Cancer care

Laser therapy put to the test in CIPN


There may be a role for laser photobiomodulation in the management of chemotherapy-induced peripheral neuropathy (CIPN), according to a phase 2 study presented at the MOGA 2022 ASM.

Dr Christina Teng’s study, conducted at Concord Hospital, comprised 44 survivors of mainly breast or colorectal cancer and with CIPN symptoms persisting for at least three months after completion of chemotherapy.

They were randomised 2:1 to either two sessions per week for six weeks of either intervention or a sham procedure with the laser directed at both hands and feet.

Dr Teng said the proportion of patients and controls reporting a CIPN response – defined as either resolution of symptoms to zero or a reduction of at least four points on the questionnaire – was 48% and 53% after six weeks of treatment and 45% and 33% respectively another six weeks later.

“So if there was any effect in the sham arm, it appeared to wear off and the patients returned to close to normal over time,” she said.

She said she expected maybe 7% of patients in the study would improve spontaneously over a three months period.

“So both arms did much better than we expected compared to historical controls.”

“Interestingly, quality of life and clinical signs assessed by a physician remained about the same.”

She said adverse events were mostly mild and none required any intervention. Patients who reported pain were offered analgesia but all declined.

“Of note, in a group of patients being treated for neuropathic pain with the photobiomodulation laser therapy in another study, transient pain flares have been reported as a side effect.”

Dr Teng said the reported response in the treated group was unlikely to be a placebo effect given the response was sustained, clinically significant and meaningful.

“As this is a safe and well-tolerated complementary therapy, I believe it warrants a bigger trial. And it’s a proof of concept, I would say, that complementary therapy can be tested in an evidence-based way.”

Dr Teng told the meeting that the intervention was included in the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for the prevention of oral mucositis.

She also told the limbic that other evidence – for example, here and here – was gradually accumulating.

“It’s hypothesised that the energy from light of various frequencies can change how cells function. That’s potentially how it works in the mucositis setting as well.”

Dr Teng was awarded the best oral presentation by a young oncologist at the MOGA 2022 ASM.

 

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