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]
