Bensadoun RJ - Photobiomodulation, mucositis, radiation-induced dermatitis, and lymphedema in oncology: a narrative review

This review provides an overview of photobiomodulation as a treatment for adverse effects of cancer therapy: oral mucositis, radiation-induced dermatitis, and lymphedema. The author describes a large body of data on oral mucositis and presents the other two indications as areas for further exploration.

What This Publication Covers

Published in 2018 in *Current Opinion in Oncology*, this review was authored solely by René-Jean Bensadoun of Nice. Its objective is to provide a state-of-the-art overview of photobiomodulation—also known as low-level laser therapy—in the management of complications from cancer treatments. The author notes from the outset that there is a large body of evidence supporting the technique’s efficacy in the prevention and treatment of oral mucositis in patients receiving radiation therapy for head and neck cancer or high-dose chemotherapy regimens. The article then broadens its scope to include two other complications: radiation-induced dermatitis and lymphedema. It also addresses mechanisms of action, dosimetry, and safety, and proposes parameters for each of these indications. A key point: in all these situations, photobiomodulation is used as supportive care to mitigate the adverse effects of treatment, and never as a treatment for the cancer itself.

Key Findings

The abstract of this journal article does not provide any figures, sample sizes, or measures of effect. We must therefore rely on the qualitative observations made by the author.

• Oral mucositis: a large body of evidence supporting its effectiveness, both for prevention and treatment, following radiation therapy for head and neck cancers or high-dose chemotherapy
• Radiation-induced dermatitis: identified as a complication for which the technique could prove effective
• Lymphedema: also identified as an avenue to explore
• The author proposes treatment guidelines for each of these three complications
• Mechanisms of action, dosimetry, and safety are discussed, along with future research directions

The wording used for dermatitis and lymphedema is forward-looking: these are indications for which photobiomodulation may prove effective, rather than indications supported by the same level of evidence as oral mucositis.

How Photobiomodulation Works for These Conditions

The author notes that recent technological advances, combined with a better understanding of the mechanisms involved and dosimetric parameters, could make it possible to manage a wider range of complications associated with cancer treatments. The abstract does not elaborate on these mechanisms and merely notes that they are discussed in the article. The reasoning presented is therefore twofold: a better understanding of what happens in the irradiated tissue and more precise selection of irradiation parameters would make it possible to expand the scope of application beyond the oral mucosa alone.

Limits You Should Know

This is a narrative review authored by a single author, not a systematic review with a meta-analysis. It includes neither a protocol for study inclusion nor a formal assessment of risk of bias, nor a quantitative estimate of the effect. The reported benefits in terms of adherence to cancer treatment, quality of life, and therapeutic outcomes are expressed in conditional terms by the author himself, as possible but unproven consequences. Finally, the text concludes with suggestions for future research, indicating that the topic was not yet settled in 2018 with regard to dermatitis and lymphedema.

What This Means in Practice

This review serves as a bridge: it begins with a well-documented indication—oral mucositis—and proposes extending the reasoning to related complications. It is useful for understanding why photobiomodulation is now being discussed far beyond the oral cavity in supportive oncology. It in no way replaces the need for a specialist’s opinion: any use in a person with cancer or in remission is a decision made and supervised by the oncology team, which determines the treatment protocols and ensures follow-up.

Frequently Asked Questions

What cancer complications does this review cover?

Three: oral mucositis, radiation-induced dermatitis, and lymphedema. According to the author, only the first is supported by a large body of data; the other two are presented as potential indications.

Does this review provide efficacy data?

No. The abstract does not include any sample sizes, percentages, or confidence intervals. It is a narrative summary of the current state of knowledge, not a meta-analysis.

Can photobiomodulation replace cancer treatment?

No. It is described in this journal as a supportive care measure intended to alleviate the side effects of treatment. The decision to use it is up to the oncology team.

Reference

Bensadoun RJ. Photobiomodulation or low-level laser therapy in the management of cancer therapy-induced mucositis, dermatitis, and lymphedema. Current Opinion in Oncology, 2018. PMID 29794809. View the study on PubMed

This summary is provided for informational purposes only and does not constitute medical advice. Photobiomodulation is not a substitute for prescribed treatment. Consult a healthcare professional.