Effectiveness of Photobiomodulation Therapy for Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients: A Systematic Review and Meta-Analysis

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and common side effect of cancer therapy, severely impacting cancer therapy compliance and the quality of life of cancer patients.Low-level laser or lightemitting diode (LED) photobiomodulation therapy (PBMT) provides a new, noninvasive therapeutic option.The purpose of the present systematic review and metaanalysis is to evaluate the efficacy of PBMT in the treatment of CIPN during cancer therapy in patients.Methodology: A systematic electronic database search was conducted using randomized controlled trials and clinical studies comparing the impact of PBMT on the symptom of CIPN in the form of modified Total Neuropathy Scores (mTNS), FACT/GOG-NTX scores, and Visual Analogue Scale (VAS) pain scores.Meta-analyses were done using RevMan 5.4.1, producing forest plots, mean differences (MD), 95% confidence intervals (CI), and heterogeneity indices (I²).Results: The review included six trials with a total of 273 patients.The metaanalysis of mTNS revealed the significant reduction of neuropathy severity in the PBMT group compared to the control group (MD = -2.10;95% CI: -3.94 to -0.26; I²=99%, p<0.0001).Furthermore, the FACT/GOG-NTX neuropathy subscale at follow-up completion, combined in four trials, illustrated the advantage in favor of PBMT as statistically significant (MD = -1.85;95% CI: -2.70 to -0.99; I²=0%, p=0.80).In addition, four studies that reported the VAS scores of pain showed that the intensity of pain was reduced significantly by PBMT (MD = -1.36;95% CI: -2.00 to -0.73; I²=87%, p<0.0001).Conclusion: PBMT exhibited statistically significant differences in neuropathy severity, neuropathy symptom, and pain intensity in cancer patients with CIPN, with considerable heterogeneity in some of the outcomes.PBMT was therefore a promising adjuvant treatment to CIPN management.