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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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Bensadoun RJ, Epstein JB. Photobiomodulation safety in cancer patients: in vivo data : (in response to S. Sonis' commentary "Could the impact of photobiomodulation on tumor response to radiation be affected by tumor heterogeneity?", Support Care Cancer 2019 (in press)). Support Care Cancer 2020; 28:3003-3006. [PMID: 32198559 DOI: 10.1007/s00520-020-05410-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/10/2020] [Indexed: 12/28/2022]
Affiliation(s)
| | - Joel B Epstein
- City of Hope Comprehensive Cancer Center, Duarte CA and Cedars-Sinai Health System, Los Angeles, CA, USA
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