Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer

part 2: proposed applications and treatment protocols

Judith A.E.M. Zecha, Judith E. Raber-Durlacher, Raj G. Nair, Joel B. Epstein, Sharon Elad, Michael R. Hamblin, Andrei Barasch, Cesar Migliorati, Dan M.J. Milstein, Marie Thérèse Genot, Liset Lansaat, Ron van der Brink, Josep Arnabat-Dominguez, Lisette van der Molen, Irene Jacobi, Judi van Diessen, Jan de Lange, Ludi E. Smeele, Mark M. Schubert, René Jean Bensadoun

Research output: Contribution to journalReview article

47 Citations (Scopus)

Abstract

Purpose: There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photobiomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved and dosimetric parameters may lead to the management of a broader range of complications associated with HNC treatment. This could enhance patient adherence to cancer therapy, and improve quality of life and treatment outcomes. The mechanisms of action, dosimetric, and safety considerations for PBM have been reviewed in part 1. Part 2 discusses the head and neck treatment side effects for which PBM may prove to be effective. In addition, PBM parameters for each of these complications are suggested and future research directions are discussed. Methods: Narrative review and presentation of PBM parameters are based on current evidence and expert opinion. Results: PBM may have potential applications in the management of a broad range of side effects of (chemo)radiation therapy (CRT) in patients being treated for HNC. For OM management, optimal PBM parameters identified were as follows: wavelength, typically between 633 and 685 nm or 780–830 nm; energy density, laser or light-emitting diode (LED) output between 10 and 150 mW; dose, 2–3 J (J/cm2), and no more than 6 J/cm2 on the tissue surface treated; treatment schedule, two to three times a week up to daily; emission type, pulsed (<100 Hz); and route of delivery, intraorally and/or transcutaneously. To facilitate further studies, we propose potentially effective PBM parameters for prophylactic and therapeutic use in supportive care for dermatitis, dysphagia, dry mouth, dysgeusia, trismus, necrosis, lymphedema, and voice/speech alterations. Conclusion: PBM may have a role in supportive care for a broad range of complications associated with the treatment of HNC with CRT. The suggested PBM irradiation and dosimetric parameters, which are potentially effective for these complications, are intended to provide guidance for well-designed future studies. It is imperative that such studies include elucidating the effects of PBM on oncology treatment outcomes.

Original languageEnglish (US)
Pages (from-to)2793-2805
Number of pages13
JournalSupportive Care in Cancer
Volume24
Issue number6
DOIs
StatePublished - Jun 1 2016

Fingerprint

Head and Neck Neoplasms
Clinical Protocols
Stomatitis
Radiotherapy
Dysgeusia
Trismus
Therapeutics
Lymphedema
Expert Testimony
Therapeutic Uses
Dermatitis
Patient Compliance
Deglutition Disorders
Mouth
Appointments and Schedules
Lasers
Necrosis
Neck
Head
Quality of Life

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer : part 2: proposed applications and treatment protocols. / Zecha, Judith A.E.M.; Raber-Durlacher, Judith E.; Nair, Raj G.; Epstein, Joel B.; Elad, Sharon; Hamblin, Michael R.; Barasch, Andrei; Migliorati, Cesar; Milstein, Dan M.J.; Genot, Marie Thérèse; Lansaat, Liset; van der Brink, Ron; Arnabat-Dominguez, Josep; van der Molen, Lisette; Jacobi, Irene; van Diessen, Judi; de Lange, Jan; Smeele, Ludi E.; Schubert, Mark M.; Bensadoun, René Jean.

In: Supportive Care in Cancer, Vol. 24, No. 6, 01.06.2016, p. 2793-2805.

Research output: Contribution to journalReview article

Zecha, JAEM, Raber-Durlacher, JE, Nair, RG, Epstein, JB, Elad, S, Hamblin, MR, Barasch, A, Migliorati, C, Milstein, DMJ, Genot, MT, Lansaat, L, van der Brink, R, Arnabat-Dominguez, J, van der Molen, L, Jacobi, I, van Diessen, J, de Lange, J, Smeele, LE, Schubert, MM & Bensadoun, RJ 2016, 'Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2: proposed applications and treatment protocols', Supportive Care in Cancer, vol. 24, no. 6, pp. 2793-2805. https://doi.org/10.1007/s00520-016-3153-y
Zecha, Judith A.E.M. ; Raber-Durlacher, Judith E. ; Nair, Raj G. ; Epstein, Joel B. ; Elad, Sharon ; Hamblin, Michael R. ; Barasch, Andrei ; Migliorati, Cesar ; Milstein, Dan M.J. ; Genot, Marie Thérèse ; Lansaat, Liset ; van der Brink, Ron ; Arnabat-Dominguez, Josep ; van der Molen, Lisette ; Jacobi, Irene ; van Diessen, Judi ; de Lange, Jan ; Smeele, Ludi E. ; Schubert, Mark M. ; Bensadoun, René Jean. / Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer : part 2: proposed applications and treatment protocols. In: Supportive Care in Cancer. 2016 ; Vol. 24, No. 6. pp. 2793-2805.
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abstract = "Purpose: There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photobiomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved and dosimetric parameters may lead to the management of a broader range of complications associated with HNC treatment. This could enhance patient adherence to cancer therapy, and improve quality of life and treatment outcomes. The mechanisms of action, dosimetric, and safety considerations for PBM have been reviewed in part 1. Part 2 discusses the head and neck treatment side effects for which PBM may prove to be effective. In addition, PBM parameters for each of these complications are suggested and future research directions are discussed. Methods: Narrative review and presentation of PBM parameters are based on current evidence and expert opinion. Results: PBM may have potential applications in the management of a broad range of side effects of (chemo)radiation therapy (CRT) in patients being treated for HNC. For OM management, optimal PBM parameters identified were as follows: wavelength, typically between 633 and 685 nm or 780–830 nm; energy density, laser or light-emitting diode (LED) output between 10 and 150 mW; dose, 2–3 J (J/cm2), and no more than 6 J/cm2 on the tissue surface treated; treatment schedule, two to three times a week up to daily; emission type, pulsed (<100 Hz); and route of delivery, intraorally and/or transcutaneously. To facilitate further studies, we propose potentially effective PBM parameters for prophylactic and therapeutic use in supportive care for dermatitis, dysphagia, dry mouth, dysgeusia, trismus, necrosis, lymphedema, and voice/speech alterations. Conclusion: PBM may have a role in supportive care for a broad range of complications associated with the treatment of HNC with CRT. The suggested PBM irradiation and dosimetric parameters, which are potentially effective for these complications, are intended to provide guidance for well-designed future studies. It is imperative that such studies include elucidating the effects of PBM on oncology treatment outcomes.",
author = "Zecha, {Judith A.E.M.} and Raber-Durlacher, {Judith E.} and Nair, {Raj G.} and Epstein, {Joel B.} and Sharon Elad and Hamblin, {Michael R.} and Andrei Barasch and Cesar Migliorati and Milstein, {Dan M.J.} and Genot, {Marie Th{\'e}r{\`e}se} and Liset Lansaat and {van der Brink}, Ron and Josep Arnabat-Dominguez and {van der Molen}, Lisette and Irene Jacobi and {van Diessen}, Judi and {de Lange}, Jan and Smeele, {Ludi E.} and Schubert, {Mark M.} and Bensadoun, {Ren{\'e} Jean}",
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TY - JOUR

T1 - Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer

T2 - part 2: proposed applications and treatment protocols

AU - Zecha, Judith A.E.M.

AU - Raber-Durlacher, Judith E.

AU - Nair, Raj G.

AU - Epstein, Joel B.

AU - Elad, Sharon

AU - Hamblin, Michael R.

AU - Barasch, Andrei

AU - Migliorati, Cesar

AU - Milstein, Dan M.J.

AU - Genot, Marie Thérèse

AU - Lansaat, Liset

AU - van der Brink, Ron

AU - Arnabat-Dominguez, Josep

AU - van der Molen, Lisette

AU - Jacobi, Irene

AU - van Diessen, Judi

AU - de Lange, Jan

AU - Smeele, Ludi E.

AU - Schubert, Mark M.

AU - Bensadoun, René Jean

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Purpose: There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photobiomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved and dosimetric parameters may lead to the management of a broader range of complications associated with HNC treatment. This could enhance patient adherence to cancer therapy, and improve quality of life and treatment outcomes. The mechanisms of action, dosimetric, and safety considerations for PBM have been reviewed in part 1. Part 2 discusses the head and neck treatment side effects for which PBM may prove to be effective. In addition, PBM parameters for each of these complications are suggested and future research directions are discussed. Methods: Narrative review and presentation of PBM parameters are based on current evidence and expert opinion. Results: PBM may have potential applications in the management of a broad range of side effects of (chemo)radiation therapy (CRT) in patients being treated for HNC. For OM management, optimal PBM parameters identified were as follows: wavelength, typically between 633 and 685 nm or 780–830 nm; energy density, laser or light-emitting diode (LED) output between 10 and 150 mW; dose, 2–3 J (J/cm2), and no more than 6 J/cm2 on the tissue surface treated; treatment schedule, two to three times a week up to daily; emission type, pulsed (<100 Hz); and route of delivery, intraorally and/or transcutaneously. To facilitate further studies, we propose potentially effective PBM parameters for prophylactic and therapeutic use in supportive care for dermatitis, dysphagia, dry mouth, dysgeusia, trismus, necrosis, lymphedema, and voice/speech alterations. Conclusion: PBM may have a role in supportive care for a broad range of complications associated with the treatment of HNC with CRT. The suggested PBM irradiation and dosimetric parameters, which are potentially effective for these complications, are intended to provide guidance for well-designed future studies. It is imperative that such studies include elucidating the effects of PBM on oncology treatment outcomes.

AB - Purpose: There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photobiomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved and dosimetric parameters may lead to the management of a broader range of complications associated with HNC treatment. This could enhance patient adherence to cancer therapy, and improve quality of life and treatment outcomes. The mechanisms of action, dosimetric, and safety considerations for PBM have been reviewed in part 1. Part 2 discusses the head and neck treatment side effects for which PBM may prove to be effective. In addition, PBM parameters for each of these complications are suggested and future research directions are discussed. Methods: Narrative review and presentation of PBM parameters are based on current evidence and expert opinion. Results: PBM may have potential applications in the management of a broad range of side effects of (chemo)radiation therapy (CRT) in patients being treated for HNC. For OM management, optimal PBM parameters identified were as follows: wavelength, typically between 633 and 685 nm or 780–830 nm; energy density, laser or light-emitting diode (LED) output between 10 and 150 mW; dose, 2–3 J (J/cm2), and no more than 6 J/cm2 on the tissue surface treated; treatment schedule, two to three times a week up to daily; emission type, pulsed (<100 Hz); and route of delivery, intraorally and/or transcutaneously. To facilitate further studies, we propose potentially effective PBM parameters for prophylactic and therapeutic use in supportive care for dermatitis, dysphagia, dry mouth, dysgeusia, trismus, necrosis, lymphedema, and voice/speech alterations. Conclusion: PBM may have a role in supportive care for a broad range of complications associated with the treatment of HNC with CRT. The suggested PBM irradiation and dosimetric parameters, which are potentially effective for these complications, are intended to provide guidance for well-designed future studies. It is imperative that such studies include elucidating the effects of PBM on oncology treatment outcomes.

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