Assessment of cold atmospheric pressure plasma therapy initiated at peak severity in a mouse model of radiation dermatitis

Radiation dermatitis (RD) is a common side effect of radiation therapy, potentially leading to treatment interruptions. This study evaluated the efficacy of cold atmospheric plasma (CAP) in a mouse model of RD, specifically focusing on treatment initiation at the peak of disease severity. As secondary objective, hyperspectral imaging (HSI) and optical coherence tomography (OCT), were evaluated as objective measures to monitor disease severity. RD was induced via gamma irradiation, with daily CAP treatment initiated at the peak severity. RD severity was monitored using macroscopic scoring and imaging. We found that CAP treatment initiated at the peak of disease did not result in a measurable improved healing under the tested conditions. HSI showed significant differences (p ≤ 0.05) between healthy and RD skin even beyond macroscopic scoring. OCT differentiated between healthy and diseased skin, however, no significant difference was observed after macroscopic healing. Our findings suggest that CAP therapy initiated at peak RD does not accelerate recovery. However, this result does not preclude potential efficacy of CAP when administered prophylactically or at the early onset of skin injury. The study underscores the critical importance of treatment timing and highlights HSI and OCT as potentially valuable non-invasive tools for objective RD assessment.