Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil.
Cedars-Sinai Health System, Los Angeles, CA, USA.
Support Care Cancer. 2021 Jun;29(6):2875-2884. doi: 10.1007/s00520-020-05949-1. Epub 2021 Jan 7.
To identify and summarize the evidence on the cost-effectiveness of photobiomodulation (PBM) therapy for the prevention and treatment of cancer treatment-related toxicities.
This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE). Scopus, MEDLINE/PubMed, and Embase were searched electronically.
A total of 1490 studies were identified, and after a two-step review, 4 articles met the inclusion criteria. The included studies analyzed the cost-effectiveness of PBM therapy used in the context of lymphedema for breast cancer and oral mucositis (OM) induced by chemotherapy and radiotherapy. Better outcomes were associated with PBM therapy. The incremental cost-effectiveness ratio ranged from 3050.75 USD to 5592.10 USD per grade 3-4 OM case prevented. PBM therapy cost 21.47 USD per percentage point reduction in lymphedema in comparison with 80.51 USD for manual lymph drainage and physical therapy.
There is limited evidence that PBM therapy is cost-effective in the prevention and treatment of specific cancer treatment-related toxicities, namely, OM and breast cancer-related lymphedema. Studies may have underreported the benefits due to a lack of a comprehensive cost evaluation. This suggests a wider acceptance of PBM therapy at cancer treatment centers, which has thus far been limited by the number of robust clinical studies that demonstrate cost-effectiveness for the prevention and treatment of toxicities.
确定并总结光生物调节（PBM）疗法预防和治疗癌症治疗相关毒性的成本效益证据。
本系统评价按照系统评价和荟萃分析报告的首选项目（PRISMA）和观察性研究荟萃分析（MOOSE）进行。电子检索 Scopus、MEDLINE/PubMed 和 Embase。
共确定了 1490 项研究，经过两步审查，有 4 篇文章符合纳入标准。纳入的研究分析了 PBM 疗法在乳腺癌淋巴水肿和化疗及放疗引起的口腔粘膜炎（OM）背景下的成本效益。更好的结果与 PBM 疗法相关联。每预防一例 3-4 级 OM 的增量成本效益比范围为 3050.75 美元至 5592.10 美元。与手动淋巴引流和物理疗法相比，PBM 疗法每使淋巴水肿减少一个百分点，成本为 21.47 美元。
有有限的证据表明 PBM 疗法在预防和治疗特定的癌症治疗相关毒性方面具有成本效益，即 OM 和乳腺癌相关的淋巴水肿。由于缺乏全面的成本评估，研究可能低估了益处。这表明在癌症治疗中心更广泛地接受 PBM 疗法，目前由于缺乏证明预防和治疗毒性的成本效益的大量稳健临床研究，该疗法的应用受到限制。
