Table 3.

WALT 2022 recommendations for PBM treatments in prevention and/or management of cancer therapy-related complications.

Complication	PBM Treatment Parameters												Level of Evidence*I to V	Level of Evidence Recommendation or Expert Opinion
	Device parameters									Delivery parameters
	Route of delivery	Beam Mode(Continuous and/or Pulsed)	Wavelength(nm)	Power(mW)	Irradiance (mW/cm²)	Time(sec)	Specified at 810 nm			Treatment area	Distance from tissue(Contact/non-contact)	Frequency(No. sessions/week andTotal sessions)
							Fluence(J/cm²)(Prophylactic or Curative intent)	Photon Fluence (p.J/cm2)	Einstein(E)
Acute Radiodermatitis	External	CW &/P	630-904	20-150	20-150	TBD	3	4.5	1	TBD	TBD	Daily10->30	II	Expert opinion
							6	9	2
Lymphedema	External	CW &/P	750-904	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	3 times a week for 4 - 6 weeks	III	Expert Opinion
							6	9	2
Radiation Fibrosis	External & Internal	CW &/P	750-850	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	3 times a week for 4 - 6 weeks	NA	Expert Opinion
							6	9	2
Palmar-Plantar Erythrodysesthesia	External	CW &/P	630-680+750-850	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	3 times a week for 4 - 6 weeks	V	Expert Opinion
							6	9	2
Graft versus Host disease	External & Internal	CW &/P	630-680+750-850	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	3 times a week for 4 - 6 weeks	IV	Expert Opinion
							6	9	2
Dysphagia	External & Internal	CW &/P	630-680+750-850	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	3 times a week for 4 - 6 weeks	V	Expert Opinion
							6	9	2
Dysgeusia	External & Internal	CW &/P	630-680+750-850	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	3 times a week for 4 - 6 weeks	V	Expert Opinion
							6	9	2
Trismus	External & Internal	CW &/P	630-680+750-850	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	3 times a week for 4 - 6 weeks	V	Expert opinion
							6	9	2
Osteonecrosis and Mucosal necrosis	External & Internal	CW &/P	630-680+750-850	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	3 times a week for 4 - 6 weeks	IV	Expert Opinion
							6	9	2
Voice and/or Speech alterations	External	CW &/P	630-680+750-850	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	3 times a week for 4 - 6 weeks	NA	Expert Opinion
							6	9	2
Chemotherapy-Induced Peripheral Neuropathy	External	CW &/P	780-970	80-120	20-150 (Red)20-80 (IR)	TBD	7.5	11.2	2.5	TBD	TBD	3 times a week for 4 - 6 weeks	IV	Expert Opinion
							48	72	16
Chemotherapy-Induced Alopecia	External	CW &/P	630-680+750-850	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	3 times a week for 4 - 6 weeks	NA	Expert Opinion
							6	9	2
Periodontal lesions after Chemotherapy and Radiotherapy	Internal	CW &/P	630-660+810-830	20-150	20-150 (Red)20-80 (IR)	TBD	2	3	0.7	TBD	TBD	Daily10 to 30	NA	Expert Opinion
							6	9	2

NA, not applicable TBD: to be decided by the operator

These proposed protocols are based on expert opinion and do not exclude other protocols. *Level I: Evidence obtained from meta-analysis of multiple, well-designed, controlled studies; randomized trials with low false-positive and false-negative errors (high power); Level II: Evidence obtained from at least 1 well-designed experimental study; randomized trials with high false-positive and/or false-negative errors (low power); Level III: Evidence obtained from well-designed, quasi-experimental studies such as nonrandomized, controlled single-group, pre-test, and post-test comparison, cohort, time, or matched case-control series; Level IV: Evidence obtained from well-designed, non-experimental studies, such as comparative and correlational descriptive and case studies; Level V: Evidence obtained from case reports and clinical examples (48).

1 Einstein = 4.5 p.J/cm2 which is the photonic fluence at 810 nm that is equivalent to the conventional fluence of 3 J/cm2 (62).

Photon Energy at 632 nm = 2 eV, 660 nm = 1.9 eV, 680 nm = 1.8 eV, 750 nm = 1.6 eV, 780 = 1.5 eV, 808 = 1.5 eV, and 850 nm = 1.5eV, 904 nm = 1.4 eV.