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

Abstract

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.