Effect of low-level laser therapy on pain and swelling in women with breast cancer-related lymphedema: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of intervention studies
PubMed 25432632 · doi:10.1007/s11764-014-0411-1
What was done
Databases (PubMed, PEDro, CINAHL, and Cochrane) were searched through October 16, 2014, without restrictions on language, year, or follow-up duration. The review identified intervention studies examining the effectiveness of low-level laser therapy (LLLT) on arm volume and pain in adults with breast cancer-related lymphedema (BCRL). Nine studies met inclusion criteria. Pooled effect sizes (ES) and 95% confidence intervals (CI) were calculated for limb volume and pain.
What was found
- Limb volume within-group (6 studies): ES -0.52 (95% CI -0.78, -0.25), representing a 75.7-ml reduction after LLLT. - Limb volume between-group (4 studies): ES -0.62 (95% CI -0.97, -0.28), representing a 90.9-ml greater reduction with LLLT versus control. - Pain within-group (3 studies): ES -0.62 (95% CI -1.06, -0.19), representing a 13.5 mm reduction on a 0–100 mm VAS. - Pain between-group (2 studies): ES -1.21 (95% CI -4.51, 2.10), which was not statistically significant.
Why it matters
Adding LLLT to lymphedema care confers modest additional arm volume reduction in breast cancer survivors, though evidence for superior pain relief compared to control remains inconclusive.
Limits
The total number of participants was not reported in the abstract. Only 4 studies contributed to the between-group volume analysis and 2 studies to the between-group pain analysis, leading to very wide confidence intervals for pain.