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

Abstract

Introduction: Oral mucositis (OM) is an unavoidable condition of the oral cavity that accompanies chemotherapy for various malignant cases. Chemotherapy-induced oral Mucositis (COM) is a frequent complication due to mucotoxic drugs and is known to deteriorate the general health significantly, while negatively affecting the quality of life (QOL). Studies have reported that low-level laser therapy (LLLT) promotes the tissue healing. The objective of the present study was to explore the efficacy of gallium-arsenide (GaAs) laser in treating COM and its impact on inflammatory cytokine levels in patients receiving chemotherapy for various malignancies. Methods: A total of 80 patients with COM received LLLT 6 days/week. OM was graded according to the World Health Organization (WHO) grading scale. The outcome parameters were the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) measured before, during and after administration of LLLT. Results: After LLLT, a significant decrease was found in the mean values of mucositis grade from 2.35 ± 0.695 to 1.13 ± 0.333 after (P < 0.001). A significant reduction in the level of TNF-α was found after LLLT among breast cancer patients (P = 0.0045), but not in head and neck cancer and lymphoma patients. A significant reduction was also found in IL-6 level after treatment among head and neck and breast cancer patients (P = 0.0307 and 0.019, respectively). Conclusion: The use of GaAs LLLT in treating COM in patients with various malignancies is well tolerated by patients, it results in improvement of mucositis, however; mechanism of action does not seem to be completely linked to the change of pro or anti-inflammatory cytokines.

Risks of Muscle Atrophy in Patients with Malignant Lymphoma after Autologous Stem Cell Transplantation

“…Also, nutrition-related adverse events occurring after ASCT are all attributable to pretreatment chemotherapy 22 ) . Oral mucositis is an unavoidable condition of the oral cavity that accompanies chemotherapy for various malignant cases and can lead to impaired nutritional status 31 ) . Oral mucositis is a potential side effect of cyclophosphamide, carboplatin, and etoposide, and carboplatin and etoposide 22) .…”

Oncological-Therapy Related Oral Mucositis as an Interdisciplinary Problem—Literature Review

“…A randomized placebo controlled trial which was conducted by Antunes et al on a group of 94 patients also proved that PBM is effective in preventing chemoradiotherapy-induced oral mucositis and improves quality of life [54]. Recent experimental studies conducted by Rezk-Allah et al on a group of 80 patients proved that PBM pose a positive effect on chemotherapy induced oral mucositis and is well-tolerated by patients [55]. All patients with oral mucositis received PBM 6 days/week and the outcome parameters were levels of TNF-α and IL-6 measured before, during, and after administration of PBM.…”

“…All patients with oral mucositis received PBM 6 days/week and the outcome parameters were levels of TNF-α and IL-6 measured before, during, and after administration of PBM. Usage of PBM results in improvement of oral mucositis; however, the mechanism of action does not seem to be related to the change of pro or anti-inflammatory cytokines and further research isrequired to fully understand the mechanisms of influence of laser therapy on oral mucosa [55]. According to a systematic review prepared by Zadik et al,photobiomodulation is recommended for the prevention of oral mucositis [56].…”

The Efficacy of Heat-Clearing (Qingre) and Detoxifying (Jiedu) Traditional Chinese Medicine Gargle for Chemotherapy-Induced Oral Mucositis: A Systematic Review and Meta-Analysis

“…Western medicine mouthwashes, which are commonly used in clinical practice and include normal saline, sodium bicarbonate, and chlorhexidine, generally have unstable drug properties and easily cause the imbalance of oropharyngeal flora ( McGuire et al, 2013 ). Laser therapy has the advantages of promoting analgesia and ulcer surface healing, but the aspects of wavelength, power, and duration of treatment remain controversial ( Ottaviani et al, 2013 ; Rezk-Allah et al, 2019 ). Cryotherapy inhibits the entry of chemotherapy drugs into mucosal tissues and thereby reduces the incidence of CIOM, but it potentially reduces the effectiveness of primary disease treatment; moreover, cold conditions causes psychological resistance ( Askarifar et al, 2016 ; Daugėlaitė et al, 2019 ).…”