Complementary low-level laser therapy for breast cancer-related lymphedema: a pilot, double-blind, randomized, placebo-controlled study

Laurie Kilmartin1 & Tara Denham1 & Mei R. Fu2 & Gary Yu2 & Ting-Ting Kuo3 & Deborah Axelrod4,5 & Amber A. Guth4,5. Lasers Med Sci (2020) 35:95–105.

Abstract

Complementary low-level laser therapy for breast cancer-related lymphedema: a pilot, double-blind, randomized, placebo-controlled study

Laurie Kilmartin1 & Tara Denham1 & Mei R. Fu2 & Gary Yu2 & Ting-Ting Kuo3 & Deborah Axelrod4,5 & Amber A. Guth4,5. Lasers Med Sci (2020) 35:95–105.

This pilot, double-blind, randomized, placebo-controlled study is aimed at evaluating the effectiveness of low-level laser therapy (LLLT) as a complementary treatment to complete decongestive therapy (CDT) treating lymphedema among breast cancer patients for 12 months post-intervention. Study population was breast cancer patients who were diagnosed and referred to lymphedema clinic for CDT. Participants (n=22) were randomized and assigned into either an active laser intervention group or an inactive laser placebo-control group. Active LLLTwas administered to participants twice a week at the beginning of each CDT session. Outcome measures included lymphedema symptoms, symptom distress, and limb volume by an infrared perometer. Participants in the active and placebo laser groups were comparable in demographic and clinical predictors of lymphedema. In comparison with the placebo group (83.3%), significantly fewer participants in the active laser group (55.6%) reported more than one lymphedema symptom (p=0.012) at 12 months post-intervention. Significantly, more patients in the active laser group (44.4%) reported less than two impaired limb mobility symptoms in comparison with the placebo group (33.3%) at 12 months  post-intervention (p=0.017). The active laser group had statistically significant improvements in symptom distress of sadness (p=0.005) from 73 to 11% and self-perception (p=0.030) from 36 to 0% over time from baseline to 12months post-intervention. There was no significant reduction in limb volume. Findings of the trial demonstrated significant benefits of complementary LLLT for relieving symptoms and improvement of emotional distress in breast cancer patients with lymphedema.

Main findings

  • N = 22
  • Results from this pilot study show significant benefit of LLLT in combination with CDT for symptom burden reduction in individuals with BCRL, but did not show additional benefit for limb volume reduction. In the future, best practice for BCRL assessment would include a combination of limb volume measurement and comprehensive symptom assessment, as this pathology has been shown to have an impact in both areas. For future studies, a larger sample size with a rigorous study design focusing on the effectiveness of LLLTas the sole treatment for the BCRL population is indicated to make more definitive conclusions.