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Baxter GD, Liu L, Petrich S, Gisselman AS, Chapple C, Anders JJ, Tumilty S, et al.
BMC cancer. Date of publication 2017 Dec 7;volume 17(1):833.
1. BMC Cancer. 2017 Dec 7;17(1):833. doi: 10.1186/s12885-017-3852-x. Low level laser therapy (Photobiomodulation therapy) for breast cancer-related lymphedema: a systematic review. Baxter GD(1), Liu L(2), Petrich S(3), Gisselman AS(2), Chapple C(2), Anders JJ(4), Tumilty S(2). Author information: (1)Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand. david.baxter@otago.ac.nz. (2)Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand. (3)Department of Surgical Sciences, Southern District Health Board, Dunedin, New Zealand. (4)Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences, Maryland, MD, USA. BACKGROUND: Breast cancer related lymphedema (BCRL) is a prevalent complication secondary to cancer treatments which significantly impacts the physical and psychological health of breast cancer survivors. Previous research shows increasing use of low level laser therapy (LLLT), now commonly referred to as photobiomodulation (PBM) therapy, for BCRL. This systematic review evaluated the effectiveness of LLLT (PBM) in the management of BCRL. METHODS: Clinical trials were searched in PubMed, AMED, Web of Science, and China National Knowledge Infrastructure up to November 2016. Two reviewers independently assessed the methodological quality and adequacy of LLLT (PBM) in these clinical trials. Primary outcome measures were limb circumference/volume, and secondary outcomes included pain intensity and range of motion. Because data were clinically heterogeneous, best evidence synthesis was performed. RESULTS: Eleven clinical trials were identified, of which seven randomized controlled trials (RCTs) were chosen for analysis. Overall, the methodological quality of included RCTs was high, whereas the reporting of treatment parameters was poor. Results indicated that there is strong evidence (three high quality trials) showing LLLT (PBM) was more effective than sham treatment for limb circumference/volume reduction at a short-term follow-up. There is moderate evidence (one high quality trial) indicating that LLLT (PBM) was more effective than sham laser for short-term pain relief, and limited evidence (one low quality trial) that LLLT (PBM) was more effective than no treatment for decreasing limb swelling at short-term follow-up. CONCLUSIONS: Based upon the current systematic review, LLLT (PBM) may be considered an effective treatment approach for women with BCRL. Due to the limited numbers of published trials available, there is a clear need for well-designed high-quality trials in this area. The optimal treatment parameters for clinical application have yet to be elucidated. DOI: 10.1186/s12885-017-3852-x PMCID: PMC5719569 PMID: 29216916 [Indexed for MEDLINE]
Appears in following Topics:
Lymphedema - Introduction and Assessment
Lymphedema - Treatment and Emerging Strategies for Prevention