Cost-effectiveness of low-level laser therapy (LLLT) in head and neck cancer patients receiving concurrent chemoradiation

Antunes, Héliton Spíndola; Schluckebier, Luciene; Herchenhorn, Daniel; Small, I. A.; Araújo, Carlos; Viégas, Célia M.; Rampini, Mariana P.; Ferreira, Elza M.S.; Dias, Fernando Luiz; Teich, Vanessa; Teich, Nelson; Ferreira, Carlos Gil

doi:10.1016/j.oraloncology.2015.10.022

Cited by 50 publications

(26 citation statements)

References 22 publications

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“…In addition to the high device prices, additional costs come when the therapeutic session is carried out by healthcare practitioners such as physical therapists, chiropractors, nurses or physicians. Only in few cases is this cost-effective when the lasers are used [26]. In this sense, the adoption of LED lights into PBM/LLLT treatment practices could support the wider acceptance of PBM/LLLT by the medical community.…”

Section: Lasers and Light-emitting Diodes (Leds) In Photobiomodulationmentioning

confidence: 99%

Photobiomodulation: lasers vs. light emitting diodes?

Heiskanen

Hamblin

2018

Photochem Photobiol Sci

193

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Photobiomodulation (PBM) is a treatment method based on research findings showing that irradiation with certain wavelengths of red or near-infrared light has been shown to produce a range of physiological effects in cells, tissues, animals and humans. Scientific research into PBM was initially started in the late 1960s by utilizing the newly invented (1960) lasers, and the therapy rapidly became known as "low-level laser therapy". It was mainly used for wound healing and reduction of pain and inflammation. Despite other light sources being available during the first 40 years of PBM research, lasers remained by far the most commonly employed device, and in fact, some authors insisted that lasers were essential to the therapeutic benefit. Collimated, coherent, highly monochromatic beams with the possibility of high power densities were considered preferable. However in recent years, non-coherent light sources such as light-emitting diodes (LEDs) and broad-band lamps have become common. Advantages of LEDs include no laser safety considerations, ease of home use, ability to irradiate a large area of tissue at once, possibility of wearable devices, and much lower cost per mW. LED photobiomodulation is here to stay.

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Section: Lasers and Light-emitting Diodes (Leds) In Photobiomodulationmentioning

confidence: 99%

Photobiomodulation: lasers vs. light emitting diodes?

Heiskanen

Hamblin

2018

Photochem Photobiol Sci

193

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“…Cost-effectiveness studies about OM treatment are rare [29, 53]. Antunes et al [29] found that the ICER was US$4961.37 per severe OM case prevented, also considering the SUS. However, the authors did not investigate any patient-reported outcomes, such as QoL, as we propose in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Antunes et al [29] conducted a cost-effectiveness study regarding the use of PBMT in the treatment of OM, taking into consideration the public health system perspective and the prevention of severe OM as the effectiveness measure. The authors concluded that the patients treated with PBMT presented an incremental cost of US$1689.00, when compared with the patients not exposed to PBMT; the incremental cost-effectiveness ratio was US$4961.37 per severe case of OM prevented.…”

Section: Introductionmentioning

confidence: 99%

Effect of photobiomodulation on the severity of oral mucositis and molecular changes in head and neck cancer patients undergoing radiotherapy: a study protocol for a cost-effectiveness randomized clinical trial

Martins

Nogueira

Morais

et al. 2019

Trials

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BackgroundOral mucositis (OM) is the most frequent and debilitating acute side effect associated with head and neck cancer (HNC) treatment. When present, severe OM negatively impacts the quality of life of patients undergoing HNC treatment. Photobiomodulation is a well-consolidated and effective therapy for the treatment and prevention of severe OM, and is associated with a cost reduction of the cancer treatment. Although an increase in the quality of life and a reduction in the severity of OM are well described, there is no study on cost-effectiveness for this approach considering the quality of life as a primary outcome. In addition, little is known about the photobiomodulation effects on salivary inflammatory mediators. Thus, this study aimed to assess the cost-effectiveness of the photobiomodulation therapy for the prevention and control of severe OM and its influence on the salivary inflammatory mediators.Methods/designThis randomized, double-blind clinical trial will include 50 HNC patients undergoing radiotherapy or chemoradiotherapy. The participants will be randomized into two groups: intervention group (photobiomodulation) and control group (preventive oral care protocol). OM (clinical assessment), saliva (assessment of collected samples) and quality of life (Oral Health Impact Profile-14 and Patient-Reported Oral Mucositis Symptoms questionnaires) will be assessed at the 1st, 7th, 14th, 21st and 30th radiotherapy sessions. Oxidative stress and inflammatory cytokine levels will be measured in the saliva samples of all participants. The costs are identified, measured and evaluated considering the radiotherapy time interval. The incremental cost-effectiveness ratio will be estimated. The study will be conducted according to the Brazilian public health system perspective.DiscussionPhotobiomodulation is an effective therapy that reduces the cost associated with OM treatment. However, little is known about its cost-effectiveness, mainly when quality of life is the effectiveness measure. Additionally, this therapy is not supported by the Brazilian public health system. Therefore, this study widens the knowledge about the safety of and strengthens evidence for the use of photobiomodulation therapy, providing information for public policy-makers and also for dental care professionals. This study is strongly encouraged due to its clinical relevance and the possibility of incorporating new technology into public health systems.Trial registrationBrazilian Registry of Clinical Trials—ReBEC, RBR-5h4y4n. Registered on 13 June 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-019-3196-8) contains supplementary material, which is available to authorized users.

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“…[4][5][6][7][8][9] The recent literature data have shown the effectiveness of low-level laser therapy (LLLT) in the prevention and treatment of OM, [4][5][6][7][8][9] producing important analgesic, biomodulatory, and anti-inflammatory effects. 4,6,[9][10][11][12][13][14][15][16] This fact contributed to the International Society of Oral Oncology and the Multinational Association of Supportive Care in Cancer (MASCC/ISOO) raised the LLLT for a recommended therapy in their clinical practice guideline for OM management. 4 However, besides LLLT, the use of light-emitting diode (LED) to treat lesions of OM has been studied with promising but still inconclusive results.…”

Section: Introductionmentioning

confidence: 99%

Phototherapy With LED as an Effective Treatment for Chemotherapy-Induced Oral Mucositis in Hamsters

et al. 2020

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Introduction: Oral mucositis (OM) has been considered one of the most feared collateral effects of oncological treatments. Some therapies have been used, such as light-emitting diode (LED), with promising results, but with no sufficient evidence in the literature. Objective: Our study aimed to evaluate, by clinical and histological analysis, the effect of LED on the treatment of chemotherapy-induced OM (CIOM) in an animal model. Methods: Twenty male hamsters were equally distributed to two groups: control (C), which received anesthesia and CIOM induction; and LED (L), which received anesthesia, CIOM induction, and LED treatment (635 nm, 120 mW, 0.48 J). The clinical analysis was performed through two specific scales for OM analysis on days 5, 7 and 10 of the experiment. In addition, the injured area of all hamsters check pouch mucosa was removed and processed for histological analysis on the last experimental day. Results: After statistical analysis, group L showed less severity of OM when compared with the C group (P < 0.05); beyond that, both healed completely on day 10. Conclusion:Our results suggested that the phototherapy with LED had a positive effect on accelerating repair, reducing the severity of CIOM.

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Cost-effectiveness of low-level laser therapy (LLLT) in head and neck cancer patients receiving concurrent chemoradiation

Cited by 50 publications

References 22 publications

Photobiomodulation: lasers vs. light emitting diodes?

Photobiomodulation: lasers vs. light emitting diodes?

Effect of photobiomodulation on the severity of oral mucositis and molecular changes in head and neck cancer patients undergoing radiotherapy: a study protocol for a cost-effectiveness randomized clinical trial

Phototherapy With LED as an Effective Treatment for Chemotherapy-Induced Oral Mucositis in Hamsters

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