Efficacy of low-level laser therapy and aluminum hydroxide in patients with chemotherapy and radiotherapy-induced oral mucositis

Abstract

This study evaluated the efficacy of low-level laser therapy (LLLT) and aluminum hydroxide (AH) in the prevention of oral mucositis (OM). A prospective, comparative and non-randomized study was conducted with 25 patients with head and neck cancer subjected to radiotherapy (RT) or radiochemotherapy (RCT). Twelve patients received LLLT (830 nm, 15 mW, 12 J/cm²) daily from the 1st day until the end of RT before each sessions during 5 consecutive days, and the other 13 patients received AH 310 mg/5 mL, 4 times/day, also throughout the duration of RT, including weekends. OM was measured using an oral toxicity scale (OTS) and pain was measured using the visual analogue scale (VAS). EORTC questionnaires were administered to the evaluate impact of OM on quality of life. The LLLT group showed lower mean OTS and VAS scores during the course of RT. A significant difference was observed in pain evaluation in the 13th RT session (p=0.036). In both groups, no interruption of RT was needed. The prophylactic use of both treatments proposed in this study seems to reduce the incidence of severe OM lesions. However, the LLLT was more effective in delaying the appearance of severe OM.

Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients

“…Studies were inconsistent in demonstrating the effectiveness of laser therapy in this population [27][28][29]. In addition, major flaws in study design reduced the overall level of evidence to IV.…”

Treatment of severe oral mucositis in a pediatric patient undergoing chemotherapy

“…These agents enable a patient to bear the lesion while it is not fully healed 22 , preventing the progression of the inflammatory response, tissue destruction 23 , and the development of opportunistic infections 20 . The protocol with low-level laser therapy has been considered an effective treatment for oral mucositis 24 . Although there is no consensus on the optimal energy dose, the wavelength is usually 660nm to 670nm, and the power, 40 to 60 mW 21 .…”

Efetividade profilática e terapêutica do laser de baixa intensidade na mucosite bucal em pacientes submetidos ao tratamento do câncer

“…Dessa forma, o comprimento de onda e a dose de energia influenciam significativamente esses resultados [8][9][10] . O emprego do laser de baixa potência elimina a dor já na primeira aplicação, promovendo o aumento na concentração de ß-endorfina no líquor cefalorraquidiano, ativando a reparação tecidual, favorecendo a proliferação de fibroblastos e a produção de fibras elásticas e colágenas, elevando, assim, a celularidade dos tecidos irradiados 11,12 .…”