TNF and neoplasm: Although the tumor response was not directly measured, they found that the lowest dose (35.7 J/cm2) produced significant increases in IL-1β, COX-2, and inducible nitric oxide synthases (iNOS), and significant reductions in IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α), thus concluding that 35.7 J/cm2 was able to produce cytotoxic effects from ROS generation causing acute inflammation; therefore, PBM at 35.7 J/cm2 can be used as the best energy dose associated with PDT [66].