Light therapy for cancer-related fatigue in (Non-)hodgkin lymphoma survivors: Results of a randomized controlled trial

Daniëlle E.J. Starreveld, Laurien A. Daniels, Jacobien M. Kieffer, Heiddis B. Valdimarsdottir, Jessie de Geus, Mirthe Lanfermeijer, Eus J.W. van Someren, G. Esther A. Habers, Jos A. Bosch, Cécile P.M. Janus, Dick Johan van Spronsen, Roel J. de Weijer, Erik W.A. Marijt, Eva de Jongh, Josée M. Zijlstra, Lara H. Böhmer, Margreet Houmes, Marie José Kersten, Catharina M. Korse, Huub H. van RossumWilliam H. Redd, Susan K. Lutgendorf, Sonia Ancoli-israel, Flora E. van Leeuwen, Eveline M.A. Bleiker*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Purpose: To evaluate the short- and long-term effects of light therapy on fatigue (primary outcome) and sleep quality, depression, anxiety, quality of life, and circadian rhythms (secondary outcomes) in survivors of (non-)Hodgkin lymphoma presenting with chronic cancer-related fatigue. Methods: We randomly assigned 166 survivors (mean survival 13 years) to a bright white light intervention (BWL) or dim white light comparison (DWL) group. Measurements were completed at baseline (T0), post-intervention (T1), at three (T2), and nine (T3) months follow-up. A mixed-effect modeling approach was used to compare linear and non-linear effects of time between groups. Re-sults: There were no significant differences between BWL and DWL in the reduction in fatigue over time. Both BWL and DWL significantly (p < 0.001) improved fatigue levels during the intervention followed by a slight reduction in this effect during follow-up (EST0-T1 = −0.71; EST1-T3 = 0.15). Similar results were found for depression, sleep quality, and some aspects of quality of life. Light therapy had no effect on circadian rhythms. Conclusions: BWL was not superior in reducing fatigue compared to DWL in HL and DLBCL survivors. Remarkably, the total sample showed clinically relevant and persistent improvements on fatigue not commonly seen in longitudinal observational studies in these survivors.

Original languageEnglish
Article number4948
Issue number19
Publication statusPublished - 1 Oct 2021

Bibliographical note

Funding Information:
This work was supported by the Dutch Cancer Society (Grant No. NKI 2015-7909). The funder had no influence on study design, data collection, project management, data analysis, interpretation, or manuscript preparation, review, or approval.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Copyright 2021 Elsevier B.V., All rights reserved.


  • Cancer-related fatigue
  • Circadian rhythms
  • Light therapy
  • Randomized controlled trial
  • Sleep


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