The first European reference guide on the use of photobiomodulation (PBM) in cancer supportive care was presented at the 16th National Congress of Oncology Support Care, organized by the French-speaking Association for Supportive Care in Cancer (AFSOS) held on October 15-17, 2025, in Lille, France.

The publication is the first scientific standard of its kind in France and Europe. Although PBM remains unfamiliar to many clinicians, there is robust evidence for its use in several indications, making it an important option for supportive care.

Antoine Lemaire, MD, head of the Cancer and Medical Specialties Department, Valenciennes General Hospital, Valenciennes, France, coordinated the document and outlined guidance on indications and use.

PBM

PBM is a mechanism in which red, near infrared, or blue light is delivered to damaged target tissues. The light may originate from a laser, also referred to as a low-intensity laser, or from light-emitting diodes (LEDs). It is a form of light therapy that is similar to the approach widely used to treat neonatal jaundice. The absorbed energy does not generate heat but is converted into metabolic energy that modulates cellular metabolism, primarily in the mitochondria. This activation stimulates the electron transport chain, increases cytochrome c oxidase activity, and boosts ATP and nitric oxide production. Together, these processes support cellular regeneration and tissue repair.

Clinical Indications

In oncology, PBM was first recommended to prevent and treat mucositis related to radiotherapy and chemotherapy. Since then, evidence has expanded, and mucositis and radiodermatitis now have the strongest levels of proof.

Other indications include the management of lymphoedema, acute dysphagia, dysphonia, dysgeusia, palmoplantar erythroderma, xerostomia, trismus, osteoradionecrosis, chemotherapy-induced neuropathy, chemotherapy-induced alopecia, and postradiation fibrosis. Evidence for these conditions is moderate because the tested protocols remain heterogeneous.

The therapeutic window for PBM is 10-12 joules/cm², with the exposure duration determined by the device and the distance between the treatment area and the system. Therefore, each device has specific operating guidelines. In general, sessions lasted approximately 20 minutes and followed 8-16 session protocols delivered once or twice weekly. The frequency may increase or decrease depending on the symptom severity and extent.

Approximately 100 authorized cancer treatment centers in France are believed to have laser and/or LED equipment. Both can be used depending on the indication, tissue involvement, and depth of treatment. When the dosimetric properties are equivalent, lasers provide more focal penetration, whereas LEDs result in more diffuse tissue penetration.

For certain indications and treatment zones, more ergonomic devices may be used, such as intraoral optic fibers positioned in the mouth for the treatment of mucositis or xerostomia.

Its use beyond oncology is also expanding to other specialties. An increasing number of private practice clinicians are acquiring PBM devices for nonaesthetic applications, such as sports medicine recovery and gynecologic symptoms. Public awareness is increasing, and patient associations are highly engaged. Some individuals now directly request PBM, making it essential for all clinicians involved in cancer care pathways to become familiar with this approach.

Wider Adoption Challenges

The main barrier to broader dissemination is the lack of reimbursement for the treatment. Currently, the cost of PBM is included in consultation fees. The new reference also aims to serve as a foundation for discussions with the health ministry to demonstrate the clinical benefits of PBM in the prevention of complications, worsening of the patient’s condition, and reduction in the number of interventions, hospitalizations, and medical transport.

The public should also be warned about home devices sold online. Many lack European Conformity marking, the designation that confirms that a device meets EU safety, quality, and performance standards, has insufficient dosimetric parameters, or may emit ultraviolet light in the blue spectrum.

This story was translated from Univadis France, part of the Medscape Professional Network.