The use of photobiomodulation therapy for the prevention of chemotherapy-induced peripheral neuropathy: a randomized, placebo-controlled pilot trial (NEUROLASER trial)

Abstract

Purpose The purpose of this study was to investigate the effectiveness of photobiomodulation (PBM) therapy for the prevention of chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients. Methods A prospective, randomized placebo-controlled pilot trial (NEUROLASER) was set up with 32 breast cancer patients who underwent chemotherapy (ClinicalTrials.gov; NCT03391271). Patients were randomized to receive PBM (n = 16) or placebo treatments (n = 16) (2 × /week) during their chemotherapy. The modified Total Neuropathy Score (mTNS), six-minute walk test (6MWT), Numeric pain Rating Scale (NRS), and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Taxane (FACT/GOG-Taxane) were used to evaluate the severity of CIPN and the patients’ quality of life (QoL). Outcome measures were collected at the first chemotherapy session, 6 weeks after initiation of chemotherapy, at the final chemotherapy session, and 3 weeks after the end of chemotherapy (follow-up). Results The mTNS score increased significantly over time in both the control and the PBM group. A significantly higher score for FACT/GOG-Taxane was observed in the PBM group during chemotherapy compared to the control group. Questions of the FACT/GOG-Taxane related to sensory peripheral neuropathy symptoms showed a significant increase in severeness over time in the control group, whereas they remained constant in the PBM group. At follow-up, a (borderline) significant difference was observed between both groups for the 6MWT and patients’ pain level, in benefit of the PBM group. Conclusions This NEUROLASER trial shows promising results concerning the prevention of CIPN with PBM in breast cancer patients. Furthermore, a better QoL was observed when treated with PBM.

Non-pharmacological therapy for chemotherapy-induced peripheral neurotoxicity: a network meta-analysis of randomized controlled trials

“…Seventeen studies reported pain-alleviating, involving 956 participants [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Among these studies, three studies applied ES as an intervention, including scrambler therapy [14], low-frequency electrical stimulation [16], and neurofeedback therapy [17], 16 studies focused on UCP, two studies adopted interventions pooled as Yoga [15,18], two studies used massage [19,27], two studies used interventions pooled as Edu, including cognitive behavioral therapy [20] and electronic symptom management system [22], six studies used Acu [23-26, 29, 30], one used vitamin and gabapentin (VG [24]), one used photobiomodulation (PBM [21]), and one used ME [28]. There were statistical differences between massage and Acu, VG, and UCP.…”

“…Fourteen studies applied other scales for assessment [14,21,27,34,[42][43][44][45][46][47][48][49][50][51], involving 857 participants. One four-arm trial [43] conducted direct a comparison among Acu, hydroelectric baths (HEB), vitamin, and UCP, one study used ES, one three-arm study conducted a direct comparison among SMT, RT, and UCP [44], five studies used massage [27,42,45,46,51], four study used ME [34,47,48,50], and one study used PBM [21]. A close loop of the network map was formed by SMT, RT, and UCP.…”