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

René‐Jean Bensadoun,Praveen Arany,Jolien Robijns,Marie‐Thérèse Genot‐Klastersky,Judith E Raber‐Durlacher,Cesar Migliorati,Raj G Nair,Nathaniel Treister,Joel B Epstein,Andrei Barasch,Joy Lodewijckx

doi:10.1002/cam4.3582

Abstract

We performed a systematic review of the current literature addressing the safety and efficacy of photobiomodulation therapy (PBMT) in cancer patients. In this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were used. In vitro, in vivo, and clinical studies, which investigated the effect of PBMT on cell proliferation/differentiation, tumor growth, recurrence rate, and/or overall survival were included. The Medline/PubMed, EMBASE, and Scopus databases were searched through April 2020. A total of 67 studies met the inclusion criteria with 43 in vitro, 15 in vivo, and 9 clinical studies identified. In vitro studies investigating the effect of PBMT on a diverse range of cancer cell lines demonstrated conflicting results. This could be due to the differences in used parameters and the frequency of PBM applications. In vivo studies and clinical trials with a follow‐up period demonstrated that PBMT is safe with regards to tumor growth and patient advantage in the prevention and treatment of specific cancer therapy‐related complications. Current human studies, supported by most animal studies, show safety with PBMT using currently recommended clinical parameters, including in Head & Neck cancer (HNC) in the area of PBMT exposure. A significant and growing literature indicates that PBMT is safe and effective, and may even offer a benefit in patient overall survival. Nevertheless, continuing research is indicated to improve understanding and provide further elucidation of remaining questions regarding PBM use in oncology.

Highlights

In 1967, Dr Endre Mester was the first scientist to discover that a low power laser had a stimulating effect on hair regrowth in mice.[1]
We considered for inclusion all in vivo and human clinical trials articles dealing with treatment and/or prevention of cancer therapy-related complications, as well as in vitro studies on the safety of photobiomodulation therapy (PBMT) on cell lines
This led to the hypothesis that the upregulation of ATP signaling by PBM stimulated differentiation of tumor cells and apoptosis, leading to an inhibition of tumor proliferation.[84,85]

Summary

| INTRODUCTION

In 1967, Dr Endre Mester was the first scientist to discover that a low power laser had a stimulating effect on hair regrowth in mice.[1]. PBM provokes a nonthermal process whereby endogenous chromophores elicit photophysical and photochemical events at diverse biological levels This process results in positive therapeutic outcomes including the stimulation of tissue regeneration and wound healing, the reduction of inflammation and pain, and immunomodulation.[3]. Since 1967, the number of clinical applications of light therapy has increased steadily in multiple medical fields, and in recent years PBM has been widely used for supportive care of cancer patients.[4,5] The best-studied cancer therapy-related complication, for which PBM is recommended, is oral mucositis (OM).

| MATERIALS AND METHODS

| DISCUSSION

Findings

| Limitations

| CONCLUSION