Use of therapeutic laser for prevention and treatment of oral mucositis

Abstract

Oral mucositis (OM) affects patients who are submitted to hematopoietic stem cell transplantation (HSCT) due to high doses of chemotherapy and/or radiotherapy. The purpose of this investigation was to perform a comparative study of the frequency and evolution of OM among patients subjected to therapeutic laser and to the conventional therapy (use of mouthwash called "Mucositis Formula"). The patients were subjected to a myeloablative conditioning regimen before the allogeneic HSCT. Twenty-two patients were selected and divided into 2 groups: group I was irradiated with InGaAlP laser (660 nm) and GaAlAs laser (780 nm), 25 mW potency, 6.3J/ cm 2 dose, in 10-s irradiation time, followed to conventional treatment; group II was subjected only to the conventional treatment. Both World Health Organization (WHO) scale and the Oral Mucositis Assessment Scale (OMAS) were used to evaluate the results. Data were analyzed by the non-parametric Wilcoxon test, with p<0.05 considered as statistically significant. Group I presented a lower frequency of OM (p=0.02) and lower mean scores, according to WHO and OMAS scales (p<0.01 and p=0.01, respectively). In conclusion, laser reduced the frequency and severity of OM, suggesting that therapeutic laser can be used both as a new form of prevention and treatment of OM.

Laser phototherapy as a treatment for radiotherapy-induced oral mucositis

“…LPT is based on nonthermal effects of light on biological tissues, and its use in the prevention and treatment of mucositis induced by antineoplastic treatment has presented promising results, especially in clinical studies (1,3,4,13). The effect of LPT is based on its ability to modulate several metabolic processes.…”

“…Accordingly, Zanin et al (1) and Lopes et al (17) reported that in their studies all patients under RT who received LPT completed the planned RT treatment, whereas patients not treated with LPT had to interrupt the RT because of decreased immunity caused by secondary asthenia and deglutition difficulties, which impacted their survival. Several protocols have been used for treating oral mucositis and the observed results sometimes differ (1,3,4,13,16,17). It is necessary to standardize the protocols for prevention and treatment of this condition in order to make different studies comparable.…”

“…It starts asymptomatic, later on, an erythema appears and it may be followed by erosion or ulceration of the oral mucosa. The ulcerations may be typically covered by a white fibrinous pseudomembrane (4,5).…”

“…Several studies (3,4,6,7,10,11) have suggested that the use of LPT seems to reduce the severity of mucositis, providing comfort and better quality of life. Zanin et al (1) evaluated the effects of a 660-nm diode laser on the prevention and treatment of chemo-and radiotherapy-induced oral mucositis in patients with head and neck cancer.…”

Complementary Therapies in the Management of Induced Oral Mucositis during Cancer Treatment

“…[29] Düşük yoğunluklu lazer tedavisinin kullanıldığı randomize kontrollü klinik araştırmalarda; tedavinin oral mukozit sıklığını ve şiddetini azalttığı belirtilmiştir. [12,30] Ayrıca yapılan araştırmalar düşük yoğunluklu lazer tedavisinin oral mukozite bağlı gelişen ağız kuruluğu ve ağrı şiddetini azalttığına ilişkin sonuçlar içermektedir. [12,31,32] Her kemoterapi seansı öncesinde oral mukozaya 630 nanometre(nm) dalga boyu ve 30 megawatt (mW) güçle düşük yoğunluklu lazer tedavisinin uygulandığı klinik bir araştırmada, uygulamanın oral mukoziti önlediği, ağız kuruluğu ve ağrı gibi semptomların şiddetini azalttığı rapor edilmiştir.…”