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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">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><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>
</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><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>
</affiliation>
<affiliation><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>
</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><nlm:aff id="A4">Department of Haematology and Oncology/Cancer Services, Gold Coast University Hospital, Queensland Health, Gold Coast, QLD, Australia</nlm:aff>
</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><nlm:aff id="A5">Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A6">Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA 91010, USA</nlm:aff>
</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><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>
</affiliation>
</author>
<author><name sortKey="Elad, Sharon" sort="Elad, Sharon" uniqKey="Elad S" first="Sharon" last="Elad">Sharon Elad</name>
<affiliation><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>
</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><nlm:aff id="A9">Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A10">Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A11">Harvard-MIT Division of Health Science and Technology, Cambridge, MA 02139, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Barasch, Andrei" sort="Barasch, Andrei" uniqKey="Barasch A" first="Andrei" last="Barasch">Andrei Barasch</name>
<affiliation><nlm:aff id="A12">Weill Cornell Medical Center, Division of Oncology, New York, NY, USA</nlm:aff>
</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><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>
</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><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>
</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><nlm:aff id="A14">Laser Therapy Unit, Institut Jules Bordet, Centre des Tumeurs de l’Université Libre de Bruxelles, Brussels, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lansaat, Liset" sort="Lansaat, Liset" uniqKey="Lansaat L" first="Liset" last="Lansaat">Liset Lansaat</name>
<affiliation><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
</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><nlm:aff id="A16">City of Hope, Duarte, CA 91010, USA</nlm:aff>
</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><nlm:aff id="A17">Department of Oral Surgery, Faculty of Dentistry, University of Barcelona, Barcelona, Spain</nlm:aff>
</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><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jacobi, Irene" sort="Jacobi, Irene" uniqKey="Jacobi I" first="Irene" last="Jacobi">Irene Jacobi</name>
<affiliation><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
</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><nlm:aff id="A18">Antoni van Leeuwenhoek Department Radiation Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
</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><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>
</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><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>
</affiliation>
<affiliation><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
</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><nlm:aff id="A19">Seattle Cancer Care Alliance (SCCA), 825 Eastlake Ave E Ste G6900, Seattle, WA 98109, USA</nlm:aff>
</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><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>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">26984240</idno>
<idno type="pmc">4846477</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846477</idno>
<idno type="RBID">PMC:4846477</idno>
<idno type="doi">10.1007/s00520-016-3152-z</idno>
<date when="2016">2016</date>
<idno type="wicri:Area/Pmc/Corpus">002157</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002157</idno>
</publicationStmt>
<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><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>
</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><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>
</affiliation>
<affiliation><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>
</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><nlm:aff id="A4">Department of Haematology and Oncology/Cancer Services, Gold Coast University Hospital, Queensland Health, Gold Coast, QLD, Australia</nlm:aff>
</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><nlm:aff id="A5">Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A6">Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA 91010, USA</nlm:aff>
</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><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>
</affiliation>
</author>
<author><name sortKey="Elad, Sharon" sort="Elad, Sharon" uniqKey="Elad S" first="Sharon" last="Elad">Sharon Elad</name>
<affiliation><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>
</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><nlm:aff id="A9">Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A10">Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A11">Harvard-MIT Division of Health Science and Technology, Cambridge, MA 02139, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Barasch, Andrei" sort="Barasch, Andrei" uniqKey="Barasch A" first="Andrei" last="Barasch">Andrei Barasch</name>
<affiliation><nlm:aff id="A12">Weill Cornell Medical Center, Division of Oncology, New York, NY, USA</nlm:aff>
</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><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>
</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><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>
</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><nlm:aff id="A14">Laser Therapy Unit, Institut Jules Bordet, Centre des Tumeurs de l’Université Libre de Bruxelles, Brussels, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lansaat, Liset" sort="Lansaat, Liset" uniqKey="Lansaat L" first="Liset" last="Lansaat">Liset Lansaat</name>
<affiliation><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
</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><nlm:aff id="A16">City of Hope, Duarte, CA 91010, USA</nlm:aff>
</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><nlm:aff id="A17">Department of Oral Surgery, Faculty of Dentistry, University of Barcelona, Barcelona, Spain</nlm:aff>
</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><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Jacobi, Irene" sort="Jacobi, Irene" uniqKey="Jacobi I" first="Irene" last="Jacobi">Irene Jacobi</name>
<affiliation><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
</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><nlm:aff id="A18">Antoni van Leeuwenhoek Department Radiation Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
</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><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>
</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><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>
</affiliation>
<affiliation><nlm:aff id="A15">Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</nlm:aff>
</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><nlm:aff id="A19">Seattle Cancer Care Alliance (SCCA), 825 Eastlake Ave E Ste G6900, Seattle, WA 98109, USA</nlm:aff>
</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><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>
</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>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<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>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9302957</journal-id>
<journal-id journal-id-type="pubmed-jr-id">8479</journal-id>
<journal-id journal-id-type="nlm-ta">Support Care Cancer</journal-id>
<journal-id journal-id-type="iso-abbrev">Support Care Cancer</journal-id>
<journal-title-group><journal-title>Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer</journal-title>
</journal-title-group>
<issn pub-type="ppub">0941-4355</issn>
<issn pub-type="epub">1433-7339</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26984240</article-id>
<article-id pub-id-type="pmc">4846477</article-id>
<article-id pub-id-type="doi">10.1007/s00520-016-3152-z</article-id>
<article-id pub-id-type="manuscript">NIHMS773662</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>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</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Zecha</surname>
<given-names>Judith A. E. M.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<email>j.zecha@amc.uva.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>Raber-Durlacher</surname>
<given-names>Judith E.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<email>j.e.raberdurlacher@amc.uva.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>Nair</surname>
<given-names>Raj G.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
<email>r.nair@griffith.edu.au</email>
</contrib>
<contrib contrib-type="author"><name><surname>Epstein</surname>
<given-names>Joel B.</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
<xref ref-type="aff" rid="A6">6</xref>
<email>joel.epstein@cshs.org</email>
</contrib>
<contrib contrib-type="author"><name><surname>Sonis</surname>
<given-names>Stephen T.</given-names>
</name>
<xref ref-type="aff" rid="A7">7</xref>
<email>ssonis@partners.org</email>
</contrib>
<contrib contrib-type="author"><name><surname>Elad</surname>
<given-names>Sharon</given-names>
</name>
<xref ref-type="aff" rid="A8">8</xref>
<email>SElad@URMC.Rochester.edu</email>
</contrib>
<contrib contrib-type="author"><name><surname>Hamblin</surname>
<given-names>Michael R.</given-names>
</name>
<xref ref-type="aff" rid="A9">9</xref>
<xref ref-type="aff" rid="A10">10</xref>
<xref ref-type="aff" rid="A11">11</xref>
<email>hamblin@helix.mgh.harvard.edu</email>
</contrib>
<contrib contrib-type="author"><name><surname>Barasch</surname>
<given-names>Andrei</given-names>
</name>
<xref ref-type="aff" rid="A12">12</xref>
<email>barasaff@cs.com</email>
</contrib>
<contrib contrib-type="author"><name><surname>Migliorati</surname>
<given-names>Cesar A.</given-names>
</name>
<xref ref-type="aff" rid="A13">13</xref>
<email>migliorati@uthsc.edu</email>
</contrib>
<contrib contrib-type="author"><name><surname>Milstein</surname>
<given-names>Dan M. J.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<email>D.M.Milstein@amc.uva.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>Genot</surname>
<given-names>Marie-Thérèse</given-names>
</name>
<xref ref-type="aff" rid="A14">14</xref>
<email>mtgenot@skynet.be</email>
</contrib>
<contrib contrib-type="author"><name><surname>Lansaat</surname>
<given-names>Liset</given-names>
</name>
<xref ref-type="aff" rid="A15">15</xref>
<email>l.lansaat@nki.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>van der Brink</surname>
<given-names>Ron</given-names>
</name>
<xref ref-type="aff" rid="A16">16</xref>
<email>RVanderbrink@coh.org</email>
</contrib>
<contrib contrib-type="author"><name><surname>Arnabat-Dominguez</surname>
<given-names>Josep</given-names>
</name>
<xref ref-type="aff" rid="A17">17</xref>
<email>joseparnabat@ub.edu</email>
</contrib>
<contrib contrib-type="author"><name><surname>van der Molen</surname>
<given-names>Lisette</given-names>
</name>
<xref ref-type="aff" rid="A15">15</xref>
<email>l.vd.molen@nki.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>Jacobi</surname>
<given-names>Irene</given-names>
</name>
<xref ref-type="aff" rid="A15">15</xref>
<email>i.jacobi@nki.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>van Diessen</surname>
<given-names>Judi</given-names>
</name>
<xref ref-type="aff" rid="A18">18</xref>
<email>j.v.diessen@nki.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>de Lange</surname>
<given-names>Jan</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<email>j.delange@amc.uva.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>Smeele</surname>
<given-names>Ludi E.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A15">15</xref>
<email>l.smeele@nki.nl</email>
</contrib>
<contrib contrib-type="author"><name><surname>Schubert</surname>
<given-names>Mark M.</given-names>
</name>
<xref ref-type="aff" rid="A19">19</xref>
<email>mschuber@seattlecca.org</email>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Bensadoun</surname>
<given-names>René-Jean</given-names>
</name>
<xref ref-type="aff" rid="A20">20</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</aff>
<aff id="A2"><label>2</label>
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</aff>
<aff id="A3"><label>3</label>
Oral Medicine Oral Pathology and Human Diseases, Menzies Health Institute Queensland, Gold Coast, QLD, Australia</aff>
<aff id="A4"><label>4</label>
Department of Haematology and Oncology/Cancer Services, Gold Coast University Hospital, Queensland Health, Gold Coast, QLD, Australia</aff>
<aff id="A5"><label>5</label>
Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA</aff>
<aff id="A6"><label>6</label>
Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA 91010, USA</aff>
<aff id="A7"><label>7</label>
Division of Oral Medicine, Brigham and Women’s Hospital and the Dana-Farber Cancer Institute and Biomodels LLC, Boston, MA 02115, USA</aff>
<aff id="A8"><label>8</label>
Division of Oral Medicine, Eastman Institute for Oral Health, and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY 14620, USA</aff>
<aff id="A9"><label>9</label>
Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA</aff>
<aff id="A10"><label>10</label>
Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA</aff>
<aff id="A11"><label>11</label>
Harvard-MIT Division of Health Science and Technology, Cambridge, MA 02139, USA</aff>
<aff id="A12"><label>12</label>
Weill Cornell Medical Center, Division of Oncology, New York, NY, USA</aff>
<aff id="A13"><label>13</label>
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</aff>
<aff id="A14"><label>14</label>
Laser Therapy Unit, Institut Jules Bordet, Centre des Tumeurs de l’Université Libre de Bruxelles, Brussels, Belgium</aff>
<aff id="A15"><label>15</label>
Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands</aff>
<aff id="A16"><label>16</label>
City of Hope, Duarte, CA 91010, USA</aff>
<aff id="A17"><label>17</label>
Department of Oral Surgery, Faculty of Dentistry, University of Barcelona, Barcelona, Spain</aff>
<aff id="A18"><label>18</label>
Antoni van Leeuwenhoek Department Radiation Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam, The Netherlands</aff>
<aff id="A19"><label>19</label>
Seattle Cancer Care Alliance (SCCA), 825 Eastlake Ave E Ste G6900, Seattle, WA 98109, USA</aff>
<aff id="A20"><label>20</label>
World Association for Laser Therapy (WALT) Scientific Secretary, Centre de Haute Energie (CHE), 10 Bd Pasteur, 06000 Nice, France</aff>
<pub-date pub-type="nihms-submitted"><day>1</day>
<month>4</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>16</day>
<month>3</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="ppub"><month>6</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>6</month>
<year>2017</year>
</pub-date>
<volume>24</volume>
<issue>6</issue>
<fpage>2781</fpage>
<lpage>2792</lpage>
<pmc-comment>elocation-id from pubmed: 10.1007/s00520-016-3152-z</pmc-comment>
<abstract><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>
</abstract>
<kwd-group><kwd>Low level laser therapy</kwd>
<kwd>Low level light therapy</kwd>
<kwd>Photobiomodulation</kwd>
<kwd>Mucositis</kwd>
<kwd>Orofacial complications</kwd>
<kwd>Chemotherapy</kwd>
<kwd>Radiation therapy</kwd>
<kwd>Head and neck cancer</kwd>
<kwd>Safety</kwd>
<kwd>LLLT and PBM</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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