Influence of different photobiomodulation protocols on the prevention of chemotherapy-induced dysgeusia in breast cancer patients treated with Doxorubicin-Cyclophosphamide: a phase III, randomized, triple-blinded non-inferiority clinical trial.

PURPOSE: To evaluate the non-inferiority of protocols with red (R) or infrared (IR) lasers alone when compared to the already established protocol of R + IR lasers.

METHODS

This is a phase III, randomized, triple-blind, non-inferiority, placebo-controlled clinical trial consisting of three study groups (n = 60/group): one receiving R + IR lasers, one receiving only R-laser and IR-placebo and the third with IR-laser and R-placebo (2 J of R-laser and 3 J of IR-laser) in 23-points symmetrically distributed on the tongue. Clinicopathological, sociodemographic data, hematological tests, taste analysis, subjective taste scales (VAS, CTCAE, and STTA), Quality-of-life (OHIP-14), ECOG general health status, body mass index (BMI), CPOD, salivary flow, and other side effects were collected. Chi-square/Fisher's exact tests and Kruskal-Wallis/Dunn (intergroup-analysis) or Friedman/Dunn (intragroup-analysis) tests were used (Margin of non-inferiority: 2-tailed p < 0.05).

RESULTS

In the R + IR group, the objective did not reduce significantly (p = 0.873), but in the R-group, there was a significant reduction of taste function (p = 0.020). VAS (p < 0.001), CTCAE (p < 0.001), STTA (p < 0.001), and OHIP-14 (p < 0.001) analysis in the IR-group was significantly worse than the R + IR group. The ECOG parameter showed an improvement in the R + IR group (20%) compared to the R (11.7%) or IR (6.7%) groups over the course of the CT cycles (p = 0.037). There was no difference in BMI (p = 0.251), but the R + IR group gained significantly more weight (p = 0.044) without an increase in the frequency of obesity (p = 0.850). Groups R (p < 0.001) and IR (p = 0.046), but not R + IR (p = 0.369), showed a reduction in salivary flow.

CONCLUSION

Protocols R or IR proved to be inferior to the R + IR laser photobiomodulation protocol.

TRIAL REGISTRATION: Brazilian Clinical Trials Registry ( www.ensaiosclinicos.gov.br ).

APPROVAL NUMBER: RBR-9 × 5zrgm.

DATE OF REGISTRATION: 12/07/2023.