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

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SUPPORTIVE CARE IN CANCER
卷 31, 期 5, 页码 -

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SPRINGER
DOI: 10.1007/s00520-023-07749-9

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

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The role of photobiomodulation (PBM) in head and neck cancer (HNC) treatment was investigated. PBM showed beneficial effects in improving quality of life (QoL), nutritional status, reducing pain and functional impairment. It may also reduce interruptions in radiotherapy (RT) and improve cancer treatment outcomes. However, it does not directly impact cancer survival/recurrences. PBM should be included in supportive cancer care for HNC patients due to its efficacy, safety, feasibility, and tolerability.
PurposeTo 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.MethodsAn 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.ResultsA 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.ConclusionsQuality 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.

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