The Effect of Photobiomodulation on Nitrite and Inflammatory Activity in Radiotherapy‐Induced Oral Mucositis: A Randomized Clinical Trial

Abstract

Background and Objectives: To investigate pro-and anti-inflammatory cytokines and nitrite salivary levels in patients with head and neck cancer receiving photobiomodulation therapy (PBMT) associated with a Preventive Oral Care Program (POCP), for prevention and control of oral mucositis (OM) during radiotherapy (RT) associated or not with chemotherapy protocol. Study Design/Materials and Methods: In this randomized double-blinded clinical trial, 48 patients were randomly assigned to two groups: PBMT (n = 25) and Control (n = 23). In the PBMT group, patients were submitted to PBMT associated with the POCP. In the Control group, patients were submitted only to the POCP. Saliva samples were collected in the 1st (baseline), 7th, 14th, 21st, and 30th sessions of RT, and the levels of interleukin-6 (IL-6), IL-8, IL-10, IL-12p70, IL-1β, and tumoral necrosis factor-α (TNF-α) were measured using the cytometric bead array. Nitrite levels were measured by colorimetric method. OM was assessed using the World Health Organization and the National Cancer Institute scales. Results: Patients in the PBMT group presented less severe OM. PBMT tended to stabilize nitrite concentration levels during the RT regimen. The IL-1β concentration was associated with higher OM scores. PBMT promoted an increase in IL-12p70, TNF-α, and IL-10 concentration. Conclusion: PBMT was effective in the prevention and control of severe OM, and its mechanism of action may be related to a better balance of inflammatory response that may favor injury control. Lasers Surg. Med.

Effect of Photobiomodulation on Salivary Cytokines in Head and Neck Cancer Patients with Oral Mucositis: A Systematic Review

“…All the studies included in this review were clinical trials conducted in Brazil [19][20][21][22]. The type of tumor was head and neck cancer in the studies of both Oton-Leite et al, 2015 [20], and Martins et al, 2021 [22].…”

Efficacy of photobiomodulation therapy in the management of oral mucositis in patients with head and neck cancer: A systematic review and meta‐analysis of randomized controlled trials

“…Of these, 32 were chosen for full-text review based on their titles and abstracts. Ultimately, 14 RCTs 21,22,[29][30][31][32][33][34][35][36][37][38][39][40] were included in the study. The meta-analysis encompassed 843 patients, with 424 in the intervention group, aged 51.30-71.57 years, and 419 in the control group, aged 49.20-69.67 years.…”

“…The quality of the literature evaluation is detailed in Figure 2. The 14 RCTs, 21,22,[29][30][31][32][33][34][35][36][37][38][39][40] conducted between 2006 and 2023, included seven trials 21,32,33,35,36,38,40 from Brazil, four 22,30,31,34 from India, and one each from the UK, 39 Spain, 37 and Egypt. 29 These studies comprised seven double-blind trials, 21,22,[35][36][37][38]40 one triple-blind trial, 34 and two phase III trials.…”

“…The 14 RCTs, 21,22,[29][30][31][32][33][34][35][36][37][38][39][40] conducted between 2006 and 2023, included seven trials 21,32,33,35,36,38,40 from Brazil, four 22,30,31,34 from India, and one each from the UK, 39 Spain, 37 and Egypt. 29 These studies comprised seven double-blind trials, 21,22,[35][36][37][38]40 one triple-blind trial, 34 and two phase III trials. 21,39 Among them, seven 21,22,[32][33][34][35]37 studies involved patients with HNC undergoing CRT, while the remaining seven [29][30][31]36,…”

“…29 These studies comprised seven double-blind trials, 21,22,[35][36][37][38]40 one triple-blind trial, 34 and two phase III trials. 21,39 Among them, seven 21,22,[32][33][34][35]37 studies involved patients with HNC undergoing CRT, while the remaining seven [29][30][31]36,[38][39][40] included patients receiving RT. Intervention durations varied from 2 to 7 weeks, with a typical frequency of five times per week.…”