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Pilot Study of the Effect of Laser on Reversing Chronic Radiation Injury

Primary Purpose

Chronic Radiation Dermatitis

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Fractional CO2 laser treatment
No treatment
Sponsored by
Massachusetts General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Radiation Dermatitis focused on measuring radiation, dermatitis, laser, fractional, CO2, chronic, fibrosis, scar

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Healthy males and females between 18 and 80 years of age with radiation-induced fibrosis and depigmentation. The fibrosis must have occurred at least 1 year prior to the date of enrollment.
  2. Having suitable areas of treatment: All wounds in the area of interest must be closed for at least two months. The scars must be deemed stable for a period of 3 months or have a suitable contralateral control before initiation of treatment. This will be determined by objective measurements of scar erythema, pliability, induration, thickness at enrollment and again at 3 months;
  3. Fitzpatrick skin types I-VI;
  4. Able and willing to comply with all visit, treatment and evaluation schedules and requirements;
  5. Able to understand and provide written informed consent;
  6. Pregnant woman can be included because study involves local intervention, no new drugs.

Exclusion Criteria:

  1. Active tanning, including the use of tanning booths, during the course of the study;
  2. Prior skin treatment with laser or other devices in the treated area within three months of initial treatment or during the course of the study;
  3. Adverse reactions to compounds of any external agent (e.g., gels, lotions or anesthetic creams) required for use in the study, if no alternative to the said agent exists;
  4. History of collagen vascular disease;
  5. Active Herpes Simplex or Zoster at the time of treatment or having experienced more than three episodes of Herpes Simplex / Zoster eruption within a year of study enrollment;
  6. History of immunosuppression/immune deficiency disorders (including human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) or use of immunosuppressive medications;
  7. Having any form of active cancer at the time of enrollment and during the course of the study;
  8. Significant concurrent illness, such as uncontrolled diabetes (with a hemoglobin A1C of more than 8) (i.e., any disease state that in the opinion of the Investigator would interfere with the anesthesia, treatment, or healing process); Mentally incompetent, prisoner or evidence of active substance or alcohol abuse;
  9. Any condition which, in the Investigator's opinion, would make it unsafe (for the subject or study personnel) to treat the subject as part of this research study;
  10. If it is determined that the contracture is due to a deeper process involving the muscles, ligaments or bones.
  11. Patient on chemotherapy (but not tamoxifen or other things that affect wound healing) and also active XRT
  12. Participation in another interventional study with potential exposure to an investigational drug within past 30 days

Sites / Locations

  • Wellman Center for Photomedicine, Massachusetts General Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Fractional CO2 laser Treatment

No Treatment

Arm Description

This is the area getting treated with CO2 laser.

This is the area receiving no treatment.

Outcomes

Primary Outcome Measures

Improvement in fibrosis (% reduction in fibrosis surface area) compared to controlled sites
The primary end point is % reduction of the fibrosis surface area compared to control sites at 6-12 months.

Secondary Outcome Measures

Adverse events
Measurement adverse events (infection, scarring, ulceration, excessive bleeding, poor wound healing)

Full Information

First Posted
June 5, 2013
Last Updated
May 25, 2021
Sponsor
Massachusetts General Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT01910818
Brief Title
Pilot Study of the Effect of Laser on Reversing Chronic Radiation Injury
Official Title
Understanding and Reversing Chronic Radiation Dermatitis - A Pilot Study
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Unknown status
Study Start Date
November 2013 (undefined)
Primary Completion Date
August 2022 (Anticipated)
Study Completion Date
August 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Massachusetts General Hospital

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Radiotherapy, an essential modality in cancer treatment, frequently induces a fibrotic process in the skin which can lead to increased risk of malignancy, poor wound healing, pain and limitation of movement, and permanent loss of skin appendages with hyper/hypopigmentation, decreased sweating and xerosis, posing significant cosmetic and quality of life issues. Advances in laser therapy has led to the use of fractional laser treatment (FLT) to treat fibrosis associated with in hypertrophic scars and morphea, leading to tissue repair, scar remodeling. The investigators propose a pilot clinical study to test the hypothesis that FLT can normalize the fibrotic process and induce normal scar remodeling in patients affected by chronic radiation injury. Understanding and correcting this underlying fibrotic process can help restore normal skin functions in patients affected with chronic radiation dermatitis (RD) and other debilitating fibrotic diseases in dermatology such as scleroderma, morphea, or nephrogenic systemic fibrosis.
Detailed Description
We propose to treat 22 patients with significant radiation induced fibrosis (RIF) and skin changes. Each patient will receive fractional treatment (FLT) using the Lumenis Ultrapulse Carbon Dioxide (CO2) laser as well as control (no treatment) randomized to site. Patient age, type of cancer, method/dosage of radiation, latency between radiation treatment and start of study, and characteristics of skin changes will be recorded, including fibrosis surface area, depth, color, and compliance. Assessments will be conducted before each treatment, after each treatment, and 3-12 months after the last treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Radiation Dermatitis
Keywords
radiation, dermatitis, laser, fractional, CO2, chronic, fibrosis, scar

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Factorial Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Fractional CO2 laser Treatment
Arm Type
Experimental
Arm Description
This is the area getting treated with CO2 laser.
Arm Title
No Treatment
Arm Type
Experimental
Arm Description
This is the area receiving no treatment.
Intervention Type
Device
Intervention Name(s)
Fractional CO2 laser treatment
Other Intervention Name(s)
Lumenis Ultrapulse CO2 laser
Intervention Description
Patient will be treated with fractional laser treatment over the areas with fibrosis.
Intervention Type
Other
Intervention Name(s)
No treatment
Intervention Description
Patient will also have an area that is not being treated with CO2 laser. This is the area not getting treatment.
Primary Outcome Measure Information:
Title
Improvement in fibrosis (% reduction in fibrosis surface area) compared to controlled sites
Description
The primary end point is % reduction of the fibrosis surface area compared to control sites at 6-12 months.
Time Frame
6-12 months
Secondary Outcome Measure Information:
Title
Adverse events
Description
Measurement adverse events (infection, scarring, ulceration, excessive bleeding, poor wound healing)
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy males and females between 18 and 80 years of age with radiation-induced fibrosis and depigmentation. The fibrosis must have occurred at least 1 year prior to the date of enrollment. Having suitable areas of treatment: All wounds in the area of interest must be closed for at least two months. The scars must be deemed stable for a period of 3 months or have a suitable contralateral control before initiation of treatment. This will be determined by objective measurements of scar erythema, pliability, induration, thickness at enrollment and again at 3 months; Fitzpatrick skin types I-VI; Able and willing to comply with all visit, treatment and evaluation schedules and requirements; Able to understand and provide written informed consent; Pregnant woman can be included because study involves local intervention, no new drugs. Exclusion Criteria: Active tanning, including the use of tanning booths, during the course of the study; Prior skin treatment with laser or other devices in the treated area within three months of initial treatment or during the course of the study; Adverse reactions to compounds of any external agent (e.g., gels, lotions or anesthetic creams) required for use in the study, if no alternative to the said agent exists; History of collagen vascular disease; Active Herpes Simplex or Zoster at the time of treatment or having experienced more than three episodes of Herpes Simplex / Zoster eruption within a year of study enrollment; History of immunosuppression/immune deficiency disorders (including human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) or use of immunosuppressive medications; Having any form of active cancer at the time of enrollment and during the course of the study; Significant concurrent illness, such as uncontrolled diabetes (with a hemoglobin A1C of more than 8) (i.e., any disease state that in the opinion of the Investigator would interfere with the anesthesia, treatment, or healing process); Mentally incompetent, prisoner or evidence of active substance or alcohol abuse; Any condition which, in the Investigator's opinion, would make it unsafe (for the subject or study personnel) to treat the subject as part of this research study; If it is determined that the contracture is due to a deeper process involving the muscles, ligaments or bones. Patient on chemotherapy (but not tamoxifen or other things that affect wound healing) and also active XRT Participation in another interventional study with potential exposure to an investigational drug within past 30 days
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard R Anderson, MD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wellman Center for Photomedicine, Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://rally.partners.org/study/chronic_radiation_dermatitis
Description
clinical trials

Learn more about this trial

Pilot Study of the Effect of Laser on Reversing Chronic Radiation Injury

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