The effect of photobiomodulation on chemotherapy-induced peripheral neuropathy: A randomized, sham-controlled clinical trial

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Abstract

Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer therapy with few efficacious treatments. Methods We enrolled 70 patients with CIPN in a randomized, double-blinded, sham-controlled, cross-over trial to determine if photobiomodulation (PBM) ± physiotherapy reduced the symptoms of neuropathy compared to sham treatment. At the conclusion of follow-up, sham-arm patients could cross-over into a third arm combining PBM and physiotherapy to determine if multimodal treatment had additive effects. Treatment included 30 minute sessions 3-times weekly for 6 weeks using either PBM or sham therapy. Neuropathy was assessed using the modified total neuropathy score (mTNS) at initiation and 4, 8, and 16 weeks after initiating treatment. Results Sham-treated patients experienced no significant change in mTNS scores at any point during the primary analysis. PBM patients experienced significant reduction in mTNS scores at all time points. Mean changes in mTNS score (and corresponding percent drop from baseline) for sham and PBM-group patients respectively were − 0.1 (− 0.7%) and − 4.2 (− 32.4%) at 4 weeks (p < 0.001), 0.2 (0.0%) and − 6.8 (− 52.6%) at 8 weeks (p < 0.001), and 0.0 (0.1%) and − 5.0 (− 38.8%) at 16 weeks (p < 0.001). Patients who crossed over into the PBM/PT-group experienced similar results to those treated primarily; changes in mTNS score from baseline were − 5.5 (− 40.6%) 4 weeks (p < 0.001), − 6.9 (− 50.9%) at 8 weeks (p < 0.001), and − 4.9 (− 35.9%) at 16 weeks (p < 0.001). The addition of physiotherapy did not improve outcomes over PBM alone. Conclusion and relevance Among patients with CIPN, PBM produced significant reduction in neuropathy symptoms.

Original languageEnglish (US)
Pages (from-to)159-166
Number of pages8
JournalGynecologic Oncology
Volume144
Issue number1
DOIs
StatePublished - Jan 1 2017

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Peripheral Nervous System Diseases
Randomized Controlled Trials
Drug Therapy
Therapeutics
Combined Modality Therapy
Cross-Over Studies
Placebos
Neoplasms

PubMed: MeSH publication types

  • Journal Article
  • Randomized Controlled Trial

Cite this

@article{c8447bd8dad1452cb8327bff78185eaf,
title = "The effect of photobiomodulation on chemotherapy-induced peripheral neuropathy: A randomized, sham-controlled clinical trial",
abstract = "Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer therapy with few efficacious treatments. Methods We enrolled 70 patients with CIPN in a randomized, double-blinded, sham-controlled, cross-over trial to determine if photobiomodulation (PBM) ± physiotherapy reduced the symptoms of neuropathy compared to sham treatment. At the conclusion of follow-up, sham-arm patients could cross-over into a third arm combining PBM and physiotherapy to determine if multimodal treatment had additive effects. Treatment included 30 minute sessions 3-times weekly for 6 weeks using either PBM or sham therapy. Neuropathy was assessed using the modified total neuropathy score (mTNS) at initiation and 4, 8, and 16 weeks after initiating treatment. Results Sham-treated patients experienced no significant change in mTNS scores at any point during the primary analysis. PBM patients experienced significant reduction in mTNS scores at all time points. Mean changes in mTNS score (and corresponding percent drop from baseline) for sham and PBM-group patients respectively were − 0.1 (− 0.7{\%}) and − 4.2 (− 32.4{\%}) at 4 weeks (p < 0.001), 0.2 (0.0{\%}) and − 6.8 (− 52.6{\%}) at 8 weeks (p < 0.001), and 0.0 (0.1{\%}) and − 5.0 (− 38.8{\%}) at 16 weeks (p < 0.001). Patients who crossed over into the PBM/PT-group experienced similar results to those treated primarily; changes in mTNS score from baseline were − 5.5 (− 40.6{\%}) 4 weeks (p < 0.001), − 6.9 (− 50.9{\%}) at 8 weeks (p < 0.001), and − 4.9 (− 35.9{\%}) at 16 weeks (p < 0.001). The addition of physiotherapy did not improve outcomes over PBM alone. Conclusion and relevance Among patients with CIPN, PBM produced significant reduction in neuropathy symptoms.",
author = "Argenta, {Peter A} and Ballman, {Karla V.} and Geller, {Melissa A} and Carson, {Linda F} and Ghebre, {Rahel G} and Mullany, {Sally A} and Teoh, {Deanna G} and Winterhoff, {Boris J} and Colleen Rivard and Erickson, {Britt K}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.ygyno.2016.11.013",
language = "English (US)",
volume = "144",
pages = "159--166",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "1",

}

TY - JOUR

T1 - The effect of photobiomodulation on chemotherapy-induced peripheral neuropathy

T2 - A randomized, sham-controlled clinical trial

AU - Argenta, Peter A

AU - Ballman, Karla V.

AU - Geller, Melissa A

AU - Carson, Linda F

AU - Ghebre, Rahel G

AU - Mullany, Sally A

AU - Teoh, Deanna G

AU - Winterhoff, Boris J

AU - Rivard, Colleen

AU - Erickson, Britt K

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer therapy with few efficacious treatments. Methods We enrolled 70 patients with CIPN in a randomized, double-blinded, sham-controlled, cross-over trial to determine if photobiomodulation (PBM) ± physiotherapy reduced the symptoms of neuropathy compared to sham treatment. At the conclusion of follow-up, sham-arm patients could cross-over into a third arm combining PBM and physiotherapy to determine if multimodal treatment had additive effects. Treatment included 30 minute sessions 3-times weekly for 6 weeks using either PBM or sham therapy. Neuropathy was assessed using the modified total neuropathy score (mTNS) at initiation and 4, 8, and 16 weeks after initiating treatment. Results Sham-treated patients experienced no significant change in mTNS scores at any point during the primary analysis. PBM patients experienced significant reduction in mTNS scores at all time points. Mean changes in mTNS score (and corresponding percent drop from baseline) for sham and PBM-group patients respectively were − 0.1 (− 0.7%) and − 4.2 (− 32.4%) at 4 weeks (p < 0.001), 0.2 (0.0%) and − 6.8 (− 52.6%) at 8 weeks (p < 0.001), and 0.0 (0.1%) and − 5.0 (− 38.8%) at 16 weeks (p < 0.001). Patients who crossed over into the PBM/PT-group experienced similar results to those treated primarily; changes in mTNS score from baseline were − 5.5 (− 40.6%) 4 weeks (p < 0.001), − 6.9 (− 50.9%) at 8 weeks (p < 0.001), and − 4.9 (− 35.9%) at 16 weeks (p < 0.001). The addition of physiotherapy did not improve outcomes over PBM alone. Conclusion and relevance Among patients with CIPN, PBM produced significant reduction in neuropathy symptoms.

AB - Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer therapy with few efficacious treatments. Methods We enrolled 70 patients with CIPN in a randomized, double-blinded, sham-controlled, cross-over trial to determine if photobiomodulation (PBM) ± physiotherapy reduced the symptoms of neuropathy compared to sham treatment. At the conclusion of follow-up, sham-arm patients could cross-over into a third arm combining PBM and physiotherapy to determine if multimodal treatment had additive effects. Treatment included 30 minute sessions 3-times weekly for 6 weeks using either PBM or sham therapy. Neuropathy was assessed using the modified total neuropathy score (mTNS) at initiation and 4, 8, and 16 weeks after initiating treatment. Results Sham-treated patients experienced no significant change in mTNS scores at any point during the primary analysis. PBM patients experienced significant reduction in mTNS scores at all time points. Mean changes in mTNS score (and corresponding percent drop from baseline) for sham and PBM-group patients respectively were − 0.1 (− 0.7%) and − 4.2 (− 32.4%) at 4 weeks (p < 0.001), 0.2 (0.0%) and − 6.8 (− 52.6%) at 8 weeks (p < 0.001), and 0.0 (0.1%) and − 5.0 (− 38.8%) at 16 weeks (p < 0.001). Patients who crossed over into the PBM/PT-group experienced similar results to those treated primarily; changes in mTNS score from baseline were − 5.5 (− 40.6%) 4 weeks (p < 0.001), − 6.9 (− 50.9%) at 8 weeks (p < 0.001), and − 4.9 (− 35.9%) at 16 weeks (p < 0.001). The addition of physiotherapy did not improve outcomes over PBM alone. Conclusion and relevance Among patients with CIPN, PBM produced significant reduction in neuropathy symptoms.

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U2 - 10.1016/j.ygyno.2016.11.013

DO - 10.1016/j.ygyno.2016.11.013

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AN - SCOPUS:85006830451

VL - 144

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JO - Gynecologic Oncology

JF - Gynecologic Oncology

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