Amelioration of oral mucositis pain by NASA near-infrared light-emitting diodes in bone marrow transplant patients

Hodgson, Brian D.; Margolis, David M.; Salzman, Donna; Eastwood, Dan; Tarima, Sergey; Williams, Lisa D.; Sande, Jane; Vaughan, William P.; Whelan, Harry T.

doi:10.1007/s00520-011-1223-8

Cited by 62 publications

(38 citation statements)

References 38 publications

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“…All studies except one were published as full text articles [38]. One study reported outcomes as a stratified analysis by underlying disease diagnosis and HSCT regimen [19] and thus, represented two separate analyses for a total of 19 prophylactic LLLT comparisons randomizing 1144 patients.…”

Section: Resultsmentioning

confidence: 99%

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Effect of Prophylactic Low Level Laser Therapy on Oral Mucositis: A Systematic Review and Meta-Analysis

et al. 2014

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BackgroundObjective was to determine whether prophylactic low level laser therapy (LLLT) reduces the risk of severe mucositis as compared to placebo or no therapy.MethodsMEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched until February 2014 for randomized controlled trials (RCTs) comparing prophylactic LLLT with placebo or no therapy in patients with cancer or undergoing hematopoietic stem cell transplantation (HSCT). All analyses used random effects models.ResultsEighteen RCTs (1144 patients) were included. Prophylactic LLLT reduced the overall risk of severe mucositis (risk ratio (RR) 0.37, 95% confidence interval (CI) 0.20 to 0.67; P = 0.001). LLLT also reduced the following outcomes when compared to placebo/no therapy: severe mucositis at the time of anticipated maximal mucositis (RR 0.34, 95% CI 0.20 to 0.59), overall mean grade of mucositis (standardized mean difference −1.49, 95% CI −2.02 to −0.95), duration of severe mucositis (weighted mean difference −5.32, 95% CI −9.45 to −1.19) and incidence of severe pain (RR 0.26, 95% CI 0.18 to 0.37).ConclusionProphylactic LLLT reduced severe mucositis and pain in patients with cancer and HSCT recipients. Future research should identify the optimal characteristics of LLLT and determine feasibility in the clinical setting.

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Section: Resultsmentioning

confidence: 99%

“…One study was a solely pediatric trial [41]. Intraoral laser therapy was used in all except two trials [19]. With respect to laser source, InGaAlP (6 trials) and helium-neon (5 trials) were the most commonly used lasers.…”

Section: Resultsmentioning

confidence: 99%

Effect of Prophylactic Low Level Laser Therapy on Oral Mucositis: A Systematic Review and Meta-Analysis

et al. 2014

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“…It indicated that LLLT significantly reduces pain, severity, and duration of symptoms in patients with OM [44]. Additional data from a trial with near-infrared light-emitting diodes applied extraorally in children and adults with hematological malignancies and solid tumors treated with HSCT demonstrated that the technology can significantly reduce patient-reported pain [45]. A recent randomized study in patients with malignancies treated with HSCT confirmed that oral mucositis incidence and severity can be reduced with LLLT [46].…”

Section: Discussionmentioning

confidence: 98%

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

Migliorati

Hewson

Lalla

et al. 2012

Support Care Cancer

213

110

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Background The aim of this study was to review the available literature and define clinical practice guidelines for the use of laser and other light therapies for the prevention and treatment of oral mucositis. the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, and no guideline possible. Results A new recommendation was made for low-level laser (wavelength at 650 nm, power of 40 mW, and each square centimeter treated with the required time to a tissue energy dose of 2 J/cm 2 (2 s/point)) for the prevention of oral mucositis in adult patients receiving hematopoietic stem cell transplantation conditioned with high-dose chemotherapy, with or without total body irradiation. A new suggestion was made for low-level laser (wavelength around 632.8 nm) for the prevention of oral mucositis in patients undergoing radiotherapy, without concomitant chemotherapy, for head and neck cancer. No guideline was possible in other populations and for other light sources due to insufficient evidence. Conclusions The increasing evidence in favor of low-level laser therapy allowed for the development of two new guidelines supporting this modality in the populations listed above. Evidence for other populations was also generally encouraging over a range of wavelengths and intensities. However, additional well-designed research is needed to evaluate the efficacy of laser and other light therapies in various cancer treatment settings. Methods

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“…Whereas in most studies, PBM is applied intra-orally on the oral mucosal tissues, studies indicate that it may also be administered extra-orally, with a resultant effect on structures at risk for OM transcutaneously, thereby enhancing the ease of delivery and possibly the efficacy of treatment [23, 26]. …”

Section: The Potential Utility Of Pbm In the Management Of Side-effecmentioning

confidence: 99%

Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations

Zecha

Raber-Durlacher

Nair

et al. 2016

Support Care Cancer

208

140

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Purpose There is a large body of evidence supporting the efficacy of low level laser therapy (LLLT), more recently termed photobiomodulation (PBM), for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved, may expand the applications for PBM in the management of other complications associated with HNC treatment. This article (part 1) describes PBM mechanisms of action, dosimetry, and safety aspects and, in doing so, provides a basis for a companion paper (part 2) which describes the potential breadth of potential applications of PBM in the management of side-effects of (chemo)radiation therapy in patients being treated for HNC and proposes PBM parameters. Methods This study is a narrative non-systematic review. Results We review PBM mechanisms of action and dosimetric considerations. Virtually, all conditions modulated by PBM (e.g., ulceration, inflammation, lymphedema, pain, fibrosis, neurological and muscular injury) are thought to be involved in the pathogenesis of (chemo)radiation therapy-induced complications in patients treated for HNC. The impact of PBM on tumor behavior and tumor response to treatment has been insufficiently studied. In vitro studies assessing the effect of PBM on tumor cells report conflicting results, perhaps attributable to inconsistencies of PBM power and dose. Nonetheless, the biological bases for the broad clinical activities ascribed to PBM have also been noted to be similar to those activities and pathways associated with negative tumor behaviors and impeded response to treatment. While there are no anecdotal descriptions of poor tumor outcomes in patients treated with PBM, confirming its neutrality with respect to cancer responsiveness is a critical priority. Conclusion Based on its therapeutic effects, PBM may have utility in a broad range of oral, oropharyngeal, facial, and neck complications of HNC treatment. Although evidence suggests that PBM using LLLT is safe in HNC patients, more research is imperative and vigilance remains warranted to detect any potential adverse effects of PBM on cancer treatment outcomes and survival.

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Amelioration of oral mucositis pain by NASA near-infrared light-emitting diodes in bone marrow transplant patients

Cited by 62 publications

References 38 publications

Effect of Prophylactic Low Level Laser Therapy on Oral Mucositis: A Systematic Review and Meta-Analysis

Effect of Prophylactic Low Level Laser Therapy on Oral Mucositis: A Systematic Review and Meta-Analysis

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

Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations

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