Low-level laser therapy for treatment of chemotherapy-induced oral mucositis in childhood: a randomized double-blind controlled study

Abstract

The aim of this study was to verify if low-level laser therapy could be useful to reduce chemotherapy-related oral mucositis grading and pain in childhood undergoing chemotherapy. A randomized double-blind clinical trial was carried out. Patients from 3 to 18 years of age undergoing cancer therapy and presenting OM grade 2 or more were eligible for this study. Patients were randomly divided in two groups: group A received laser therapy from the day of OM diagnosis and other 3 consecutive days (830 nm wavelength, power 150 mW, spot size 1 cm(2), 30 s per cm(2), energy density 4.5 J/cm(2)); group B received sham therapy (placebo) with the same timing. Two blind clinicians performed OM scoring and pain evaluation at day 1 (immediately before the beginning of laser treatment-T0), day 4 (after finishing laser therapy cycle-T1) and at day 7 (T2) as follow-up. A total of 123 patients were included in the study. Group A was composed of 62 children while group B is 61; in both groups, there was a progressive reduction in grade of OM, and at day 7, not every mucosal lesion disappeared. The difference in the decline of OM grading between the two groups resulted not statistically significant (p = 0.07). A statistically significant difference in pain reduction between two groups both at T1 and at T2 (p < 0.005) was observed. This study demonstrated the efficacy of LLLT in reducing pain due to chemotherapy-induced oral mucositis in children, while no significant benefit was noted in reducing OM grade.

Effect of Low-Level Laser Therapy in Treatment of Chemotherapy Induced Oral Mucositis

“…10 Because there is no sufficient evidence, the MASCC/ISOO guidelines did not recommend LLLT for the management of COM in patients receiving conventional chemotherapy protocols. The current study investigated LLLT for COM in cancer patients receiving conventional chemotherapy protocols and the results concur with those of some other studies, [19][20][21] we found a significant decrease in the mean scores of mucositis after LLLT. Grade 3 mucositis decrease from 48% before treatment with LLLT to 0% after treatment.…”

Management of oral mucositis in pediatric patients receiving cancer therapy: A systematic review and meta‐analysis

“…6,28 This systematic review and meta-analysis intended to shed some light on agents that may be used to prevent OM in children. Our search yielded to several agents or techniques that had been used to manage OM in different studies: palifermin, [18][19][20]29,30 LLLT, 17,[31][32][33] caphosol, 34,35 propolis, 36 curcumin, 37 honey and a mixture of honey, beeswax, and olive oil, propolis extract, 38 oral solution of 0.12% chlorhexidine gluconate, 39,40 topical vitamin E, 41 TGF-beta2, 42 chewing gum, 43 vitamin E, pycnogenol, 44 near-infrared light-emitting diodes, 45 and GelX oral spray. 46 Among all these studies, there were enough studies (three studies) for two agents (palifermin and LLLT); hence, they were selected to be included in the systematic and meta-analysis.…”

Treatment of oral manifestations of toxic epidermal necrolysis with low‐level laser therapy in a pediatric patient

“…Furthermore, a systematic review and meta‐analysis of the effect of LLLT in pediatric and young patients revealed reductions in the severity of oral mucositis and pain . Moreover, a double‐blind randomized clinical trial demonstrated the efficacy of LLLT in reducing oral mucositis‐associated pain in children, whereas no significant benefit in reduction of the oral mucositis score was verified . This apparent discrepancy can be explained by the wavelengths used (830 nm).…”