Low-level Laser Therapy in the Management of Oral Mucositis Induced by Radiotherapy: A Randomized Double-blind Clinical Trial

Carli, João Paulo De; Dogenski, Letícia Copatti; Kuhn-Dall'Magro, Alessandra; Zamboni, Eduardo; Fontana, Tobias; Dall’Magro, Eduardo; Fornari, Fernado

doi:10.5005/jp-journals-10024-3277

Cited by 10 publications

(7 citation statements)

References 32 publications

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“…Furthermore, these rates are comparable and very close to those seen in patients with head and neck cancer and HSCT patients. [28][29][30][31][32][33] In current study, we applied PBM before the start of the chemotherapy session and this is consistent with WALT recommendations to apply PBM within 30-120 minutes before tumor treatment. We used the 635 wave length for intraoral irradiation and this is consistent with the WALT recommendations which suggested the use of an LED/laser device with a visible wavelength (630-680 nm) for the prevention of mucositis.…”

Section: Discussionmentioning

confidence: 64%

The role of preconditioning with photobiomodulation in preventing oral mucositis and xerostomia and improving quality of life in cancer patients undergoing chemotherapy: a randomized clinical trial

khalil,

hamadah,

saifo

2024

Preprint

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Background Given the suffering experienced by cancer patients, effective solutions must be found to prevent painful and debilitating side effects of anticancer treatment. This trial aims to study the effect of preconditioning with photobiomodulation in preventing oral mucositis and xerostomia in cancer patients undergoing chemotherapy alone for the first time, and to examine its role in affecting patients' quality of life. Materials and Methods This is a prospective, randomized, double-blind clinical trial including 45 patients divided into three age- and sex-matched groups. Group 1: received basic oral care instructions before undergoing chemotherapy. Group 2: received basic oral care instructions plus photobiomodulation using an intraoral 650 nm diode laser. Group 3: received basic oral care instructions plus photobiomodulation using 650 nm diode laser intraorally and 980 nm extraoral. Results In Group 2 and Group 3, 73.3% and 80% of patients did not develop mucositis, respectively, while the remaining patients in both groups had only mild erythema. In contrast, all patients in Group 1 had oral mucositis that ranged from mild erythema to ulceration > 3 cm2. There were statistically significant differences between the three groups in oral mucositis assessment scale after a week and after 2 weeks (p = .000). Regarding LENT SOMA scale, there was a statistically significant difference between the three groups studied (P = .037). There was also a statistically significant difference in the Oral Health Impact Profile (OHIP-14) between the three groups studied (P = .003 after a week, P = .023 after 2 weeks). conclusions Preconditioning before starting chemotherapy, whether with the intraoral red laser alone or in combination with the extraoral infrared laser, has shown significant results in preventing oral mucositis and dry mouth, and it has also played a major role in improving the quality of life of patients. Trial registration This trial was registered in ISRCTN registry under no ISRCTN70634383 (https://doi.org/10.1186/ISRCTN70634383) on 24/07/2023.

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Section: Discussionmentioning

confidence: 64%

The role of preconditioning with photobiomodulation in preventing oral mucositis and xerostomia and improving quality of life in cancer patients undergoing chemotherapy: a randomized clinical trial

khalil,

hamadah,

saifo

2024

Preprint

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“…Among the treatments recommended for this condition, PBMT has proven effective and is the first choice for treating and preventing OM ( 12 ). There is a constant search in the literature for preventive protocols with the greatest efficacy, so different protocols have been studied and approached, but there are still no standard protocols for preventing this adverse effect ( 12 , 13 ).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown the effectiveness of daily protocols for preventing OM ( 12 , 13 ). However, daily applications of PBMT during RCT can be costly for the service, overburden the dental team, and reduce the number of patients that could receive the treatment.…”

Section: Introductionmentioning

confidence: 99%

Comparison of a daily and alternate-day photobiomodulation protocol in the prevention of oral mucositis in patients undergoing radiochemotherapy for oral cancer: a triple-blind, controlled clinical trial

Oliveira,

Borges,

Malta

et al. 2024

Med Oral

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Background Preventive Photobiomodulation Therapy (PBMT) significantly reduces oral mucositis (OM) severity in patients undergoing Radiochemotherapy (RCT) for the treatment of oral cancer, but daily applications generate cost, overload the dental team, and reduce the number of patients assisted.To evaluate the effectiveness of two PBMT protocols in preventing OM in patients undergoing RCT for oral cancer. Material and Methods 16 patients diagnosed with oral cancer undergoing RCT were included, equally divided into two groups: a group treated daily with PBMT, and another group also submitted to daily treatment, however, performing the application of PBMT every three days, interspersed with a simulation of PBMT (placebo). A red laser was used (~660 nm), 0.1W power, 1J of energy applied per point, 9 points per area (labial mucosa, buccal mucosa, lateral borders of the tongue, body of the tongue, and floor of the mouth) from the beginning of RCT until the end of the oncological treatment. Daily assessments were performed regarding OM scores, the World Health Organization (WHO) pain scale, and the visual analog scale (VAS). Weight, salivary flow (SGAPP), OHIP-14, and DMFT were evaluated on the initial and final days of RT. OM incidence and clinical data were compared by Pearson's chi-square test or Fisher's exact test. Pain and other scale scores were compared using the Mann-Whitney and Friedman/Dunn tests (SPSS v20.0 p <0.05). Results In the group with PBMT on alternate days, there was an increase in the frequency of grade 2 and grade 3 oral mucositis and an increased risk of grade 2 oral mucositis, in addition to higher mean pain scores and greater reduction in salivary flow. Conclusions The daily PBMT protocol proved more effective in controlling the frequency and severity of OM, pain, and salivary flow. Key words: Stomatitis, oral neoplasms, radiotherapy, antineoplastic combined chemotherapy protocols, low-intensity light therapy.

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“…Among the most explored therapeutic resources for the management of oral mucositis is photobiomodulation with Low-Level Laser Therapy. A randomized double-blind clinical study (38) investigated the efficacy of red and infrared lasers for the prevention and treatment of radiation-induced oral mucositis in patients with HNC. The authors concluded that the use of photobiomodulation is effective to prevent and treat oral mucositis in patients undergoing RDT, either associated with chemotherapy or not.…”

Section: Impact On Swallowing and Management Of Hypopharyngeal Mucositismentioning

confidence: 99%

Management of hypopharyngeal mucositis in patients undergoing chemoradiotherapy in the head and neck region and its impact on swallowing: an integrative literature review

Costa,

Tomazelli,

Grando

et al. 2023

Audiol., Commun. Res.

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Purpose To investigate the impact of chemoradiation-induced hypopharyngeal mucositis on swallowing and its management, based on an integrative literature review. Research strategy Two researchers were responsible for the search and selection of articles, within the following databases: PubMed, Embase, Scopus, Science Direct, and Lilacs. Selection criteria The search terms used were “Pharyngeal Mucositis”, “Radiotherapy” and “Esophagitis”, with the aid of the Boolean operator (AND). The search equation used was “Pharyngeal Mucositis” AND Radiotherapy AND Esophagitis. The following central question guided the study: “What is the assessment and management of radiation-induced hypopharyngeal mucositis in the head and neck region and its impact on swallowing?” Results 75 studies were identified, of which 6 were excluded due to duplicity and 60 were excluded for not meeting the inclusion criteria; the remaining articles were read in full and 4 were selected to be part of the integrative literature review. Conclusion Despite the scarce literature and little information on methods for evaluating hypopharyngeal mucositis, the articles point out that, regardless of the radiation dose, radiotherapy in the cervical region causes hypopharyngeal mucositis. Hypopharyngeal mucositis causes a great impact on swallowing, resulting in the need to use an alternative feeding route. In addition to the lack of information regarding the assessment and grading of hypopharyngeal mucositis, the studies do not discussitsdirect treatment or prevention.

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Low-level Laser Therapy in the Management of Oral Mucositis Induced by Radiotherapy: A Randomized Double-blind Clinical Trial

Cited by 10 publications

References 32 publications

The role of preconditioning with photobiomodulation in preventing oral mucositis and xerostomia and improving quality of life in cancer patients undergoing chemotherapy: a randomized clinical trial

The role of preconditioning with photobiomodulation in preventing oral mucositis and xerostomia and improving quality of life in cancer patients undergoing chemotherapy: a randomized clinical trial

Comparison of a daily and alternate-day photobiomodulation protocol in the prevention of oral mucositis in patients undergoing radiochemotherapy for oral cancer: a triple-blind, controlled clinical trial

Management of hypopharyngeal mucositis in patients undergoing chemoradiotherapy in the head and neck region and its impact on swallowing: an integrative literature review

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