Low-level laser therapy in the prevention and treatment of oral mucositis: a systematic review and meta-analysis

Peng, Jiakuan; Shi, Yunchao; Wang, Jiongke; Wang, Fei; Dan, Hongxia; Xu, Hao; Zeng, Xin

doi:10.1016/j.oooo.2020.05.014

Cited by 27 publications

(34 citation statements)

References 44 publications

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“…The most used chemotherapeutic agents in the HSCT conditioning regimens are: busulfan, cyclophosphamide, melphalan, cytarabine, carmustine, etoposide, fludarabine and carboplatin, which are grouped in different protocols depending on both the specificity and the response of neoplastic cells. [4,5,6,7,8,9]. DOI: 10.46765/2675-374X.2020v2n1p44-54 Unlike other measure treatments, antineoplastic agents act systemically, at the cellular level, more specifically, in cells that are in the process of active cell division, interfering in the growth and division process, and they do not have a specific action, that is, they do not selectively and exclusively destroy cancer cells.…”

Section: Introductionmentioning

confidence: 99%

“…In general, they are toxic to tissues of intense proliferation, characterized by high mitotic activity and short cell cycles [10,11,12]. Since they present a systemic mechanism, antineoplastic agents can have several side effects such as dysgeusia, dysphagia, dry mouth, vomiting, nausea, stomatitis and mucosal necrosis [9,13].…”

Section: Introductionmentioning

confidence: 99%

“…The most common oral alterations are: mucositis, xerostomia, bacterial infections, periodontal diseases, odontogenic infections and cavities [16]. The non-keratinized mucosa is the most affected, being the most common sites, the labial and cheek mucosa, the floor of the mouth, lateral and ventral fauces of the tongue, and the soft palate [1,6,9,16,17].…”

Section: Introductionmentioning

confidence: 99%

“…Oral mucositis (OM) is an adverse effect related to the toxicity of the antineoplastic treatment commonly observed in patients undergoing HSCT. It consists of inflammation of the oral mucosa and gastrointestinal tract, which can progress to painful ulcers, causing difficulty in chewing and swallowing, leaving the patient predisposed to secondary infection, with a significant impact on the nutritional status of the patients [1,3,9,16,18,19].…”

Section: Introductionmentioning

confidence: 99%

“…Therapy mainly involves oral antiseptics, corticosteroids for local use and chamomile tea washes. Additional drugs can be used for the local treatment of mucositis, such as antibacterials, antifungals and antivirals, or other drugs that stimulate the regeneration of the injured mucosa [9,18,19].…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Risk Factors for Oral Mucositis After Bone Marrow Transplantation Patients Under Low Intensity Laser Therapy: A Longitudinal Study

Malta

Rodrigues

Lemos

et al. 2020

jbmtct

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Bone marrow transplantation (BMT) has been used to treat numerous malignant and non-malignant hematological diseases, genetic and immunological diseases with a high risk of oral mucositis (OM) due to the action of antineoplastic drugs. As photobiomodulation therapy (FBMT) with low-level laser is a proven non-invasive treatment for OM, the objective of this study was to evaluate the incidence of OM in patients on BMT undergoing FBM. 53 patients undergoing treatment received FBMT (red laser, 2J, 20s, 100mW) as a preventive protocol. If MO was observed, an infrared laser (4J, 40s, 100W) was administered. The following data were collected from patients' medical records: sex, age, chemotherapy protocol (QT) and type of BMT. An incidence of 34% was observed in the population studied (20% grade I, 11.3% grade II and 1.9% grade III). Prevention protocols using FBMT significantly reduced the incidence of oral mucositis (p = 0.004). Now, young patients with myeloid leukemia, the time between QT and BMT (p = 0.010) and time of QT (p = 0.018) were directly associated with the increased incidence of oral mucositis. It was concluded that low-intensity preventive laser therapy was associated with a reduction in the incidence of oral mucositis, showing the importance of this therapy in the management of patients undergoing BMT.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Incidence and Risk Factors for Oral Mucositis After Bone Marrow Transplantation Patients Under Low Intensity Laser Therapy: A Longitudinal Study

Malta

Rodrigues

Lemos

et al. 2020

jbmtct

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Long-term safety of photobiomodulation therapy for oral mucositis in hematopoietic cell transplantation patients: a 15-year retrospective study

Bezinelli

Corrêa

Vogel

et al. 2021

Support Care Cancer

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Photobiomodulation therapy (PBMT) has demonstrated e cacy in the prevention and treatment of oral mucositis (OM) in hematopoietic cell transplantation (HCT). However, based on the cell stimulation properties, its long-term safety has been questioned, mainly in relation to risk for secondary malignancies in the oral cavity. The aim of this study was to investigate if different PBMT protocols for OM control have association with immediate and late adverse effects in HCT patients. Data on autologous and allogeneic transplantation, conditioning regimen, PBMT protocols, and OM severity were retrospectively collected from medical and dental records. Presence of secondary malignancies in the oral cavity was surveyed during a 15-year follow-up. Impact of OM on overall survival was also analyzed. Different PBMT protocols for prevention and treatment of OM were recorded over the years. Severe OM (grades 3 and 4) was infrequently observed. When present we observed a signi cant decrease of the overall survival. No immediate adverse effect and secondary malignancy was associated to PBMT. In conclusion, the PBMT protocols used in the study were considered safe. The low frequency of severe OM observed encourages the implementation of this technique, with a special emphasis on the dosimetry adjustments focused on the HCT context.

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Preventive versus curative photobiomodulation for oral mucositis in patients with multiple myeloma undergoing hematopoietic stem cell transplantation: which approach is more effective?

Rupel,

Cornacchia,

Poiani

et al. 2024

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There is increasing evidence that photobiomodulation (PBM) therapy is both an effective and safe approach in hematopoietic stem cells transplantation (HSCT) for the management of oral mucositis (OM), but its use in clinical practice is still limited and the timing of application is under discussion. The aim of this retrospective study was to evaluate possible differences between patients treated either with preventive or curative PBM therapy. MethodsThe retrospective study included 24 patients suffering from multiple myeloma who underwent the same conditioning and transplantation protocol. Patients were treated either with preventive PBM starting from the rst day of conditioning up to two days post-HSCT, or with curative PBM (starting at OM onset for four days). OM score, pain and functional parameters were recorded. ResultsAll patients developed OM. Preventive PBM was signi cantly more effective in limiting OM severity (p < 0.0001) and pain (p < 0.0001) 7 days post-HSCT than curative PBM. We found a lower number of patients reporting discomfort in all subjective parameters (pain during swallowing, chewing and speaking) at T7 in the preventive PBM group. No adverse events related to PBM therapy were recorded in both groups. ConclusionThe timing for PBM therapy in patients undergoing HSCT is crucial: when started on the rst day of conditioning, it signi cantly reduces both pain and OM severity, providing an important bene t also in subjective oral functions such as speaking, swallowing, and chewing thus increasing the overall adherence to the oncological therapies.

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Low-level laser therapy in the prevention and treatment of oral mucositis: a systematic review and meta-analysis

Cited by 27 publications

References 44 publications

Incidence and Risk Factors for Oral Mucositis After Bone Marrow Transplantation Patients Under Low Intensity Laser Therapy: A Longitudinal Study

Incidence and Risk Factors for Oral Mucositis After Bone Marrow Transplantation Patients Under Low Intensity Laser Therapy: A Longitudinal Study

Long-term safety of photobiomodulation therapy for oral mucositis in hematopoietic cell transplantation patients: a 15-year retrospective study

Preventive versus curative photobiomodulation for oral mucositis in patients with multiple myeloma undergoing hematopoietic stem cell transplantation: which approach is more effective?

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