Does laser photobiomodulation prevent hyposalivation in patients undergoing head and neck radiotherapy? A systematic review and meta-analysis of controlled trials

Louzeiro, Gabriel Campos; Teixeira, Dieni Da Silveira; Cherubini, Karen; Figueiredo, Maria Antonia Zancanaro de; Salum, Fernanda Gonçalves

doi:10.1016/j.critrevonc.2020.103115

Cited by 19 publications

(7 citation statements)

References 61 publications

(115 reference statements)

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“…Of note, none of the studies disclosed the ethnic backgrounds of the patient population. Skin pigmentation may severely affect the biological effect of PBMT since decreased chromophores’ adsorption may result in insufficient or inhibitory effects; as such, the therapy should be modulated according to skin color [ 48 ]. An interesting advantage over the studies conducted by Robijns et al is the use of PBMT to specifically treat RD, whereas many studies on PBMT describe a single technique to be used for various side effects [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Photobiomodulation therapy for the prevention of acute radiation dermatitis: a systematic review and meta-analysis

Gobbo

Rico

Marta

et al. 2023

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Purpose Approximately 95% of patients undergoing radiotherapy (RT) experience radiation dermatitis (RD). Evidence has suggested that photobiomodulation therapy (PBMT) can stimulate skin renewal and minimize RD. The aim of the present paper was to investigate the efficacy of PBMT in RD prevention through a comprehensive literature review. Methods A literature search of Ovid MEDLINE, Embase, and Cochrane databases was conducted from 1980 to March 2021 to identify RCT on the use of PBMT for RD prevention. Forest plots were developed using RevMan software to quantitatively compare data between studies. Results Five papers were identified: four in breast and one in head and neck cancer patients. Patients receiving PBMT experienced less severe RD than the control groups after 40 Gray (Gy) of RT (grade 3 toxicity: Odds Ratio (OR): 0.57, 95% CI 0.14–2.22, p = 0.42) and at the end of RT (grade 0 + 1 vs. 2 + 3 toxicity: OR: 0.28, 95% CI 0.15–0.53, p < 0.0001). RT interruptions due to RD severity were more frequent in the control group (OR: 0.81, 95% CI 0.10–6.58, p = 0.85). Conclusion Preventive PBMT may be protective against the development of severe grades of RD and reduce the frequency of RT interruptions. Larger sample sizes and other cancer sites at-risk of RD should be evaluated in future studies to confirm the true efficacy of PBMT, also in preventing the onset of RD and to finalize a standardized protocol to optimize the technique. At present, starting PBMT when RT starts is recommendable, as well as performing 2 to 3 laser sessions weekly. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-023-07673-y.

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Section: Discussionmentioning

confidence: 99%

Photobiomodulation therapy for the prevention of acute radiation dermatitis: a systematic review and meta-analysis

Gobbo

Rico

Marta

et al. 2023

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“…Even if the wavelength falls within the correct absorption spectrum, low doses of energy are insufficient to start the biological effect, and excessive dosages can result in inhibitory. Moreover, therapeutic responses are restricted to a limited therapeutic dose window termed the Arndt Schultz curve [53]. Recent papers emerged in the literature regarding the possibility of enabling comparisons between protocols, creating a system of "dosing consistency, " which is effective with multiple combined wavelengths.…”

Section: Discussionmentioning

confidence: 99%

Quality assessment of PBM protocols for oral complications in head and neck cancer patients: part 2

Gobbo

Arany

Merigo

et al. 2023

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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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“…Furthermore, the regulation of extracellular signal-regulated kinase (ERK) and aquaporin-1 (AQP1) proteins can modulate morphological changes in Schwann cells, supporting the progression of facial nerve oedema [45]. In this context, authors have shown that PBM can regulate p53 and PUMA in human dermal fibroblasts and human acinar cells [46,47], as well as AQP1, mediating its effects on human erythrocytes [48].…”

Section: Discussionmentioning

confidence: 99%

Recovery from Idiopathic Facial Paralysis (Bell’s Palsy) Using Photobiomodulation in Patients Non-Responsive to Standard Treatment: A Case Series Study

et al. 2021

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Diminished facial movement and marked facial asymmetry can lead to a consistent psychological burden. Bell′s palsy (BP) is one of the most common causes of facial nerve illness, which comes with unilateral acute facial paresis. Nowadays, no clear guidelines for treating BP are available. We carried out a case series study to test the efficacy of photobiomodulation (PBM) therapy in patients with BP non-responsive to standard treatment. The study was experimentally performed at the Department of Surgical and Diagnostic Sciences, University of Genoa (Genoa, Italy), in accordance with case report guidelines. Patients were referred to our department by colleagues for evaluation to be included in the case series because no consistent improvement was observed at least 3 months from the diagnosis of BP. All the patients interrupted their pharmacological therapy before the initiation of PBM therapy. PBM therapy (808 nm, 1 W irradiated in continuous-wave for 60 s on spot-size 1 cm2; 1 W/cm2; 60 J/cm2; and 60 J) was administered every 2 days until complete resolution. Evaluation of the House-Brackmann scale was performed before and after treatments. Fourteen patients were screened as eligible for the study. Patients were Caucasians (36% females and 64% males) with a mean age ± standard deviation of 56.07 ± 15.21 years. Eleven patients out of 14, who experienced BP a maximum of 6 months, completely recovered through PBM. The three patients that did not show improvement were those who had experienced BP for years. PBM could be a supportive therapy for the management of BP in patients non-responsive to standard treatment. However, randomized controlled trials are necessary to sustain our encouraging results, exclude bias, and better explain the boundary between the time from diagnosis and the recovery of BP through PBM therapy.

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Does laser photobiomodulation prevent hyposalivation in patients undergoing head and neck radiotherapy? A systematic review and meta-analysis of controlled trials

Cited by 19 publications

References 61 publications

Photobiomodulation therapy for the prevention of acute radiation dermatitis: a systematic review and meta-analysis

Photobiomodulation therapy for the prevention of acute radiation dermatitis: a systematic review and meta-analysis

Quality assessment of PBM protocols for oral complications in head and neck cancer patients: part 2

Recovery from Idiopathic Facial Paralysis (Bell’s Palsy) Using Photobiomodulation in Patients Non-Responsive to Standard Treatment: A Case Series Study

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