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The effect of low-level laser therapy (LLLT) in cancer treatment-induced oral mucositis

Oral mucositis is a serious side-effect for patients undergoing cancer therapy. The oral mucositis is associated with pain, infections, need for enteral or parental nutrition, impaired nutritional status and quality of life, and interruptions or dose reduction in chemotherapy or radiotherapy.

Low-level laser therapy (LLLT) is a local application of a monochromatic, narrow-band, coherent light source. The action of LLLT is controversial, but one observation is that the laser seems to modulate various metabolic processes in biological tissues by conversion of the laser light energy input into energy useful to cells.

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

Question

Is there any scientific evidence that LLLT can reduce cancer therapy-induced oral mucositis?

Identified literature

  1. Oberoi S, Zamperlini-Netto G, Beyene J, Treister NS, Sung L. Effect of prophylactic low level laser therapy on oral mucositis: a systematic review and meta-analysis. PLoS One 2014;9:e107418.
  2. Fekrazad R, Chiniforush N. Oral mucositis prevention and management by therapeutic laser in head and neck cancers. J Lasers Med Sci 2014;5:1-7.
  3. Figueiredo AL, Lins L, Cattony AC, Falcao AF. Laser therapy in the control of oral mucositis: a meta-analysis. Rev Assoc Med Bras (1992) 2013;59:467-74.
  4. Bjordal JM, Bensadoun RJ, Tuner J, Frigo L, Gjerde K, Lopes-Martins RA. A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis. Support Care Cancer 2011;19:1069-77.
  5. Clarkson JE, Worthington HV, Furness S, McCabe M, Khalid T, Meyer S. Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev 2010:Cd001973.
  6. Chaveli-Lopez B, Bagan-Sebastian JV. Treatment of oral mucositis due to chemotherapy. J Clin Exp Dent 2016;8:e201-9.
  7. Amadori F, Bardellini E, Conti G, Pedrini N, Schumacher RF, Majorana A. Low-level laser therapy for treatment of chemotherapy-induced oral mucositis in childhood: a randomized double-blind controlled study. Lasers Med Sci 2016;31:1231-6.
  8. Ferreira B, da Motta Silveira FM, de Orange FA. Low-level laser therapy prevents severe oral mucositis in patients submitted to hematopoietic stem cell transplantation: a randomized clinical trial. Support Care Cancer 2016;24:1035-42.
  9. Soto M, Lalla RV, Gouveia RV, Zecchin VG, Seber A, Lopes NN. Pilot study on the efficacy of combined intraoral and extraoral low-level laser therapy for prevention of oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation. Photomed Laser Surg 2015;33:540-6.
  10. Eduardo Fde P, Bezinelli LM, de Carvalho DL, Lopes RM, Fernandes JF, Brumatti M, et al. Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation: clinical outcomes in a context of specialized oral care using low-level laser therapy. Pediatr Transplant 2015;19:316-25.
  11. Silva LC, Sacono NT, Freire Mdo C, Costa LR, Batista AC, Silva GB. The Impact of Low-Level Laser Therapy on Oral Mucositis and Quality of Life in Patients Undergoing Hematopoietic Stem Cell Transplantation Using the Oral Health Impact Profile and the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation Questionnaires. Photomed Laser Surg 2015;33:357-63.
  12. Bezinelli LM, Eduardo FP, Neves VD, Correa L, Lopes RM, Michel-Crosato E, et al. Quality of life related to oral mucositis of patients undergoing haematopoietic stem cell transplantation and receiving specialised oral care with low-level laser therapy: a prospective observational study. Eur J Cancer Care (Engl) 2016;25:668-74.
  13. de Castro JF, Abreu EG, Correia AV, da Mota Vasconcelos Brasil C, da Cruz Perez DE, de Paula Ramos Pedrosa F. Low-level laser in prevention and treatment of oral mucositis in pediatric patients with acute lymphoblastic leukemia. Photomed Laser Surg 2013;31:613-8.
  14. Arbabi-Kalati F, Arbabi-Kalati F, Moridi T. Evaluation of the effect of low level laser on prevention of chemotherapy-induced mucositis. Acta Med Iran 2013;51:157-62.
  15. Cauwels RG, Martens LC. Low level laser therapy in oral mucositis: a pilot study. Eur Arch Paediatr Dent 2011;12:118-23.
  16. Gonzalez-Arriagada WA, Ramos LMA, Andrade MAC, Lopes MA. Efficacy of low-level laser therapy as an auxiliary tool for management of acute side effects of head and neck radiotherapy. J Cosmet Laser Ther 2017.
  17. Antunes HS, Herchenhorn D, Small IA, Araújo CMM, Viégas CMP, de Assis Ramos G, et al. Long-term survival of a randomized phase III trial of head and neck cancer patients receiving concurrent chemoradiation therapy with or without low-level laser therapy (LLLT) to prevent oral mucositis. Oral Oncology 2017;71:11-15.
  18. Gautam AP, Fernandes DJ, Vidyasagar MS, Maiya AG, Guddattu V. Low level laser therapy against radiation induced oral mucositis in elderly head and neck cancer patients-a randomized placebo controlled trial. J Photochem Photobiol B 2015;144:51-6.
  19. Oton-Leite AF, Silva GB, Morais MO, Silva TA, Leles CR, Valadares MC, et al. Effect of low-level laser therapy on chemoradiotherapy-induced oral mucositis and salivary inflammatory mediators in head and neck cancer patients. Lasers Surg Med 2015;47:296-305.
  20. Arora H, Pai KM, Maiya A, Vidyasagar MS, Rajeev A. Efficacy of He-Ne Laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:180-6, 186.e1.
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Helena Domeij and Sally Saad at SBU.

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