SYSTEMATIC REVIEW/META-ANALYSIS
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
This review analysed the efficiency of low-level laser therapy in treating breast cancer-related lymphedema (BCRL) in women.

Material and methods:
Databases such as Scopus, PEDro, PubMed, Cochrane, and Web of Science were searched for RCTs using low-level laser therapy (LLLT) or photo-bio modulation therapy (PBMT) on BCRL published between 2010 and August 2023. Primary outcomes were arm circumference, volume, and hand grip strength, while secondary outcomes were pain, shoulder mobility, and quality of life.

Results:
Eleven RCTs with a total of 379 patients were analysed, and 8 studies were included for meta-analysis. We found no significant difference between laser-treated and control groups in any of the trials in terms of arm circumference, arm volume, grip strength, and quality of life post-intervention, and a significant difference between the groups in terms of pain intensity and shoulder mobility.

Conclusions:
This review revealed that low-level laser therapy (photobiostimulation) was successful in reducing arm circumference, volume, and pain, as well as enhancing grip strength, life quality, and mobility. However, the meta-analysis did not show any improvement except in pain and shoulder mobility. Further trials are required to assess the long- and short-term efficacy of LLLT in managing lymphoedema secondary to breast cancer.

REFERENCES (39)
1.
Arnold M, Morgan E, Rumgay H, et al. Current and future burden of breast cancer: Global statistics for 2020 and 2040. Breast 2022; 66: 15-23.
 
2.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394-424.
 
3.
DiSipio T, Rye S, Newman B, Hayes S. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol 2013; 14: 500-15.
 
4.
Mustian KM, Sprod LK, Janelsins M, Peppone LJ, Mohile S. Exercise recommendations for cancer-related fatigue, cognitive impairment, sleep problems, depression, pain, anxiety, and physical dysfunction: a review. Oncol Hematol Rev 2012; 8: 81-8.
 
5.
Smoot B, Chiavola-Larson L, Lee J, Manibusan H, Allen DD. Effect of low-level laser therapy on pain and swelling in women with breast cancer-related lymphedema: a systematic review and meta-analysis. J Cancer Surviv 2015; 9: 287-304.
 
6.
Hayes SC, Johansson K, Stout NL, et al. Upper-body morbidity after breast cancer: incidence and evidence for evaluation, prevention, and management within a prospective surveillance model of care. Cancer 2012; 118: 2237-49.
 
7.
Ridner SH. Quality of life and a symptom cluster associated with breast cancer treatment-related lymphedema. Support Care Cancer 2005; 13: 904-11.
 
8.
Chen HY, Tsai HH, Tam KW, Huang TW. Effects of photobiomodualtion therapy on breast cancer-related lymphoedema: a systematic review and meta-analysis of randomised controlled trials. Complement Ther Med 2019; 47: 102200.
 
9.
Lima MTBRME, Lima JGME, De Andrade MFC, Bergmann A. Low-level laser therapy in secondary lymphedema after breast cancer: systematic review. Lasers Med Sci 2014; 29: 1289-95.
 
10.
Baxter GD, Liu L, Petrich S, et al. Low level laser therapy (Photobiomodulation therapy) for breast cancer-related lymphedema: a systematic review. BMC Cancer 2017; 17: 833.
 
11.
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016; 5: 210.
 
12.
Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 2003; 83: 713-21.
 
13.
Pitsillides A, Stasinopoulos D, Mamais I. Blood flow restriction training in patients with knee osteoarthritis: Systematic review of randomized controlled trials. J Bodyw Mov Ther 2021; 27: 477-86.
 
14.
Cashin AG, McAuley JH. Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale. J Physiother 2020;.
 
15.
66: 59.
 
16.
Straus SE, Richardson WS, Glasziou P, Haynes RB. Evidence-based Medicine. How to Practice and Teach EBM. Edinburgh, London, New York. Oxford, Philadelphia, St. Louis, Sydney, Toronto: Elsevier Churchill Livingstone; 2005.
 
17.
Sackett DL. Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 1989; 95: 2S-4S.
 
18.
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 2009; 151: W-65.
 
19.
Yilmaz SS, Ayhan FF. The randomized controlled study of low-level laser therapy, kinesio-taping and manual lymphatic drainage in patients with stage II breast cancer-related lymphedema. Eur J Breast Heal 2023; 19: 34-44.
 
20.
Kozanoglu E, Gokcen N, Basaran S, Paydas S. Long-Term effectiveness of combined intermittent pneumatic compression plus low-level laser therapy in patients with postmastectomy lymphedema: a randomized controlled trial. Lymphat Res Biol 2022; 20: 175-84.
 
21.
Mogahed HG, Badawy MM, Aziz NM. Low-level laser diode on post modified radical mastectomy lymphedema: a randomized controlled trial. J Adv Pharm Educ Res 2020; 10: 105-9.
 
22.
Mokhtar SM, Omar S, Alawady H, Abdelrahman M, Sherif Omar O. Can low level LASER therapy be used as a practical alternative to Combined decongestive therapy in young female patients with post-mastectomy Lymphedema? Pan Arab J Oncol 2020; 13. Available from: www.amaac.org.
 
23.
Baxter GD, Liu L, Tumilty S, Petrich S, Chapple C, Anders JJ. Low level laser therapy for the management of breast cancer-related lymphedema: a randomized controlled feasibility study. Lasers Surg Med 2018; 50: 924-32.
 
24.
Storz MA, Gronwald B, Gottschling S, Schöpe J, Mavrova R, Baum S. Photobiomodulation therapy in breast cancer-related lymphedema: a randomized placebo-controlled trial. Photodermatol Photoimmunol Photomed 2017; 33: 32-40.
 
25.
Ridner SH, Poage-Hooper E, Kanar C, Doersam JK, Bond SM, Dietrich MS. A pilot randomized trial evaluating low-level laser therapy as an alternative treatment to manual lymphatic drainage for breast cancer-related lymphedema. Oncol Nurs Forum 2013; 40: 383-93.
 
26.
Ahmed Omar MT, Abd-El-Gayed Ebid A, El Morsy AM. Treatment of post-mastectomy lymphedema with laser therapy: double blind placebo control randomized study. J Surg Res 2011; 165: 82-90.
 
27.
Khalaf MM, Hassan MA, Ibrahim ZM. Helium neon laser therapy for post mastectomy lymphedema and shoulder mobility. Egypt J Med Hum Genet 2013; 14: 195-9.
 
28.
Bramlett O, Daysudov I, Odaira T, Rodriguez B. The long-term effects of low level laser therapy (LLLT) combined with complex decongestive therapy (CDT) in the treatment of breast cancer lymphedema: a double-blind, randomized, placebo-controlled study. CUMY Academic Works 2014.
 
29.
Kilmartin L, Denham T, Fu MR, et al. Complementary low-level laser therapy for breast cancer-related lymphedema: a pilot, double-blind, randomized, placebo-controlled study. Lasers Med Sci 2020; 35: 95-105.
 
30.
Dirican A, Andacoglu O, Johnson R, McGuire K, Mager L, Soran A. The short-term effects of low-level laser therapy in the management of breast-cancer-related lymphedema. Support Care Cancer 2011; 19: 685-90.
 
31.
Wang Y, Ge Y, Xing W, et al. The effectiveness and safety of low-level laser therapy on breast cancer-related lymphedema: an overview and update of systematic reviews. Lasers Med Sci 2022; 37: 1389-413.
 
32.
Omar MTA, Shaheen AAM, Zafar H. A systematic review of the effect of low-level laser therapy in the management of breast cancer-related lymphedema. Support Care Cancer 2012; 20: 2977-84.
 
33.
Hamblin MR, Demidova TN. Mechanisms of low level light therapy. Mech Low-light Ther 2006; 6140: 614001.
 
34.
Mahmood D, Ahmad A, Sharif F, Arslan SA. Clinical application of low-level laser therapy (photo-biomodulation therapy) in the management of breast cancer-related lymphedema: a systematic review. BMC Cancer 2022; 22: 937.
 
35.
Park JE, Jang HJ, Seo KS. Quality of life, upper extremity function and the effect of lymphedema treatment in breast cancer related lymphedema patients. Ann Rehabil Med 2012; 36: 240-7.
 
36.
Penha TRL, Botter B, Heuts EM, Voogd AC, Von Meyenfeldt MF, Van Der Hulst RR. Quality of life in patients with breast cancer-related lymphedema and reconstructive breast surgery. J Reconstr Microsurg 2016; 32: 484-90.
 
37.
Wang X, Tian F, Reddy DD, et al. Up-regulation of cerebral cytochrome-c-oxidase and hemodynamics by transcranial infrared laser stimulation: a broadband near-infrared spectroscopy study. J Cereb Blood Flow Metab 2017; 37: 3789-802.
 
38.
Jang DH, Song DH, Chang EJ, Jeon JY. Anti-inflammatory and lymphangiogenetic effects of low-level laser therapy on lymphedema in an experimental mouse tail model. Lasers Med Sci 2016; 31: 289-96.
 
39.
Carati CJ, Anderson SN, Gannon BJ, Piller NB. Treatment of postmastectomy lymphedema with low-level laser therapy: a double blind, placebo-controlled trial. Cancer 2003; 98: 1114-22.
 
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ISSN:1734-1922
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