapy (LLLT) has been widely studied to relieve pain and accelerate the wound healing process. Considering the occurrence of radiation-induced vaginal stenosis due to the treatment of cervical cancer, as well as the pain and tissue injury that ionizing radiation therapy causes, this study discusses the use of LLLT as a therapeutic resource to complement the recommended therapy of dilation of the vaginal canal. Methods: Case report of a woman with radiation-induced vaginal stenosis after brachytherapy cervical cancer treatment, complaining of pain and local bleeding. Results: LLLT favored vaginal dilation therapy, reducing vaginal pain and bleeding, reducing recovery time. Conclusions: LLLT can be a resource to be considered in the treatment of radiation-induced vaginal stenosis. Implications for Cancer Survivors: The use of this technique demonstrates improving the patient's quality of life after treatment, leads to a decrease in pain, improves adherence to physical therapy treatment, facilitates sexual intercourse and follow-up exams.

References

Boer SM, Powell ME, Mileshkin L, et al. Toxicity and quality of life after adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): an open- label, multicentre, randomised, phase 3 trial. Lancet Oncol 2016; 17:1114e1126.

Vaz AF, Conde DM, Costa-Paiva L, Morais SS, Esteves SB, Pinto-Neto AM. Quality of life and adverse events after radiotherapy in gynecologic cancer survivors: a cohort study. Arch Gynecol Obstet. 2011;284(6):1523?1531. doi:10.1007/s00404-011-1886-x

Bahng AY, Dagan A, Bruner DW, Lin LL. Determination of prognostic factors for vaginal mucosal toxicity associated with intravaginal high-dose rate brachytherapy in patients with endometrial cancer. Int J Radiat Oncol Biol Phys. 2012;82(2):667–73.

Morris L, Do V, Chard J, Brand AH. Radiation-induced vaginal stenosis: Current perspectives. Int J Womens Health. 2017;9:273–9.

Zecha JAEM, Raber-Durlacher JE, Nair RG, Epstein JB, Elad S, Hamblin MR, et al. Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2: proposed applications and treatment protocols. Support Care Cancer. 2016;24(6):2793–805.

Yoshida K, Yamazaki H, Nakamura S, et al. Longitudinal analysis of late vaginal mucosal reactions after high-dose-rate brachytherapy in patients with gynecological cancer. Anticancer Res. 2014;34(8):4433?4438.

Yarnold J, Vozenin Brotons MC. Pathogenetic mechanisms in radiation fibrosis. Radiother Oncol [Internet]. 2010;97(1):149–61. Available from: http://dx.doi.org/10.1016/j.radonc.2010.09.002

Yoshida K, Yamazaki H, Nakamura S, et al. Role of vaginal pallor reaction in predicting late vaginal stenosis after high-dose-rate brachytherapy in treatment-naive patients with cervical cancer. J Gynecol Oncol. 2015; 26(3):179–184.

Yoshida K, Yamazaki H, Nakamura S, et al. Comparisons of late vaginal mucosal reactions between interstitial and conventional intracavitary brachytherapy in patients with gynecological cancer: speculation on the relation between pallor reaction and stenosis. Anticancer Res. 2013;33(9):3963–3968.

Gondi V, Bentzen SM, Sklenar KL, Dunn EF, Petereit DG, Tannehill SP, Straub M and Bradley KA: Severe late toxicities following concomitant chemoradiotherapy compared to radiotherapy alone in cervical cancer: an inter-era analysis. Int J Radiat Oncol Biol Phys 84: 973-982, 2012.

Matos SRL, Lucas Rocha Cunha M, Podgaec S, Weltman E, Yamazaki Centrone AF, Cintra Nunes Mafra AC. Consensus for vaginal stenosis prevention in patients submitted to pelvic radiotherapy. PLoS One. 2019;14(8):e0221054. Published 2019 Aug 9. doi:10.1371/journal.pone.02210540

Miles T, Johnson N. Vaginal dilator therapy for women receiving pelvic radiotherapy. The Cochrane database of systematic reviews. 2014:CD007291.

Law E, Kelvin JF, Thom B, et al. Prospective study of vaginal dilator use adherence and efficacy following radiotherapy. Radiother Oncol. 2015;116(1):149-155. doi:10.1016/j.radonc.2015.06.018

Reports TC, Roles PA, Raber-durlacher JE. Photobiomodulation Therapy Alleviates Tissue Fibroses. 2017;XX(Xx):1–8.

Wickenheisser VA, Zywot EM, Rabjohns EM, Lee HH, Lawrence DS, KathleenTarrant T. Laser Light Therapy in Inflammatory, Musculoskeletal, and Autoimmune Disease. Curr Allergy Asthma Rep. 2019;19(8).

Hamblin MR. NB Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophys. 2017;4(3):337–61.

Andreo L, Soldera CB, Ribeiro BG, de Matos PRV, Bussadori SK, Fernandes KPS, et al. Effects of photobiomodulation on experimental models of peripheral nerve injury. Lasers Med Sci. 2017;32(9):2155–65.

Robijns J, Censabella S, Claes S, Pannekoeke L, Bussé L, Colson D, et al. Prevention of acute radiodermatitis by photobiomodulation: A randomized, placebo-controlled trial in breast cancer patients (TRANSDERMIS trial). Lasers Surg Med. 2018;50(7):763–71.

Censabella S, Claes S, Robijns J, Bulens P, Mebis J. Photobiomodulation for the management of radiation dermatitis: the DERMIS trial, a pilot study of MLS®laser therapy in breast cancer patients. Support Care Cancer [Internet]. 2016;24(9):3925–33. Available from: http://dx.doi.org/10.1007/s00520-016-3232-0

Robijns J, Lodewijckx J, Mebis J. Photobiomodulation therapy for acute radiodermatitis. Curr Opin Oncol. 2019;31(4):291–8.

Lanzafame RJ, de la Torre S, Leibaschoff GH. The Rationale for Photobiomodulation Therapy of Vaginal Tissue for Treatment of Genitourinary Syndrome of Menopause: An Analysis of Its Mechanism of Action, and Current Clinical Outcomes. Photobiomodul Photomed Laser Surg. 2019 Jul;37(7):395-407. doi: 10.1089/photob.2019.4618. Epub 2019 Jun 17. PMID: 31210575; PMCID: PMC6648197.t

de Pauli Paglioni M, Araújo ALD, Arboleda LPA, Palmier NR, Fonsêca JM, Gomes-Silva W, et al. Tumor safety and side effects of photobiomodulation therapy used for prevention and management of cancer treatment toxicities. A systematic review. Oral Oncol [Internet]. 2019;93(April):21–8. Available from: https://doi.org/10.1016/j.oraloncology.2019.04.004

Zadik Y, Arany PR, Fregnani ER, Bossi P, Antunes HS, Bensadoun RJ, et al. Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer. 2019;27(10):3969–83.

Chung H, Dai T, Sharma SK, Huang Y, Carroll JD, Hamblin MR. The Nuts and Bolts of Low-lwvael LAser (Light) Therapy. 2012; 40 (2): 516-533.

Bensadoun RJ, Nair RG. Low-Level Laser Therapy in the Management of Mucositis and Dermatitis Induced by Cancer Therapy. Photomed Laser Surg. 2015;33(10):487-491. doi:10.1089/pho.2015.4022

Zecha JAEM, Raber-durlacher JE, Nair RG, Epstein JB, Sonis ST, Elad S, Hamblin MR, Barasch A, Migliorati CA, Milstein DMJ, Genot M, Lansaat L, Brink RVD, Arnabat-Domingues J, Molen LVD, Jacobi I, Diessen, JV, Lange, JD, Smeele LE, Schubert MM, Bensadoun R. Low Level Laser therapy/photobiomodulation in the Management of Side Effects of Chemoradiation Therapy in Head and Neck Cancer: Part 1: Mechanisms of Action, Dosimetric, and Safety Considerations. Support Care Cancer. 2016. v. 28. n 6. pg.2781-92. doi: 10.1007/s00520-016-3152-z.

Pauli M De, Luíza A, Araújo D, Paola, Lady, Arboleda A, Madrid-troconis CC, et al. Tumor safety and side effects of photobiomodulation therapy used for prevention and management of cancer treatment toxicities . A systematic review. Oral Oncol [Internet]. 2019;93(January):21–8. Available from: https://doi.org/10.1016/j.oraloncology.2019.04.004

Oliveira KF, Silva ML, Morais RM, Rodrigues TS, Silveira GWS, Paiva-oliveira EL. Fotobiomodulação no tratamento de úlceras por pressão: revisão da literatura. Revista Científica da FAMINAS (2019), v. 14, n. 1, p. 61-69.

Taradaj J, Rajfur K, Rajfur J, Ptaszkowski K, Ptaszkowska L, Sopel M, Rosinczuk J, Dymarek R. Effect of laser treatment on postural control parameters in patients with chronic nonspecific low back pain: a randomized placebo-controlled trial. Brazilian Journal of Medical and Biological Research. (2019) 52(12): e8474, http://dx.doi.org/10.1590/1414-431X20198474

Camargo BTS, Coca KP, Amir LH, Correa L, Aranha ACC, Marcacine KO, Abuchaim ESV, Abrao ACFV. The effect of a single irradiation of low-level laser on nipple pain in breastfeeding women: a randomized controlled trial. Lasers In Medical Science, [s.l.], 2019. v. 35, n. 1, p.63-69. http://dx.doi.org/10.1007/s10103-019-02786-5.

Cerentini TM, Schlöttgen J, Viana da Rosa P, et al. Clinical and Psychological Outcomes of the Use of Vaginal Dilators After Gynaecological Brachytherapy: a Randomized Clinical Trial. Adv Ther. 2019;36(8):1936-1949. doi:10.1007/s12325-019-01006-4

Wei J, Meng L, Hou X, Qu C, Wang B, Xin Y, Jiang X. Radiation-induced skin reactions: mechanism and treatment. Cancer Manag Res. 2018; 11: 167-177

Paglioni MP, Alves CGB, Fontes EK, Lopes MA, Ribeiro ACP, Brandao TB, Migliorati CA, Santos-Silva ARS. Is photobiomodulation therapy effective in reducing pain caused by toxicities related to head and neck cancer treatment? A systematic review. Supportive Care in Cancer. 2019 https://doi.org/10.1007/s00520-019-04939-2

Berger AA & Echols KT. Treatment of Vaginal Shortening and Narrowing With Autologous Buccal Mucosa Graft Augmentation Without Vaginal Mold. Female Pelvic Medicine & Reconstructive Surgery. 2019. v.25, n1. doi: 10.1097/SPV.0000000000000648

Bakker RM, Vermeer WM, Creutzberg CL, Mens JW, Nout RA, Ter Kuile MM. Qualitative accounts of patients" determinants of vaginal dilator use after pelvic radiotherapy. J Sex Med. 2015;12(3):764Y773.

Heiskanen V, Hamblin MR. Photobiomodulation: Lasers: vs. light emitting diodes? Photochem Photobiol Sci. 2018;17(8):1003–17.

Yoshida K. Current Considerations for Low-Level Laser Therapy/Photobiomodulation Therapy in the Management of Side Effects of Chemoradiation Therapy for Cancer. Photomed Laser Surg [Internet]. 2017;XX(Xx):pho.2017.4322. Available from: http://online.liebertpub.com/doi/10.1089/pho.2017.4322

Avci P, Gupta A, Sadasivam M, Vecchio D, Pam Z, Pam N, et al. Low-level laser (light) therapy (LLLT) in skin: Stimulating, healing, restoring. Semin Cutan Med Surg. 2013;32(1):41–52.

Baxter GD, Liu L, Petrich S, Chapple C, Anders JJ, Tumilty S. Low level laser therapy in the management of breast cancer-related lymphedema: protocol for a randomized controlled feasibility trial. Phys Ther Rev. 2018;

Oliveira PY, Resende LM, Lima CO, Lacerda MFLS, Maranduba CMC,Carmo AMR. Evaluation of the effects of low intensity laser in proliferation of dental pulp stem cells. Braz. J. of Develop. 2019; 5 (12): 33248 – 33260.

Zein R, Selting W, Hamblin MR. Review of light parameters and photobiomodulation efficacy: dive into complexity. J Biomed Opt. 2018;23(12):1.

Bourbonne V, Otz J, Bensadoun RJ, Dissaux G, Lucia F, Leclere JC, et al. Radiotherapy mucositis in head and neck cancer: Prevention by low-energy surface laser. BMJ Support Palliat Care. 2019;1–8.

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Published

2021-04-06

How to Cite

Dias, M., Roussenq, S. C., Rezende, L. F. de, & Lenzi, J. (2021). Low level Laser therapy in radiation-induced vaginal stenosis after cervical cancer treatment: Case Report/ Terapia a laser de baixa potência na estenose vaginal induzida por radiação após tratamento do câncer cervical: relato de caso. Brazilian Journal of Development, 7(4), 35230–35240. https://doi.org/10.34117/bjdv7n4-133

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Original Papers