Photobiomodulation for the Prevention of Chemotherapy-Induced Peripheral Neuropathy: Randomized Clinical Trial Protocol

Authors

DOI:

https://doi.org/10.29289/2594539420250002

Keywords:

breast cancer, peripheral nerve repair, photobiomodulation therapy

Abstract

Chemotherapy applied as a breast cancer treatment may result in chemotherapy-induced peripheral neuropathy (CIPN) as a side effect, encompassing varying degrees of toxicity, according to the employed drug’s pharmacokinetics, administration period, and cumulative dose. In this sense, photobiomodulation employing LASER or LED comprises a safe and non-pharmacological low-cost resource that has been widely studied for the mitigation and even resolution of various oncological comorbidities. The objective of this study is to evaluate the effectiveness of photobiomodulation employing a LED Therapeutic Display (LTD) in the prevention of lower limb CIPN in breast cancer female patients undergoing chemotherapy. Methods: This study encompasses a randomized double-blind superiority clinical trial including women aged 18 and over presenting breast cancer stages I to IIIC with indication for curative treatment applying neoadjuvant or adjuvant chemotherapy. Following recruitment, patients will be allocated into three groups: two intervention groups, which will undergo infrared and red LTD (A) and infrared, red, and violet LTD (B), and a control group (C), which will apply LTD with no light emission. The LTD applications will be conducted at home for 20 minutes daily on each plantar region, until the last day of chemotherapy. All groups will be assessed at the beginning of the chemotherapy treatment, during each cycle, and at the end of the treatment (at 30 days, 3 and 6 months). Lower limb CIPN incidence, pain, body balance, sensitivity, and quality of life will be evaluated, as well as LTD use satisfaction, treatment adherence, and CIPN impacts on daily living activities. Results: This study will evaluate the effectiveness of photobiomodulation employing LTD in preventing lower limb CIPN in Brazilian breast cancer female patients undergoing neoadjuvant or adjuvant chemotherapy. The results will encompass quantitative and self-reported patient data. Conclusions: This study is expected to demonstrate a new prevention modality for this breast cancer treatment complication.

Downloads

Download data is not yet available.

References

Santos MO, Lima FCS, Martins LFL, Oliveira JFP, Almeida LM, Cancela MC. Estimativa de Incidência de Câncer no Brasil, 2023-2025. Rev Bras Cancerol. 2023;69(1):e-213700. https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3700

Joy L, Jolien R, Marithé C, Stijn E, Laura S, Hilde L, et al. The use of photobiomodulation therapy for the prevention of chemotherapy-induced peripheral neuropathy: a randomized, placebo-controlled pilot trial (NEUROLASER trial). Support Care Cancer. 2022;30(6):5509-17. https://doi.org/10.1007/s00520-022-06975-x

Shien T, Iwata H. Adjuvant and neoadjuvant therapy for breast cancer. Jpn J Clin Oncol. 2020;50(3):225-29. https://doi.org/10.1093/jjco/hyz213

Fisusi FA, Akala EO. Drug Combinations in Breast Cancer Therapy. Pharm Nanotechnol. 2019;7(1):3-23. https://doi.org/10.2174/2211738507666190122111224

Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, et al. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. CA Cancer J Clin. 2016;66(1):43-73. https://doi.org/10.3322/caac.21319

Costa TC, Lopes M, Anjos ACY dos, Zago MMF. Chemotherapy-induced peripheral neuropathies: an integrative review of the literature. Rev Esc de Enferm USP. 2015;49(2):335-45. https://doi.org/10.1590/S0080-623420150000200020

Simão DAS, Murad M, Martins C, Fernandes VC, Captein KM, Teixeira AL. Chemotherapy-induced peripheral neuropathy: review for clinical practice. Rev Dor São Paulo. 2015;16(3):215-20. https://doi.org/10.5935/1806-0013.20150043

Castelli G, Desai KM, Cantone RE. Peripheral Neuropathy: Evaluation and Differential Diagnosis. Am Fam Physician. 2020;102(12):732-9.

Hsieh YL, Fan YC, Yang CC. Low-level laser therapy alleviates mechanical and cold allodynia induced by oxaliplatin administration in rats. Supportive Care Cancer. 2015;24(1):233-242. https://doi.org/10.1007/s00520-015-2773-y

Alberto T, Corbo BFB, Macina ECD, Leite JV, Inacio RF. Effects of a red light transmitter (led) on the stimulation of fibroblasts: with emphasis on tissue repair. Rev Intellectus. 2016;1(33):94-105.

Malta CEN, Carlos ACAM, de Alencar MCM, E Silva EFA, Nogueira VBC, Alves APNN, et al. Photobiomodulation therapy prevents dysgeusia chemotherapy induced in breast cancer women treated with doxorubicin plus cyclophosphamide: a triple-blinded, randomized, placebo-controlled clinical trial. Support Care Cancer. 2022;30(3):2569-80. https://doi.org/10.1007/s00520-021-06642-7

Wang Y, Ge Y, Xing W, Liu J, Wu J, Lin H, 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(3):1389-413. https://doi.org/10.1007/s10103-021-03446-3

Bensadoun RJ, Bollet MA, Liem X, Cao K, Magné N. New photobiomodulation device for prevention and cure of radiotherapy-induced oral mucositis and dermatitis: results of the prospective Safe PBM study. Support Care Cancer. 2022;30(2):1569-77. https://doi.org/10.1007/s00520-021-06574-2

Argenta PA, Ballman KV, Geller MA, Carson LF, Ghebre R, Mullany SA, et al. The effect of photobiomodulation on chemotherapy-induced peripheral neuropathy: A randomized, sham- controlled clinical trial. Gynecol Oncol. 2017;144(1):159-66. https://doi.org/10.1016/j.ygyno.2016.11.013

Cheng K, Martin LF, Slepian MJ, Patwardhan AM, Ibrahim MM. Mechanisms and Pathways of Pain Photobiomodulation: A Narrative Review. J Pain. 2021;22(7):763-77. https://doi.org/10.1016/j.jpain.2021.02.005

Zhang WW, Wang XY, Chu YX, Wang YQ. Light-emitting diode phototherapy: pain relief and underlying mechanisms. Lasers Med Sci. 2022;37(5):2343-52. https://doi.org/10.1007/s10103-022-03540-0

Cronshaw M, Parker S, Arany P. Feeling the Heat: Evolutionary and Microbial Basis for the Analgesic Mechanisms of Photobiomodulation Therapy. Photobiomodul Photomed Laser Surg. 2019;37(9):517-26. https://doi.org/10.1089/photob.2019.4684

Tofthagen CS, McMillan SC, Kip KE. Development and psychometric evaluation of the chemotherapy-induced peripheral neuropathy assessment tool. Cancer Nurs. 2011;34(4):E10-20. https://doi.org/10.1097/NCC.0b013e31820251de

Melzack R. The short-form McGill Pain Questionnaire. Pain. 1987;30(2):191-7. https://doi.org/10.1016/0304-3959(87)91074-8

Bretan O, Júnior JES, Ribeiro OR, Corrente JE. Risk of falling among elderly persons living in the Community: Assessment by the Timed up and go test. Braz J Otorhinolaryngol. 2013;79(1):18-21. https://doi.org/10.5935/1808-8694.20130004

da Silva Simão DA, Teixeira AL, Souza RS, de Paula Lima ED. Evaluation of the Semmes-Weinstein filaments and a questionnaire to assess chemotherapy-induced peripheral neuropathy. Support Care Cancer. 2014;22(10):2767-73. https://doi.org/10.1007/s00520-014-2275-3

Bell-Krotoski J. Weinstein monofilament using for determining cutaneous light touch deep pressure sensation. The Star. 1984;44(2):8-11.

Calhoun EA, Welshman EE, Chang CH, Lurain JR, Fishman DA, Hunt TL, et al. Psychometric evaluation of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (Fact/GOG-Ntx) questionnaire for patients receiving systemic chemotherapy. Int J Gynecol Cancer. 2003;13(6):741-8. https://doi.org/10.1111/j.1525-1438.2003.13603.x

Downloads

Published

2025-09-19

How to Cite

Fernandes, M. C., Fabro, E. A. N., Costa, R. M., Torres, D. M., de Aguiar, S. S., Lenzi, J., … Bergmann, A. (2025). Photobiomodulation for the Prevention of Chemotherapy-Induced Peripheral Neuropathy: Randomized Clinical Trial Protocol. Mastology, 35. https://doi.org/10.29289/2594539420250002

Issue

Section

Original Articles