Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations
Identifieur interne : 001B69 ( Main/Exploration ); précédent : 001B68; suivant : 001B70Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations
Auteurs : Judith A. E. M. Zecha [Pays-Bas] ; Judith E. Raber-Durlacher [Pays-Bas] ; Raj G. Nair [Australie] ; Joel B. Epstein [États-Unis] ; Stephen T. Sonis [États-Unis] ; Sharon Elad [États-Unis] ; Michael R. Hamblin [États-Unis] ; Andrei Barasch [États-Unis] ; Cesar A. Migliorati [États-Unis] ; Dan M. J. Milstein [Pays-Bas] ; Marie-Thérèse Genot [Belgique] ; Liset Lansaat [Pays-Bas] ; Ron Van Der Brink [États-Unis] ; Josep Arnabat-Dominguez [Espagne] ; Lisette Van Der Molen [Pays-Bas] ; Irene Jacobi [Pays-Bas] ; Judi Van Diessen [Pays-Bas] ; Jan De Lange [Pays-Bas] ; Ludi E. Smeele [Pays-Bas] ; Mark M. Schubert [États-Unis] ; René-Jean Bensadoun [France]Source :
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [ 0941-4355 ] ; 2016.
Descripteurs français
- KwdFr :
- Chimioradiothérapie (effets indésirables), Effets secondaires indésirables des médicaments (), Effets secondaires indésirables des médicaments (étiologie), Humains, Photothérapie de faible intensité (), Photothérapie de faible intensité (effets indésirables), Photothérapie de faible intensité (normes), Protocoles cliniques, Tumeurs de la tête et du cou (), Tumeurs de la tête et du cou (radiothérapie), Tumeurs de la tête et du cou (traitement médicamenteux).
- MESH :
- effets indésirables : Chimioradiothérapie, Photothérapie de faible intensité.
- normes : Photothérapie de faible intensité.
- radiothérapie : Tumeurs de la tête et du cou.
- traitement médicamenteux : Tumeurs de la tête et du cou.
- étiologie : Effets secondaires indésirables des médicaments.
- Effets secondaires indésirables des médicaments, Humains, Photothérapie de faible intensité, Protocoles cliniques, Tumeurs de la tête et du cou.
English descriptors
- KwdEn :
- Chemoradiotherapy (adverse effects), Clinical Protocols, Drug-Related Side Effects and Adverse Reactions (etiology), Drug-Related Side Effects and Adverse Reactions (therapy), Head and Neck Neoplasms (drug therapy), Head and Neck Neoplasms (radiotherapy), Head and Neck Neoplasms (therapy), Humans, Low-Level Light Therapy (adverse effects), Low-Level Light Therapy (methods), Low-Level Light Therapy (standards).
- MESH :
- adverse effects : Chemoradiotherapy, Low-Level Light Therapy.
- drug therapy : Head and Neck Neoplasms.
- etiology : Drug-Related Side Effects and Adverse Reactions.
- methods : Low-Level Light Therapy.
- radiotherapy : Head and Neck Neoplasms.
- standards : Low-Level Light Therapy.
- therapy : Drug-Related Side Effects and Adverse Reactions, Head and Neck Neoplasms.
- Clinical Protocols, Humans.
Abstract
There is a large body of evidence supporting the efficacy of low level laser therapy (LLLT), more recently termed photobiomodulation (PBM), for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved, may expand the applications for PBM in the management of other complications associated with HNC treatment. This article (part 1) describes PBM mechanisms of action, dosimetry, and safety aspects and, in doing so, provides a basis for a companion paper (part 2) which describes the potential breadth of potential applications of PBM in the management of side-effects of (chemo)radiation therapy in patients being treated for HNC and proposes PBM parameters.
This study is a narrative non-systematic review.
We review PBM mechanisms of action and dosimetric considerations. Virtually, all conditions modulated by PBM (e.g., ulceration, inflammation, lymphedema, pain, fibrosis, neurological and muscular injury) are thought to be involved in the pathogenesis of (chemo)radiation therapy-induced complications in patients treated for HNC. The impact of PBM on tumor behavior and tumor response to treatment has been insufficiently studied. In vitro studies assessing the effect of PBM on tumor cells report conflicting results, perhaps attributable to inconsistencies of PBM power and dose. Nonetheless, the biological bases for the broad clinical activities ascribed to PBM have also been noted to be similar to those activities and pathways associated with negative tumor behaviors and impeded response to treatment. While there are no anecdotal descriptions of poor tumor outcomes in patients treated with PBM, confirming its neutrality with respect to cancer responsiveness is a critical priority.
Based on its therapeutic effects, PBM may have utility in a broad range of oral, oropharyngeal, facial, and neck complications of HNC treatment. Although evidence suggests that PBM using LLLT is safe in HNC patients, more research is imperative and vigilance remains warranted to detect any potential adverse effects of PBM on cancer treatment outcomes and survival.
Url:
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846477
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846551
DOI: 10.1007/s00520-016-3152-z
PubMed: 26984240
PubMed Central: 4846477
Affiliations:
- Australie, Belgique, Espagne, France, Pays-Bas, États-Unis
- Californie, Catalogne, Hollande-Septentrionale, Massachusetts, Provence-Alpes-Côte d'Azur, Région de Bruxelles-Capitale, Tennessee, Washington (État), État de New York
- Amsterdam, Barcelone, Bruxelles, Nice
- Université d'Amsterdam
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Le document en format XML
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<author><name sortKey="Van Der Molen, Lisette" sort="Van Der Molen, Lisette" uniqKey="Van Der Molen L" first="Lisette" last="Van Der Molen">Lisette Van Der Molen</name>
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<author><name sortKey="Jacobi, Irene" sort="Jacobi, Irene" uniqKey="Jacobi I" first="Irene" last="Jacobi">Irene Jacobi</name>
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<author><name sortKey="Van Diessen, Judi" sort="Van Diessen, Judi" uniqKey="Van Diessen J" first="Judi" last="Van Diessen">Judi Van Diessen</name>
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<author><name sortKey="De Lange, Jan" sort="De Lange, Jan" uniqKey="De Lange J" first="Jan" last="De Lange">Jan De Lange</name>
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<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea>
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<author><name sortKey="Smeele, Ludi E" sort="Smeele, Ludi E" uniqKey="Smeele L" first="Ludi E." last="Smeele">Ludi E. Smeele</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea>
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<affiliation wicri:level="3"><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
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<author><name sortKey="Schubert, Mark M" sort="Schubert, Mark M" uniqKey="Schubert M" first="Mark M." last="Schubert">Mark M. Schubert</name>
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<wicri:regionArea>Seattle Cancer Care Alliance (SCCA), 825 Eastlake Ave E Ste G6900, Seattle, WA 98109</wicri:regionArea>
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<author><name sortKey="Bensadoun, Rene Jean" sort="Bensadoun, Rene Jean" uniqKey="Bensadoun R" first="René-Jean" last="Bensadoun">René-Jean Bensadoun</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations</title>
<author><name sortKey="Zecha, Judith A E M" sort="Zecha, Judith A E M" uniqKey="Zecha J" first="Judith A. E. M." last="Zecha">Judith A. E. M. Zecha</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea>
<orgName type="university">Université d'Amsterdam</orgName>
<placeName><settlement type="city">Amsterdam</settlement>
<region>Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Raber Durlacher, Judith E" sort="Raber Durlacher, Judith E" uniqKey="Raber Durlacher J" first="Judith E." last="Raber-Durlacher">Judith E. Raber-Durlacher</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea>
<orgName type="university">Université d'Amsterdam</orgName>
<placeName><settlement type="city">Amsterdam</settlement>
<region>Hollande-Septentrionale</region>
</placeName>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="A2">Department of Medical Dental Interaction and Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Medical Dental Interaction and Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, P.O. Box 22660, 1100 DD Amsterdam</wicri:regionArea>
<wicri:noRegion>1100 DD Amsterdam</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Nair, Raj G" sort="Nair, Raj G" uniqKey="Nair R" first="Raj G." last="Nair">Raj G. Nair</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Department of Haematology and Oncology/Cancer Services, Gold Coast University Hospital, Queensland Health, Gold Coast, QLD, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Haematology and Oncology/Cancer Services, Gold Coast University Hospital, Queensland Health, Gold Coast, QLD</wicri:regionArea>
<wicri:noRegion>QLD</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Epstein, Joel B" sort="Epstein, Joel B" uniqKey="Epstein J" first="Joel B." last="Epstein">Joel B. Epstein</name>
<affiliation wicri:level="2"><nlm:aff id="A5">Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048</wicri:regionArea>
<placeName><region type="state">Californie</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A6">Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA 91010, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA 91010</wicri:regionArea>
<placeName><region type="state">Californie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sonis, Stephen T" sort="Sonis, Stephen T" uniqKey="Sonis S" first="Stephen T." last="Sonis">Stephen T. Sonis</name>
<affiliation wicri:level="2"><nlm:aff id="A7">Division of Oral Medicine, Brigham and Women’s Hospital and the Dana-Farber Cancer Institute and Biomodels LLC, Boston, MA 02115, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Oral Medicine, Brigham and Women’s Hospital and the Dana-Farber Cancer Institute and Biomodels LLC, Boston, MA 02115</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Elad, Sharon" sort="Elad, Sharon" uniqKey="Elad S" first="Sharon" last="Elad">Sharon Elad</name>
<affiliation wicri:level="2"><nlm:aff id="A8">Division of Oral Medicine, Eastman Institute for Oral Health, and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY 14620, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Oral Medicine, Eastman Institute for Oral Health, and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY 14620</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Hamblin, Michael R" sort="Hamblin, Michael R" uniqKey="Hamblin M" first="Michael R." last="Hamblin">Michael R. Hamblin</name>
<affiliation wicri:level="2"><nlm:aff id="A9">Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A10">Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Dermatology, Harvard Medical School, Boston, MA 02115</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A11">Harvard-MIT Division of Health Science and Technology, Cambridge, MA 02139, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Harvard-MIT Division of Health Science and Technology, Cambridge, MA 02139</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Barasch, Andrei" sort="Barasch, Andrei" uniqKey="Barasch A" first="Andrei" last="Barasch">Andrei Barasch</name>
<affiliation wicri:level="2"><nlm:aff id="A12">Weill Cornell Medical Center, Division of Oncology, New York, NY, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Weill Cornell Medical Center, Division of Oncology, New York, NY</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Migliorati, Cesar A" sort="Migliorati, Cesar A" uniqKey="Migliorati C" first="Cesar A." last="Migliorati">Cesar A. Migliorati</name>
<affiliation wicri:level="2"><nlm:aff id="A13">Department of Diagnostic Sciences and Oral Medicine, University of Tennessee Health Science Center, College of Dentistry, 875 Union Ave. Suite N231, Memphis, TN 38163, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Diagnostic Sciences and Oral Medicine, University of Tennessee Health Science Center, College of Dentistry, 875 Union Ave. Suite N231, Memphis, TN 38163</wicri:regionArea>
<placeName><region type="state">Tennessee</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Milstein, Dan M J" sort="Milstein, Dan M J" uniqKey="Milstein D" first="Dan M. J." last="Milstein">Dan M. J. Milstein</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea>
<orgName type="university">Université d'Amsterdam</orgName>
<placeName><settlement type="city">Amsterdam</settlement>
<region>Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Genot, Marie Therese" sort="Genot, Marie Therese" uniqKey="Genot M" first="Marie-Thérèse" last="Genot">Marie-Thérèse Genot</name>
<affiliation wicri:level="3"><nlm:aff id="A14">Laser Therapy Unit, Institut Jules Bordet, Centre des Tumeurs de l’Université Libre de Bruxelles, Brussels, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Laser Therapy Unit, Institut Jules Bordet, Centre des Tumeurs de l’Université Libre de Bruxelles, Brussels</wicri:regionArea>
<placeName><settlement type="city">Bruxelles</settlement>
<region nuts="2">Région de Bruxelles-Capitale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lansaat, Liset" sort="Lansaat, Liset" uniqKey="Lansaat L" first="Liset" last="Lansaat">Liset Lansaat</name>
<affiliation wicri:level="3"><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Van Der Brink, Ron" sort="Van Der Brink, Ron" uniqKey="Van Der Brink R" first="Ron" last="Van Der Brink">Ron Van Der Brink</name>
<affiliation wicri:level="2"><nlm:aff id="A16">City of Hope, Duarte, CA 91010, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>City of Hope, Duarte, CA 91010</wicri:regionArea>
<placeName><region type="state">Californie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Arnabat Dominguez, Josep" sort="Arnabat Dominguez, Josep" uniqKey="Arnabat Dominguez J" first="Josep" last="Arnabat-Dominguez">Josep Arnabat-Dominguez</name>
<affiliation wicri:level="3"><nlm:aff id="A17">Department of Oral Surgery, Faculty of Dentistry, University of Barcelona, Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Oral Surgery, Faculty of Dentistry, University of Barcelona, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Van Der Molen, Lisette" sort="Van Der Molen, Lisette" uniqKey="Van Der Molen L" first="Lisette" last="Van Der Molen">Lisette Van Der Molen</name>
<affiliation wicri:level="3"><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Jacobi, Irene" sort="Jacobi, Irene" uniqKey="Jacobi I" first="Irene" last="Jacobi">Irene Jacobi</name>
<affiliation wicri:level="3"><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Van Diessen, Judi" sort="Van Diessen, Judi" uniqKey="Van Diessen J" first="Judi" last="Van Diessen">Judi Van Diessen</name>
<affiliation wicri:level="3"><nlm:aff id="A18">Antoni van Leeuwenhoek Department Radiation Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Antoni van Leeuwenhoek Department Radiation Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="De Lange, Jan" sort="De Lange, Jan" uniqKey="De Lange J" first="Jan" last="De Lange">Jan De Lange</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea>
<orgName type="university">Université d'Amsterdam</orgName>
<placeName><settlement type="city">Amsterdam</settlement>
<region>Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Smeele, Ludi E" sort="Smeele, Ludi E" uniqKey="Smeele L" first="Ludi E." last="Smeele">Ludi E. Smeele</name>
<affiliation wicri:level="4"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam</wicri:regionArea>
<orgName type="university">Université d'Amsterdam</orgName>
<placeName><settlement type="city">Amsterdam</settlement>
<region>Hollande-Septentrionale</region>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Schubert, Mark M" sort="Schubert, Mark M" uniqKey="Schubert M" first="Mark M." last="Schubert">Mark M. Schubert</name>
<affiliation wicri:level="2"><nlm:aff id="A19">Seattle Cancer Care Alliance (SCCA), 825 Eastlake Ave E Ste G6900, Seattle, WA 98109, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Seattle Cancer Care Alliance (SCCA), 825 Eastlake Ave E Ste G6900, Seattle, WA 98109</wicri:regionArea>
<placeName><region type="state">Washington (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Bensadoun, Rene Jean" sort="Bensadoun, Rene Jean" uniqKey="Bensadoun R" first="René-Jean" last="Bensadoun">René-Jean Bensadoun</name>
<affiliation wicri:level="3"><nlm:aff id="A20">World Association for Laser Therapy (WALT) Scientific Secretary, Centre de Haute Energie (CHE), 10 Bd Pasteur, 06000 Nice, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>World Association for Laser Therapy (WALT) Scientific Secretary, Centre de Haute Energie (CHE), 10 Bd Pasteur, 06000 Nice</wicri:regionArea>
<placeName><region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region>
<settlement type="city">Nice</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer</title>
<idno type="ISSN">0941-4355</idno>
<idno type="eISSN">1433-7339</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Chemoradiotherapy (adverse effects)</term>
<term>Clinical Protocols</term>
<term>Drug-Related Side Effects and Adverse Reactions (etiology)</term>
<term>Drug-Related Side Effects and Adverse Reactions (therapy)</term>
<term>Head and Neck Neoplasms (drug therapy)</term>
<term>Head and Neck Neoplasms (radiotherapy)</term>
<term>Head and Neck Neoplasms (therapy)</term>
<term>Humans</term>
<term>Low-Level Light Therapy (adverse effects)</term>
<term>Low-Level Light Therapy (methods)</term>
<term>Low-Level Light Therapy (standards)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Chimioradiothérapie (effets indésirables)</term>
<term>Effets secondaires indésirables des médicaments ()</term>
<term>Effets secondaires indésirables des médicaments (étiologie)</term>
<term>Humains</term>
<term>Photothérapie de faible intensité ()</term>
<term>Photothérapie de faible intensité (effets indésirables)</term>
<term>Photothérapie de faible intensité (normes)</term>
<term>Protocoles cliniques</term>
<term>Tumeurs de la tête et du cou ()</term>
<term>Tumeurs de la tête et du cou (radiothérapie)</term>
<term>Tumeurs de la tête et du cou (traitement médicamenteux)</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Chemoradiotherapy</term>
<term>Low-Level Light Therapy</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Head and Neck Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Chimioradiothérapie</term>
<term>Photothérapie de faible intensité</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Drug-Related Side Effects and Adverse Reactions</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Low-Level Light Therapy</term>
</keywords>
<keywords scheme="MESH" qualifier="normes" xml:lang="fr"><term>Photothérapie de faible intensité</term>
</keywords>
<keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Head and Neck Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Tumeurs de la tête et du cou</term>
</keywords>
<keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Low-Level Light Therapy</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Drug-Related Side Effects and Adverse Reactions</term>
<term>Head and Neck Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Tumeurs de la tête et du cou</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Effets secondaires indésirables des médicaments</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Clinical Protocols</term>
<term>Humans</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Effets secondaires indésirables des médicaments</term>
<term>Humains</term>
<term>Photothérapie de faible intensité</term>
<term>Protocoles cliniques</term>
<term>Tumeurs de la tête et du cou</term>
</keywords>
</textClass>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title>
<p id="P1">There is a large body of evidence supporting the efficacy of low level laser therapy (LLLT), more recently termed photobiomodulation (PBM), for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved, may expand the applications for PBM in the management of other complications associated with HNC treatment. This article (part 1) describes PBM mechanisms of action, dosimetry, and safety aspects and, in doing so, provides a basis for a companion paper (part 2) which describes the potential breadth of potential applications of PBM in the management of side-effects of (chemo)radiation therapy in patients being treated for HNC and proposes PBM parameters.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">This study is a narrative non-systematic review.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">We review PBM mechanisms of action and dosimetric considerations. Virtually, all conditions modulated by PBM (e.g., ulceration, inflammation, lymphedema, pain, fibrosis, neurological and muscular injury) are thought to be involved in the pathogenesis of (chemo)radiation therapy-induced complications in patients treated for HNC. The impact of PBM on tumor behavior and tumor response to treatment has been insufficiently studied. In vitro studies assessing the effect of PBM on tumor cells report conflicting results, perhaps attributable to inconsistencies of PBM power and dose. Nonetheless, the biological bases for the broad clinical activities ascribed to PBM have also been noted to be similar to those activities and pathways associated with negative tumor behaviors and impeded response to treatment. While there are no anecdotal descriptions of poor tumor outcomes in patients treated with PBM, confirming its neutrality with respect to cancer responsiveness is a critical priority.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">Based on its therapeutic effects, PBM may have utility in a broad range of oral, oropharyngeal, facial, and neck complications of HNC treatment. Although evidence suggests that PBM using LLLT is safe in HNC patients, more research is imperative and vigilance remains warranted to detect any potential adverse effects of PBM on cancer treatment outcomes and survival.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>Belgique</li>
<li>Espagne</li>
<li>France</li>
<li>Pays-Bas</li>
<li>États-Unis</li>
</country>
<region><li>Californie</li>
<li>Catalogne</li>
<li>Hollande-Septentrionale</li>
<li>Massachusetts</li>
<li>Provence-Alpes-Côte d'Azur</li>
<li>Région de Bruxelles-Capitale</li>
<li>Tennessee</li>
<li>Washington (État)</li>
<li>État de New York</li>
</region>
<settlement><li>Amsterdam</li>
<li>Barcelone</li>
<li>Bruxelles</li>
<li>Nice</li>
</settlement>
<orgName><li>Université d'Amsterdam</li>
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<tree><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Zecha, Judith A E M" sort="Zecha, Judith A E M" uniqKey="Zecha J" first="Judith A. E. M." last="Zecha">Judith A. E. M. Zecha</name>
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<name sortKey="Milstein, Dan M J" sort="Milstein, Dan M J" uniqKey="Milstein D" first="Dan M. J." last="Milstein">Dan M. J. Milstein</name>
<name sortKey="Raber Durlacher, Judith E" sort="Raber Durlacher, Judith E" uniqKey="Raber Durlacher J" first="Judith E." last="Raber-Durlacher">Judith E. Raber-Durlacher</name>
<name sortKey="Raber Durlacher, Judith E" sort="Raber Durlacher, Judith E" uniqKey="Raber Durlacher J" first="Judith E." last="Raber-Durlacher">Judith E. Raber-Durlacher</name>
<name sortKey="Smeele, Ludi E" sort="Smeele, Ludi E" uniqKey="Smeele L" first="Ludi E." last="Smeele">Ludi E. Smeele</name>
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<name sortKey="Van Der Molen, Lisette" sort="Van Der Molen, Lisette" uniqKey="Van Der Molen L" first="Lisette" last="Van Der Molen">Lisette Van Der Molen</name>
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<country name="Australie"><noRegion><name sortKey="Nair, Raj G" sort="Nair, Raj G" uniqKey="Nair R" first="Raj G." last="Nair">Raj G. Nair</name>
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<country name="États-Unis"><region name="Californie"><name sortKey="Epstein, Joel B" sort="Epstein, Joel B" uniqKey="Epstein J" first="Joel B." last="Epstein">Joel B. Epstein</name>
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<name sortKey="Barasch, Andrei" sort="Barasch, Andrei" uniqKey="Barasch A" first="Andrei" last="Barasch">Andrei Barasch</name>
<name sortKey="Elad, Sharon" sort="Elad, Sharon" uniqKey="Elad S" first="Sharon" last="Elad">Sharon Elad</name>
<name sortKey="Epstein, Joel B" sort="Epstein, Joel B" uniqKey="Epstein J" first="Joel B." last="Epstein">Joel B. Epstein</name>
<name sortKey="Hamblin, Michael R" sort="Hamblin, Michael R" uniqKey="Hamblin M" first="Michael R." last="Hamblin">Michael R. Hamblin</name>
<name sortKey="Hamblin, Michael R" sort="Hamblin, Michael R" uniqKey="Hamblin M" first="Michael R." last="Hamblin">Michael R. Hamblin</name>
<name sortKey="Hamblin, Michael R" sort="Hamblin, Michael R" uniqKey="Hamblin M" first="Michael R." last="Hamblin">Michael R. Hamblin</name>
<name sortKey="Migliorati, Cesar A" sort="Migliorati, Cesar A" uniqKey="Migliorati C" first="Cesar A." last="Migliorati">Cesar A. Migliorati</name>
<name sortKey="Schubert, Mark M" sort="Schubert, Mark M" uniqKey="Schubert M" first="Mark M." last="Schubert">Mark M. Schubert</name>
<name sortKey="Sonis, Stephen T" sort="Sonis, Stephen T" uniqKey="Sonis S" first="Stephen T." last="Sonis">Stephen T. Sonis</name>
<name sortKey="Van Der Brink, Ron" sort="Van Der Brink, Ron" uniqKey="Van Der Brink R" first="Ron" last="Van Der Brink">Ron Van Der Brink</name>
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<country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Genot, Marie Therese" sort="Genot, Marie Therese" uniqKey="Genot M" first="Marie-Thérèse" last="Genot">Marie-Thérèse Genot</name>
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<country name="Espagne"><region name="Catalogne"><name sortKey="Arnabat Dominguez, Josep" sort="Arnabat Dominguez, Josep" uniqKey="Arnabat Dominguez J" first="Josep" last="Arnabat-Dominguez">Josep Arnabat-Dominguez</name>
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<country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Bensadoun, Rene Jean" sort="Bensadoun, Rene Jean" uniqKey="Bensadoun R" first="René-Jean" last="Bensadoun">René-Jean Bensadoun</name>
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