Skip to main content
Oncology and supportive care
Published on
August 30, 2022

Robijns J. et al. - WALT Position Paper on Photobiomodulation and the Side Effects of Cancer Therapies

Share this article:

This position statement from the World Association for Photobiomodulation Therapy, published in 2022, outlines the uses of photobiomodulation in addressing the side effects of cancer treatments and specifies the associated parameters. It is an informative expert consensus and not a meta-analysis providing a quantified effect size.

What this study measured

This text is not a clinical trial. It is based on the recommendations from the 12th WALT Congress, held in Nice from October 3 to 6, 2018, supplemented by a review of existing data and the clinical observations of an international multidisciplinary panel.

This study reviews the potential prophylactic and therapeutic effects of photobiomodulation on the side effects of cancer treatments: chemotherapy, radiation therapy, and hematopoietic stem cell transplantation. A literature review on efficacy and dosimetry was conducted, and a systematic review was performed when numerous randomized trials were available. The results were discussed at an international consensus meeting.

Key Findings

The panel selected the following items.

  • A substantial body of evidence supports the effectiveness of photobiomodulation in preventing oral mucositis during ENT radiation therapy, chemotherapy, or hematopoietic stem cell transplantation.
  • The WALT group builds on the work of MASCC/ISOO and expands the review of evidence and guidelines to other indications for supportive care.
  • Covered indications: radiation dermatitis, dysphagia, xerostomia, dysgeusia, trismus, mucosal and bone necrosis, lymphedema, hand-foot syndrome, alopecia, chronic oral and cutaneous graft-versus-host disease, voice and speech changes, peripheral neuropathy, and late-onset fibrosis in survivors.
  • According to the authors, this could improve quality of life, adherence to prescribed treatment, and outcomes, while reducing the cost of care.
  • No overall quantitative estimate of the effect is provided: the document sets out recommendations, not effect sizes.

How photobiomodulation works for this indication

The document examines potential mechanisms of action and, above all, the dosimetry parameters to be followed according to the indications. Photobiomodulation is consistently positioned in the document as a supportive therapy: it targets complications from cancer treatments, never the tumor itself.

The text follows a protocol-based approach: for each complication, specific parameters are prescribed, rather than photobiomodulation in general. The level of evidence varies from one indication to another.

Limits You Should Know

The main limitation stems from the nature of the document. The authors themselves note that it is intended to be informative and reflects a collective opinion, not necessarily that of each individual author. They emphasize that research and practice will continue to shape these recommendations.

This is therefore not a meta-analysis providing an effect estimate: no aggregated figures or confidence intervals are reported in the summary. The body of evidence is strong for the prevention of oral mucositis, but the other indications are based on varying levels of evidence, sometimes relying solely on expert consensus. The text also draws on a conference held in 2018, and the authors announce that they will conduct periodic updates.

What This Means in Practice

This document serves as a reference for teams wishing to incorporate photobiomodulation into supportive care in oncology: it brings together indications and parameters in a single document. It does not alter the cancer treatment strategy in any way: photobiomodulation complements treatment and does not replace it. Its use is subject to a medical decision made in consultation with the oncology team.

Frequently Asked Questions

Is a position statement as valuable as a clinical study?

No, these are two different types of documents. A position statement summarizes the current state of knowledge and translates it into recommendations, but it does not measure an effect. Its strength depends on the studies on which it is based, the quality of which varies depending on the specific findings.

For which cancer-related side effects is photobiomodulation considered?

The spectrum is broad: oral mucositis, radiation dermatitis, dysphagia, xerostomia, dysgeusia, trismus, mucosal and bone necrosis, lymphedema, hand-foot syndrome, and alopecia. Added to these are chronic graft-versus-host disease, voice changes, peripheral neuropathy, and late-onset fibrosis. The level of evidence varies across these conditions.

Does photobiomodulation affect the tumor itself?

No. This document focuses on supportive care: complications from cancer treatments. Photobiomodulation is never presented here as a cancer treatment and is not a substitute for chemotherapy or radiation therapy.

Reference

Robijns J, Nair RG, Lodewijckx J, et al. Photobiomodulation therapy in the management of cancer therapy-induced side effects: WALT position paper 2022. Frontiers in Oncology, 2022. PMID 36110957. https://pubmed.ncbi.nlm.nih.gov/36110957/

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.