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Wang JY, Kabakova M, Patel P, Bitterman D, Zafar K, Philip R, Gollogly JM, Rivas S, Kurtti A, Yousefi N, Onikoyi O, Masub N, Jagdeo J. Outstanding user reported satisfaction for light emitting diodes under-eye rejuvenation. Arch Dermatol Res 2024; 316:511. [PMID: 39133416 DOI: 10.1007/s00403-024-03254-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/23/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024]
Abstract
The under-eye region is an area of significant cosmetic concern. Photobiomodulation (PBM) has emerged as an effective, safe, inexpensive, and convenient treatment for skin rejuvenation. Herein, we aim to evaluate the safety and efficacy of a LED under-eye device for under-eye rejuvenation, as measured by objective and patient reported outcomes. Eleven participants self-administered treatment using a commercially available LED device emitting red (633 nm) and near infrared (830 nm) light for six weeks. Standardized photographs and questionnaires were administered at baseline and six weeks. Photographic digital analysis indicated an improvement in under-eye wrinkles at six weeks compared to baseline, with a reduction in wrinkle score from 20.05 to 19.72. However, this finding was not statistically significant. Participants self-reported consistent improvements in under-eye wrinkles, texture, dark circles, bags, pigmentation, and erythema. All participants reported a high degree of comfortability, ease of use, and satisfaction with the eye device. The participants noted no moderate or severe adverse events and few reports of transient expected outcomes such as mild erythema. The participants' self-reported improvements and high user satisfaction, and the device's favorable safety profile, highlights the benefits of at-home LED devices for under-eye rejuvenation. Future randomized controlled trials with larger sample sizes could further establish the safety and efficacy of at-home LED under-eye treatments.
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Affiliation(s)
- Jennifer Y Wang
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Margaret Kabakova
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Paras Patel
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
- Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - David Bitterman
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
- New York Medical College, Valhalla, NY, USA
| | - Kayla Zafar
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
- St. George's University School of Medicine, West Indies, Grenada
| | - Raichel Philip
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Jessica Mineroff Gollogly
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Sharen Rivas
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alana Kurtti
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Nyousha Yousefi
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Omobola Onikoyi
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Natasha Masub
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Jared Jagdeo
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA.
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA.
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Lairedj K, Klausner G, Robijns J, Arany PR, Bensadoun RJ. [Photobiomodulation in the prevention and the management of side effects of cancer treatments: Bases, results and perspectives]. Bull Cancer 2024; 111:314-326. [PMID: 37858427 DOI: 10.1016/j.bulcan.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/11/2023] [Accepted: 08/13/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Assess the current and potential indications of photobiomodulation (PBM) therapy and their level of evidence in the prevention or treatment of side effects related to oncology treatments (radiation therapy, and to a minimal extent favored and hematopoietic stem cell transplants). And report on the recommended modalities (parameters and doses) of PBM therapy. MATERIALS AND METHODS The Embase, Medline/PubMed, Cochrane, EBSCO, Scopus, and LILACS databases were systematically reviewed to include and analyze publications of clinical studies that evaluated PBM in the prevention or management side effects related to cancer treatments. The keywords used were "photobiomodulation"; "low level laser therapy"; "acute oral mucositis"; "acute dysphagia"; "acute radiation dermatitis"; "lymphedema"; "xerostomia"; "dysgeusia"; "hyposalivation"; "lockjaw"; "bone necrosis"; "osteoradionecrosis"; "radiation induced fibrosis"; "voice and speech alterations"; "palmar-plantar erythrodysesthesia"; "graft versus host disease"; "peripheral neuropathy"; "chemotherapy induced alopecia". Prospective studies were included, while retrospective cohorts and non-original articles were excluded from the analysis. RESULTS PBM in the red or infrared spectrum has been shown to be effective in randomized controlled trials in the prevention and management of certain complications related to radiotherapy, in particular acute mucositis, epitheliitis and upper limb lymphedema. The level of evidence associated with PBM was heterogeneous, but overall remained moderate. The main limitations were the diversity and the lack of precision of the treatment protocols which could compromise the efficiency and the reproducibility of the results of the PBM. For other effects related to chemo/radiation therapy (dysgeusia, osteonecrosis, peripheral neuropathy, alopecia, palmar-plantar erythrodysaesthesia) and haematopoietic stem cell transplantation (graft versus host disease), treatment with PBM suffers from a lack of studies or limited studies at the origin of a weakened level of proof. However, based on these results, it was possible to establish safe practice parameters and doses of PBM. CONCLUSION Published data suggest that PBM could therefore be considered as supportive care in its own right for patients treated with radiation, chemotherapy, immunotherapy, hormone therapy or targeted therapies, whether in clinical practice or clinical trials. therapies. However, until solid data have been published on its long-term safety, the use of PBM should be considered with caution and within the recommended parameters and doses, particularly when practiced in areas of known or possible tumours. In this case, the patient should be informed of the theoretical benefits and risks of PBM in order to obtain informed consent before treatment.
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Affiliation(s)
- Kamel Lairedj
- Médecine générale, centre de santé Saint-Paul, 32, Delmas rue Louverture # 44, Delmas, Haïti; Université républicaine d'Haïti, # 22, Delmas 55, Lalue Ave John-Brown # 293 Bis, 1640 Port-au-Prince, Haïti
| | - Guillaume Klausner
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France; Polyclinique Maymard, 13, rue Marcel-Paul, 20200 Bastia, France
| | - Julien Robijns
- Hasselt University, Faculty of Medicine and Life Sciences, Martelarenlaan 42, 3500 Hasselt, Belgique
| | - Praveen R Arany
- University at Buffalo, Oral Biology, Surgery and Biomedical Engineering, Buffalo, New York, États-Unis
| | - René-Jean Bensadoun
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France; Département d'oncologie-radiothérapie, Gustave-Roussy, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
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Lopez-Garzon M, López-Fernández MD, Ruíz-Martínez AM, Galván-Banqueri P, Lozano-Lozano M, Tovar-Martín I, Postigo-Martin P, Ariza-Vega P, Artacho-Cordón F, Fernández-Lao C, Cantarero-Villanueva I, Fernández-Gualda MÁ, Arroyo-Morales M, Ruíz-Villaverde R, Galiano-Castillo N. Efficacy of photobiomodulation therapy combined with mobile health education in patients with head and neck cancer suffering from chronic xerostomia after radiotherapy: protocol for a three-arm, randomised, placebo-controlled, double-blinded study. BMJ Open 2024; 14:e078068. [PMID: 38267245 PMCID: PMC10824058 DOI: 10.1136/bmjopen-2023-078068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION The role of photobiomodulation (PBM) therapy for oral tissue damage induced by cancer treatment is currently unclear, and there is low-quality to moderate-quality evidence supporting the use of this approach for treating xerostomia and/or hyposalivation. Consequently, patients with head and neck cancer increasingly turn to basic oral hygiene to alleviate salivary gland dysfunction, and their adherence can be improved by mobile health (mHealth) education. The primary objective of this study will be to analyse the effects of different doses of PBM therapy (7.5 J/cm2 vs 3 J/cm2) plus mHealth education on quality of life (QoL), oral health, salivary secretion and salivary gland ultrasound assessment at postintervention and at the 6-month follow-up in patients with head and neck cancer after radiotherapy compared with those in control group. METHODS AND ANALYSIS A prospective, three-arm, randomised, placebo-controlled, double-blinded study will be conducted among patients with head and neck cancer suffering from chronic xerostomia. A total of 20 patients per arm will be included and randomly assigned to receive 7.5 J/cm2 of PBM, 3 J/cm2 of PBM or placebo therapy. PBM therapy will be applied during 24 sessions at 22 points extra and intraorally two times per week for 3 months, combined with a mobile application (https://www.laxer.es). The assessments will be recorded at the beginning of the study, at postintervention and at the 6-month follow-up. The primary outcomes will be QoL, oral health, salivary secretion and salivary gland ultrasound. The pain pressure threshold, functional performance, mood and sleep quality will be secondary indicators. ETHICS AND DISSEMINATION This study received ethics approval from the Andalusian Biomedical Research Ethics Portal (2402-N-21 CEIM/CEI Provincial de Granada) according to the Declaration of Helsinki for Biomedical Research. The results of this study will be presented at national and international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT05106608.
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Affiliation(s)
- Maria Lopez-Garzon
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - María Dolores López-Fernández
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
| | - Alba Maria Ruíz-Martínez
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Pilar Galván-Banqueri
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Mario Lozano-Lozano
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Isabel Tovar-Martín
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Paula Postigo-Martin
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Physical Activity for HEaLth Promotion (PA-HELP), Department of Physical and Sport Education, Sports Sciences Faculty, University of Granada, Granada, Spain
| | - Francisco Artacho-Cordón
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiology and Physical Medicine, Medicine Faculty, University of Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Carolina Fernández-Lao
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Irene Cantarero-Villanueva
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Miguel Ángel Fernández-Gualda
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
| | - Manuel Arroyo-Morales
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Ricardo Ruíz-Villaverde
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Medical Surgical Dermatology and Venereology, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - Noelia Galiano-Castillo
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
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Potrich AR, Só BB, Schuch LF, Wagner VP, Silveira FM, de Abreu Alves F, Prado-Ribeiro AC, Santos-Silva AR, Treister NS, Martins MD, Martins MAT. Impact of photobiomodulation for prevention of oral mucositis on the quality of life of patients with head and neck cancer: a systematic review. Lasers Med Sci 2023; 39:1. [PMID: 38057605 DOI: 10.1007/s10103-023-03940-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/15/2023] [Indexed: 12/08/2023]
Abstract
The aim of this study was to perform a systematic review to evaluate the impact of photobiomodulation therapy (PBMT) for the prevention of oral mucositis (OM) on the quality of life (QoL) of patients with head and neck cancer (HNC) undergoing radiation therapy. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search strategy was performed in five electronic databases (Cochrane, Embase, PubMed, Scopus, and Web of Science). The included studies assessed the QoL of patients undergoing radiation therapy (RT) for HNC and undergoing PBMT for the management of OM. Seven articles met the eligibility criteria. Data extraction was performed in the selected studies including the PBMT parameters (active medium, application procedure, wavelength, fluence, power, irradiance, irradiation time, spot size, energy per point, schedule of irradiation, and total energy). The included studies were qualitatively analyzed, and descriptive analyses were performed. Also, summary results were evaluated for group comparison analysis. All included studies confirmed a decrease in the QoL of the patients that developed OM throughout the RT progress when compared to baseline. Of the informed cases, most of the patients who received PBMT showed grades 1 and 2 OM, while the control group showed more individuals with severe forms of OM (grades 3 and 4). In this sense, patients submitted to PBMT reported better QoL at the end of the treatment compared with the control group. PBMT used for the management of OM preserves the QoL of patients with head and neck cancer.
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Affiliation(s)
- Ana Rita Potrich
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruna Barcelos Só
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Molecular Pathology Area, School of Dentistry, Universidad de la República, Montevideo, Uruguay
| | | | - Felipe Martins Silveira
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Molecular Pathology Area, School of Dentistry, Universidad de la República, Montevideo, Uruguay
| | | | - Ana Carolina Prado-Ribeiro
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, São Paulo, SP, Brazil
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Nathaniel Simon Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Marco Antonio Trevizani Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
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Vieira Nascimento M, Costa FWG, de Oliveira Filho OV, Silva PGDB, de Freitas Pontes KM. Management of Cancer Therapy-Induced Oral Mucositis Using Photobiomodulation Therapy: An Overview of Systematic Reviews. Photobiomodul Photomed Laser Surg 2023; 41:513-538. [PMID: 37788454 DOI: 10.1089/photob.2023.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Objective: To systematically summarize the evidence for photobiomodulation therapy (PBMT) in the prevention and treatment of oral mucositis (OM) in patients undergoing cancer treatment. An electronic search was conducted in 8 databases and grey literature. Background: PBMT is recommended for the management of OM resulting from cancer treatment, with several systematic reviews (SRs) being published in recent years on this topic. Methods: Only SRs with outcomes from clinical trials were included, with no language or year restriction. The AMSTAR 2 tool was used to assess the methodological quality of the SRs. Results: Five thousand eight hundred fifty-six references were found, and 16 were selected for this review. OM prevention and treatment were favorable for PBMT in most studies, with a significant reduction in OM severity. Most studies obtained moderate confidence. Conclusions: PBMT represents an effective strategy in the management of OM, and this evidence is supported by studies with acceptable methodological quality.
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Affiliation(s)
| | | | - Osias Vieira de Oliveira Filho
- Graduate Program in Dentistry, Federal University of Ceará, Fortaleza, Brazil
- College of Dentistry, Christus University, Fortaleza, Brazil
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Fitzmaurice BC, Heneghan NR, Rayen ATA, Grenfell RL, Soundy AA. Whole-Body Photobiomodulation Therapy for Fibromyalgia: A Feasibility Trial. Behav Sci (Basel) 2023; 13:717. [PMID: 37753995 PMCID: PMC10525895 DOI: 10.3390/bs13090717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/28/2023] [Accepted: 08/18/2023] [Indexed: 09/28/2023] Open
Abstract
Effective treatment for fibromyalgia (FM) is lacking and further treatment options are needed. Photobiomodulation therapy (PBMT) represents one potential treatment option. Whilst favourable findings have been reported using localised PBMT, no investigations have established the value of whole-body PBMT for the complete set of symptom domains in FM. A single-arm feasibility study was conducted in accordance with CONSORT (Consolidated Standards of Reporting Trials) guidelines. A non-probability sampling method was used to access individuals with FM. The primary outcome measure was identified as the Revised Fibromyalgia Impact Questionnaire (FIQR). Forty-nine participants were screened and twenty-one trial participants entered the trial. Nineteen participants completed the intervention (18 whole-body PBMT sessions over approximately six weeks). Descriptive statistics and qualitative analysis was undertaken to represent feasibility outcomes. Acceptability of the trial device and processes were established. Outcome measures towards efficacy data were guided by core and peripheral OMERACT (outcomes measures in rheumatological clinical trials) domains, utilising a combination of participant-reported and performance-based outcome measures. Data for the embedded qualitative component of the trial were captured by participant-reported experience measures and audio-recorded semi-structured interviews. Positive changes were observed for FM-specific quality of life, pain, tenderness, stiffness, fatigue, sleep disturbance, anxiety, depression and cognitive impairment. Patient global assessment revealed improvements at 6 weeks, with continued effect at 24 weeks. FM-specific quality of life at 24 weeks remained improved compared with baseline scores. The findings provided evidence to support a full-scale trial and showed promise regarding potential efficacy of this novel non-invasive treatment in an FM population.
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Affiliation(s)
- Bethany C. Fitzmaurice
- Department of Pain Management, Sandwell and West Birmingham NHS Trust, Birmingham B71 4HJ, UK;
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK; (N.R.H.); (A.A.S.)
| | - Nicola R. Heneghan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK; (N.R.H.); (A.A.S.)
| | - Asius T. A. Rayen
- Department of Pain Management, Sandwell and West Birmingham NHS Trust, Birmingham B71 4HJ, UK;
| | - Rebecca L. Grenfell
- Clinical Research Facility, Sandwell and West Birmingham NHS Trust, Birmingham B71 4HJ, UK;
| | - Andrew A. Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK; (N.R.H.); (A.A.S.)
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Chan X, Tay L, Yap SJ, Wu VX, Klainin-Yobas P. Effectiveness of Photobiomodulation and Oral Cryotherapy on Oral Mucositis Among Patients Undergoing Chemotherapy Conditioning Prior to Hematological Stem Cell Transplantation. Semin Oncol Nurs 2023; 39:151405. [PMID: 36935333 DOI: 10.1016/j.soncn.2023.151405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/16/2022] [Accepted: 02/15/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVES This review evaluated the best available evidence concerning the effectiveness of photobiomodulation compared to oral cryotherapy in oral-mucositis prevention among patients with hematological stem cell transplantation (HSCT) receiving chemo-conditioning. DATA SOURCES An extensive search for published and unpublished studies was conducted in 11 electronic databases and reference lists. Only randomized controlled trials (RCTs) were included. Two reviewers independently screened relevant studies for eligibility, extracted data using a standardized data collection form, and appraised data using the Cochrane Risk of Bias Tool and Grading Recommendations, Assessment, Development and Evaluation (GRADE). Meta-analyses using a random-effect model was performed using Review Manager software. Subgroup analyses were conducted to examine the differential effect of interventions across subgroups and to explore potential sources of heterogeneity. Meta-analyses included 18 RCTs (involving 1,018 patients). Both photobiomodulation and cryotherapy were effective in reducing oral-mucositis severity, severe oral-mucositis incidence, duration, and pain with small to large effect sizes. No significant differences were detected between photobiomodulation and cryotherapy across all outcomes. Subgroup analyses showed significant differences for chemo-conditioning regimens. The overall Grading Recommendations, Assessment, Development and Evaluation quality of evidence was low. CONCLUSION Both photobiomodulation and cryotherapy were effective nonpharmacological oral-mucositis prophylaxis and analgesia, with no significant difference in effectiveness. Chemo-conditioning regimens may influence their effectiveness. Future RCTs may directly compare the effectiveness of photobiomodulation and cryotherapy on the HSCT patients. Rigorous cost-effectiveness studies are also required. IMPLICATIONS FOR NURSING PRACTICE Photobiomodulation and cryotherapy can be offered to HSCT patients in clinical settings. A clinical guideline of both interventions can be also developed.
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Affiliation(s)
- Xin Chan
- Staff nurse, Alexandra Hospital, Singapore, Singapore
| | - Lyn Tay
- Staff nurse. National University Hospital, Singapore, Singapore
| | - Shi Jed Yap
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Vivien Xi Wu
- Assistant Professor, Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre, Singapore, Singapore
| | - Piyanee Klainin-Yobas
- Associate ProfessorAlice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre, Singapore, Singapore.
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Twenty-year analysis of photobiomodulation clinical studies for oral mucositis: a scoping review. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:626-641. [PMID: 36870898 DOI: 10.1016/j.oooo.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/12/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Our objective was to review the first 20 years of photobiomodulation (PBM) clinical studies for oral mucositis (OM) mitigation. STUDY DESIGN A scoping review screened controlled clinical studies. The PBM devices, protocols, and clinical outcomes were analyzed. RESULTS Seventy-five studies met the inclusion criteria. The first study dated from 1992, and the term "PBM" was first published in 2017. Public services, placebo-controlled randomized trials, and patients with head and neck chemoradiation were predominant among included studies. Prophylactic red intraoral laser protocols were mostly used. Comparing the outcomes of all protocols was unfeasible due to missing treatment parameters and nonhomogeneous measurements. CONCLUSIONS The main barrier to optimizing clinical protocols of PBM for OM was the lack of standardization in clinical studies. Although PBM use is now globally present in oncology settings and generally marked by good outcomes reported, additional randomized clinical trials with well-described methods are necessary.
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Gobbo M, Merigo E, Arany PR, Bensadoun RJ, Santos-Silva AR, Gueiros LA, Ottaviani G. Quality Assessment of PBM Protocols for Oral Complications in Head and Neck Cancer Patients: Part 1. FRONTIERS IN ORAL HEALTH 2022; 3:945718. [PMID: 35874125 PMCID: PMC9300948 DOI: 10.3389/froh.2022.945718] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background Radiotherapy and chemotherapy are frequently employed in head and neck cancer (HNC) patients causing significant side effects that impair life quality and prognosis. Photobiomodulation (PBM) has become a growing approach to managing such oral complications. Despite its proven efficacy and absence of contraindications, there is still a lack of universally accepted disease-specific PBM protocols. Objective A narrative review was conducted to identify the current proposals relating to the use of PBM to treat complications of oncological treatments in HNC patients. Methods An electronic search in PubMed and Scopus databases was performed with the following keywords: (“photobiomodulation” OR “PBM” OR “laser therapy” OR “LLLT” OR “laser”) AND (“head and neck cancer” OR “oral cancer”) AND (“mucositis” OR “oral mucositis” OR “dysgeusia” OR “oedema” OR “xerostomia” OR “dermatitis” OR “trismus”) until October 2021. Results A total of 35 papers were included in the narrative review. Oral mucositis was the most studied complication, and advisable protocols are conceivable. Although there is a growing interest in PBM to manage of xerostomia, radiodermatitis, pain, and trismus, literature is still scarce to propose a universally feasible protocol. Conclusions PBM therapy could significantly prevent or reduce the severity of many side effects related to cancer therapies. More research is needed to obtain recommendations over the preferable parameters.
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Affiliation(s)
- Margherita Gobbo
- Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, Treviso, Italy
| | | | - Praveen R. Arany
- Oral Biology, Surgery and Biomedical Engineering, University at Buffalo, Getzville, NY, United States
| | | | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Luiz Alcino Gueiros
- Department of Clinic and Preventive Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - Giulia Ottaviani
- Department of Surgical, Medical and Health Sciences, University of Trieste, Trieste, Italy
- *Correspondence: Giulia Ottaviani
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10
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Lipko NB. Photobiomodulation: Evolution and Adaptation. Photobiomodul Photomed Laser Surg 2022; 40:213-233. [DOI: 10.1089/photob.2021.0145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Nancy B. Lipko
- Nancy B. Lipko, MD, MBA, Home Office, Beachwood, Ohio, USA
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11
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Moskvin SV, Strazhev SV. [Low-level laser therapy in oncology - what's new? Analysis of 2018-2021 publications]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2022; 99:56-66. [PMID: 36538405 DOI: 10.17116/kurort20229906156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Low-level laser therapy (LLLT) is included in the Federal project «Fight against oncological diseases», which provides for equipping all specialized medical institutions in Russia with the appropriate devices until 2026. PURPOSE OF THE STUDY Publications analysis on the use of LLLT in oncology. MATERIAL AND METHODS To search for publications, databases and libraries were used: PubMed, Scopus, ResearchGate, Google Scholar, J-STAGE, eLibrary.ru for the period 2018-2021. For analysis, publications were selected that are of interest from the point of view of improving the methodology of LLLT, the prospects for the development of this method in the prevention, treatment and rehabilitation of patients. A total of 223 publications were found, including 39 reviews and meta-analyses, mostly in English (165) and Portuguese (41). RESULTS AND DISCUSSION The inclusion of LLLT in the ISOO/MASCC/ASCO recommendations for the treatment of complications such as mucositis, salivary gland hypofunction and xerostomia caused by non-surgical methods of treating cancer patients should be considered as a promising trend. An extremely low level of quality of LLLT techniques was noted, most often the replacement with meaningless «doses», «fluences» instead of the necessary parameters: wavelength, operating mode, power, frequency, exposure, etc. The use of only local illumination instead of systemic methods of LLLT does not allow obtaining the best results of treatment and prevention. Eliminating the shortcomings of treatment protocols with a focus on Russian experience, when laser blood illumination (intravenously or externally) and laser acupuncture are also necessarily carried out with local illumination of the lesion, will bring the effectiveness of LLLT to a qualitatively new, higher level.
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Affiliation(s)
- S V Moskvin
- Academy of Postgraduate Education of Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency, Moscow, Russia
| | - S V Strazhev
- City Polyclinic No.212 of the Department of Health of the City of Moscow - Branch No. 70, Moscow, Russia
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12
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Extraoral photobiomodulation for prevention of oral and oropharyngeal mucositis in head and neck cancer patients: interim analysis of a randomized, double-blind, clinical trial. Support Care Cancer 2021; 30:2225-2236. [PMID: 34708311 PMCID: PMC8550910 DOI: 10.1007/s00520-021-06625-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/11/2021] [Indexed: 12/20/2022]
Abstract
Purpose To assess the safety and efficacy of prophylactic extraoral photobiomodulation (PBM) for the prevention of oral and oropharyngeal mucositis (OM) on clinical outcomes and survival in patients with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC). Methods OOPSCC patients who received radiotherapy (RT) were prospectively randomized to two groups: prophylactic extraoral PBM and placebo. OM grade (NCI), pain (VAS), analgesia, and anti-inflammatory prescriptions were assessed weekly. Quality of life questionnaires (QoL) were performed at the first and last day of RT. Following RT, participants were evaluated quarterly for oncological outcomes follow-up. Results Fifty-five patients met the inclusion criteria. The first occurrence of OM was observed at week 1, for the placebo group (p = 0.014). Later, OM onset and severity was observed for the PBM group, with first occurrence at week 2 (p = 0.009). No difference in severe OM incidence was observed (p > 0.05). Lower mean pain score was noted at week 7 for the PBM group (2.1) compared to placebo group (4.5) (p = 0.009). Less analgesics (week 3; p = 0.009/week 7; p = 0.02) and anti-inflammatory prescription (week 5; p = 0.0346) were observed for the PBM group. Better QoL scores were observed for the PBM group at last day of RT (p = 0.0034). No difference in overall survival among groups was observed in 1 year of follow-up (p = 0.889). Conclusion Prophylactic extraoral PBM can delay OM onset, reduce pain, and reduce analgesic and anti-inflammatory prescription requirements. Extraoral PBM was associated with better QoL. There was no evidence of PBM impact on oncological outcomes. Trial registration TRN:RBR-4w4swx (date of registration: 01/20/2020). Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06625-8.
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13
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Klausner G, Troussier I, Canova CH, Bensadoun RJ. Clinical use of photobiomodulation as a supportive care during radiation therapy. Support Care Cancer 2021; 30:13-19. [PMID: 34623486 DOI: 10.1007/s00520-021-06518-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Guillaume Klausner
- Oncology - Radiotherapy, Pierre and Marie Curie University, Paris Sorbonne University, 91-105 Boulevard de l'Hôpital, 75013, Paris, France
| | - Idriss Troussier
- Oncology - Radiotherapy, Centre de Haute Énergie (CHE), 10 Boulevard Pasteur, 06000, Nice, France.,Radio-Oncology, University Hospitals of Geneva (HUG), Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Charles-Henry Canova
- Oncology - Radiotherapy, Centre de Haute Énergie (CHE), 10 Boulevard Pasteur, 06000, Nice, France
| | - René-Jean Bensadoun
- Oncology - Radiotherapy, Centre de Haute Énergie (CHE), 10 Boulevard Pasteur, 06000, Nice, France.
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Carroll JD. 2021 Summary of Photobiomodulation Literature. Photobiomodul Photomed Laser Surg 2021; 39:499-501. [DOI: 10.1089/photob.2021.0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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15
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Klausner G, Bensadoun RJ, Champion A, Benzaquen D, Canova CH, Claren A, Mancuso V, Suhl J, Balard R, Troussier I. [State of art of photobiomodulation in the management of radiotherapy adverse events: Indications and level of evidence]. Cancer Radiother 2021; 25:584-592. [PMID: 34272181 DOI: 10.1016/j.canrad.2021.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/18/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the current and potential indications of photobiomodulation (PBM) and their level of evidence in the prevention or management of radiation therapy-related side effects. MATERIALS AND METHODS The Embase, Medline/PubMed, Cochrane, EBSCO, Scopus, and LILACS databases were systematically reviewed to include and analyze publications of clinical studies that have assessed PBM in the prevention or management of radiotherapy-related side effects. The keywords used were "photobiomodulation"; "low level laser therapy"; "acute oral mucositis"; "acute dysphagia"; "acute radiation dermatitis"; "lymphedema"; "xerostomia"; "hyposalivation"; "trismus"; "bone necrosis"; "osteoradionecrosis"; and "radiation induced fibrosis". Prospective studies were included, whereas retrospective cohorts and non-original articles were excluded from the analysis. RESULTS PBM in the red or infrared spectrum has demonstrated efficacy in randomized controlled trials in the prevention and management of radiotherapy-related side effects, especially acute oral mucositis, acute radiation dermatitis, and upper extremity lymphedema. The level of evidence associated with PBM was heterogeneous, but overall was still moderate. The main shortcomings were the diversity and lack of detail in treatment protocols, which could have compromised efficiency and reproducibility of PBM results. CONCLUSION The published data suggest that PBM may be considered as a full-fledged supportive care for patients treated with radiotherapy, or at least in the setting of a therapeutic clinical trial. However, until strong evidence has been published on its long-term safety, the use of PBM should be considered with caution, specifically when applied near areas with proven or potential tumors. The patient should be informed of the theoretical benefits and risks of PBM in order to obtain his informed consent before treatment.
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Affiliation(s)
- G Klausner
- Oncologie - radiothérapie, université Pierre-et-Marie-Curie, Paris Sorbonne université, 91-105, boulevard de l'Hôpital, 75013 Paris, France
| | - R J Bensadoun
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France
| | - A Champion
- Oncologie - radiothérapie, hôpital Latour, avenue J.-D.-Maillard 3, 1217 Meyrin, Suisse
| | - D Benzaquen
- Radio-oncologie, hôpitaux universitaire de Genève (HUG), rue Gabrielle-Perret-Gentil 4, 1205 Genève, Suisse
| | - C H Canova
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France
| | - A Claren
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France
| | - V Mancuso
- Médecine générale, 40 bis, rue Marcel-Miquel, 92130 Issy-Les-Moulineaux, France
| | - J Suhl
- Médecine interne - médecine vasculaire, hôpital Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - R Balard
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France
| | - I Troussier
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France; Médecine interne - médecine vasculaire, hôpital Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
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