Photobiomodulation in Treatment of Head and Neck Cancer-Related Chronic Lymphedema: A Pilot Randomized Controlled Trial

Background: Chronic lymphedema is a common late effect after completion of head and neck cancer (HNC) treatment, contributing to substantial symptom burden and negatively impacting quality of life. No effective approaches are available to treat this progressive condition. This study aimed to evaluate the preliminary efficacy of photobiomodulation (PBM) therapy for chronic lymphedema in HNC survivors. Methods: This was a pilot, randomized, wait-list controlled trial. Eligible HNC survivors included those with chronic lymphedema after completion of complete decongestive therapy. Participants were randomized (1:1) to 1 of 2 arms: intervention group (active) or wait-list control group (control). The active group received 12 PBM therapy sessions (twice a week for 6 weeks). The control group completed the study assessments and was then offered the same dose of PBM therapy as the active group. Lymphedema and fibrosis (LEF), symptom burden, jaw range of motion, and neck range of motion were measured at baseline, end-of-intervention, 4-week, and 8-week post-intervention. Results: Twenty five HNC survivors were randomized to the active group (n = 12) and the control group (n = 13). About 91.7% planned PBM treatment sessions were completed. No adverse events were reported. Compared to the control group, the active group demonstrated improvements at 8-week post-intervention in the severity of external LEF ( P < .001), symptom burden (eg, Soft Tissue and Neurologic Toxicity subscale, Cohen’s d = − 0.47), and neck range of motion (eg, extension, Cohen’s d = 0.65). Conclusion: PBM therapy may improve chronic lymphedema-associated outcomes. Future large randomized controlled trials are warranted to examine the efficacy of PBM therapy for HNC-related chronic lymphedema.