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

Margherita Gobbo; Praveen R Arany; Elisabetta Merigo; René-Jean Bensadoun; Alan Roger Santos-Silva; Luiz Alcino Gueiros; Giulia Ottaviani

doi:10.1007/s00520-023-07749-9

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

Support Care Cancer. 2023 Apr 28;31(5):306. doi: 10.1007/s00520-023-07749-9.

Authors

Margherita Gobbo¹, Praveen R Arany², Elisabetta Merigo³, René-Jean Bensadoun⁴, Alan Roger Santos-Silva⁵, Luiz Alcino Gueiros⁶, Giulia Ottaviani⁷

Affiliations

¹ Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, Treviso, Italy.
² Oral Biology, Surgery and Biomedical Engineering, University at Buffalo, Buffalo, NY, USA.
³ Faculty of Dentistry, Côte d'Azur University, Nice, France.
⁴ Department of Radiation Oncology, Centre de Haute Energie, Nice, France.
⁵ Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, São Paulo, Brazil.
⁶ Department of Clinic and Preventive Dentistry, Federal University of Pernambuco, Pernambuco, Brazil.
⁷ Department of Surgical, Medical and Health Sciences, University of Trieste, Trieste, Italy. gottaviani@units.it.

PMID: 37115315
DOI: 10.1007/s00520-023-07749-9

Abstract

Purpose: To investigate the role of photobiomodulation (PBM) in patients undergoing head and neck cancer (HNC) treatment. We focused on the consequences of the main complications, such as quality of life (QoL), analgesia, functional impairment, and nutritional status, as well as on the impact on survival/ recurrences, radiotherapy (RT) interruption, adherence, cost-effectiveness, safety, feasibility, and tolerability.

Methods: An electronic search in PubMed and Scopus databases was performed. Full texts were carefully assessed, and data were assimilated into a tabular form for discussion and consensus among the expert panel.

Results: A total of 22 papers were included. Overall, a beneficial effect of PBM was evidenced in the amelioration of QoL, nutritional status, the reduction of pain, and functional impairment. Preventive PBM may reduce the incidence and duration of RT interruptions, potentially contributing to improved cancer treatment outcomes. PBM treatments are safe and recommended for routine use, with the caveat of avoiding direct tumor exposures where feasible. However, it does not appear to impact cancer survivorship/recurrences directly. Despite additional clinical efforts involving routine PBM use, the individual and public health benefits will positively impact oncology care.

Conclusions: Quality of life, pain and functional impairment, nutritional status, and survival may be effectively improved with PBM. Given its established efficacy also in reducing RT interruptions and its safety, feasibility, and tolerability, PBM should be included in the field of supportive cancer care in HNC patients. Improved understanding of PBM mechanisms and precise dose parameters is enabling the generation of more robust, safe, and reproducible protocols; thus, it is imperative to support further clinical implementation as well as both applied and basic science research in this novel field.

Keywords: Head and neck neoplasms; Laser therapy; Nutritional status; Pain; Photobiomodulation; Quality of life.

Publication types

Review

MeSH terms

Head and Neck Neoplasms* / radiotherapy
Humans
Low-Level Light Therapy* / methods
Neoplasm Recurrence, Local
Quality of Life
Treatment Outcome