Tumor safety and side effects of photobiomodulation therapy used for prevention and management of cancer treatment toxicities. A systematic review

Paglioni, Mariana de Pauli; Araujo, André; Arboleda, Lady Paola Aristizábal; Palmier, Natália Rangel; Fonsêca, Jéssica Montenegro; Gomes-Silva, Wagner; Madrid-Troconis, Cristhian Camilo; Silveira, Felipe Martins; Martins, Manoela Domingues; Faria, Karina Morais; Ribeiro, Ana Carolina Prado; Brandão, Thaís Bianca; Lopes, Márcio Ajudarte; Leme, Adriana Franco Paes; Migliorati, Cesar A.; Santos‐Silva, Alan Roger

doi:10.1016/j.oraloncology.2019.04.004

Cited by 63 publications

(40 citation statements)

References 56 publications

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“…Thus, we agree with Bannuru et al (2014) who suggested that "Guideline developers should word recommendations carefully to avoid losing therapeutic options that may benefit a subset of patients in a field in which few safe and effective treatments are available" [56]. The safety of LLLT has been investigated and confirmed in the published literature [57,58].…”

Section: Discussionsupporting

confidence: 82%

Guidelines versus evidence: what we can learn from the Australian guideline for low-level laser therapy in knee osteoarthritis? A narrative review

Chow

Liebert

Tilley³

et al. 2020

Lasers Med Sci

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This narrative review analyses the Australian Guideline (2018) for the treatment of knee osteoarthritis (KOA) developed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The Guideline recommended against the use low-level laser therapy (LLLT). Why this conclusion was reached is discussed in this review in the context of evidence provided in other systematic reviews, the latest of which was published in 2019 and which provided strong support for LLLT for knee OA. We evaluated the reference list cited for the recommendation "against" LLLT and compared this with reference lists of systematic reviews and studies published before and after the publication date of the Guideline. Eight randomised controlled trials (RCTs) of LLLT were cited in the Guideline the latest of which was published in 2012. There were seventeen additional RCTs, five of which together with one systematic review were located in the year of publication, 2018. The most recent systematic review in 2019 included 22 RCTs in its analysis. Discordance with the levels of evidence and recommendations was identified. Although GRADE methodology is said to be robust for systematically evaluating evidence and developing recommendations, many studies were not identified in the Guideline. In contrast, the latest systematic review and meta-analysis provides robust evidence for supporting the use of LLLT in knee OA. The conflict between guidelines based on opinion and evidence based on meta-analysis is highlighted. Given the totality of the evidence, we recommend that the Australian Guideline should be updated immediately to reflect a "for" recommendation.

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Section: Discussionsupporting

confidence: 82%

Guidelines versus evidence: what we can learn from the Australian guideline for low-level laser therapy in knee osteoarthritis? A narrative review

Chow

Liebert

Tilley³

et al. 2020

Lasers Med Sci

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“…24,25 Considering the conflicting evidence from animal models regarding the effect of PBM on tumor behavior, the clinician is advised to inform patients about the expected benefits and potential risks of PBM. 23,26…”

Section: A Recommendation For the Prevention Of Om Withmentioning

confidence: 99%

MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy

Lalla

Bowen

Barasch

et al. 2020

Cancer

587

183

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Background Mucositis is a significant toxicity of cancer therapy with numerous systemic sequelae. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for the management of mucositis. Methods The literature was reviewed systematically to identify interventions for mucositis. Studies were rated according to the presence of major and minor flaws according to previously published criteria. The body of evidence for each intervention and in each treatment setting was assigned a level of evidence based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. Results The guideline covers evidence from 1197 publications related to oral or gastrointestinal mucositis. Thirteen new guidelines were developed for or against the use of various interventions in specific treatment settings, and 11 previous guidelines were confirmed after aa review of new evidence. Thirteen previously established guidelines were carried over because there was no new evidence for these interventions. Conclusions The updated MASCC/ISOO Clinical Practice Guidelines for mucositis provide professional health caregivers with a clinical setting‐specific, evidence‐based tool to help with the management of mucositis in patients who have cancer.

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“…As there is a clear contrast between in vivo and human studies versus in vitro cell culture studies, related to the tumor microenvironment. 66,97,98 In vitro studies strengthen the meaning of dosimetry and exact description and control of PBM parameters for clinical, oncologic use. The benefits of the use of PBM and levels of theoretical risk should be considered for the best patient care.…”

Section: Discussionmentioning

confidence: 97%

Safety and efficacy of photobiomodulation therapy in oncology: A systematic review

et al. 2020

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Tumor safety and side effects of photobiomodulation therapy used for prevention and management of cancer treatment toxicities. A systematic review

Cited by 63 publications

References 56 publications

Guidelines versus evidence: what we can learn from the Australian guideline for low-level laser therapy in knee osteoarthritis? A narrative review

Guidelines versus evidence: what we can learn from the Australian guideline for low-level laser therapy in knee osteoarthritis? A narrative review

MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy

Safety and efficacy of photobiomodulation therapy in oncology: A systematic review

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