Abstract
Background
One of the most common complications in radiotherapy and chemotherapy treatment is oral mucositis (OM). OM affects between 80 and 90% of children undergoing chemotherapy, radiotherapy, or bone marrow transplant. It has been suggested that low-level laser therapy (LLLT) can reduce the intensity of oral mucositis as well as associated pain. The aim of this systematic review is to assess the effectiveness of low-level laser therapy (LLLT) in reducing pain associated with oral mucositis in children with cancer.
Materials and methods
We conducted a systematic review following the PRISMA 2020 guidelines. The search for studies was performed in the MEDLINE (PubMed) and Cochrane Central Register of Controlled Trials databases, using Mesh terms and specific PICO criteria. Randomized clinical trials published between January 2013 and November 2023 were included, with participants aged 1 to 18 undergoing chemotherapy and/or radiotherapy.
Results
We found six randomized clinical trials with a total of 437 patients. Five studies reported an improvement in pain reduction, and four of them reported a reduction in the grade of oral mucositis. The most commonly used wavelength was 660 nm, with a power of 100–150 mW, for an application time of 25 s, and an application area of 0.4 cm2.
Conclusion
In pediatric and young cancer patients, the use of low-level laser therapy (LLLT) reduces the severity of mucositis and oral pain. Further research is recommended to determine the optimal parameters for LLLT in this patient group, ensuring studies with high methodological quality.
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References
Ignacio P, Wike N, Cristóbal, Contreras AL, Donoso-Hofer F, Navarro WP (2021) Mucositis oral: Actualización en El Diagnóstico, Prevención Y Tratamiento oral mucositis: update in diagnosis, Prevention and Treatment. 15, Int J Odontostomat
Anschau F, Webster J, Capra MEZ, de Azeredo da Silva ALF, Stein AT (2019) Efficacy of low-level laser for treatment of cancer oral mucositis: a systematic review and meta-analysis. Lasers in Medical Science, vol 34. Springer London, pp 1053–1062
Mazhari F, Shirazi AS, Shabzendehdar M (2019) Management of oral mucositis in pediatric patients receiving cancer therapy: a systematic review and meta-analysis. Pediatric Blood and Cancer, vol 66. John Wiley and Sons Inc.
He M, Zhang B, Shen N, Wu N, Sun J (2018) A systematic review and meta-analysis of the effect of low-level laser therapy (LLLT) on chemotherapy-induced oral mucositis in pediatric and young patients. European Journal of Pediatrics, vol 177. Springer, pp 7–17
Oberoi S, Zamperlini-Netto G, Beyene J, Treister NS, Sung L (2014) Effect of prophylactic low level laser therapy on oral mucositis: a systematic review and meta-analysis. PLoS ONE. ;9(9)
Cronshaw M, Parker S, Anagnostaki E, Mylona V, Lynch E, Grootveld M (2020) Photobiomodulation and oral mucositis: a systematic review, vol 8. MDPI AG, Dentistry Journal
Wells G, Shea B, O’Connell D, Peterson J, Welch V, Losos M et al The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonran- domised studies in meta-analyses. [Internet]. 2021 Aug [cited 2021 Aug 20]. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
World association for laser therapy, Laakso EL (2015) North American association for photobiomodulation therapy. WALT biennal congress and NAALT annual conference: Arlington, Virginia (USA), September 9–12, 2014. Medimond Publishing Company
Bensadoun RJ, Nair RG (2012) Low-level laser therapy in the prevention and treatment of cancer therapy-induced mucositi. Curr Opin Oncol 24:363–370
Migliorati C, Hewson I, Lalla RV, Antunes HS, Estilo CL, Hodgson B et al (2013) Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Supportive Care in Cancer, vol 21. Springer, pp 333–341
Guimaraes DM, Ota TMN, Da Silva DAC, Almeida FDLDS, Schalch TD, Deana AM et al (2021) Low-level laser or LED photobiomodulation on oral mucositis in pediatric patients under high doses of methotrexate: prospective, randomized, controlled trial. Support Care Cancer 29(11):6441–6447
De Castro JFL, Abreu EGF, Correia AVL, Da Mota Vasconcelos Brasil C, Da Cruz Perez DE (2013) 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 31(12):613–618
Fornaini C, Arany P, Rocca JP, Merigo E (2019) Photobiomodulation in Pediatric Dentistry: A Current State-of-the-Art. Vol. 37, Photobiomodulation, Photomedicine, and laser surgery. Mary Ann Liebert Inc., pp 798–813
Amadori F, Bardellini E, Conti G, Pedrini N, Schumacher RF, Majorana A (2016) Low-level laser therapy for treatment of chemotherapy-induced oral mucositis in childhood: a randomized double-blind controlled study. Lasers Med Sci 31(6):1231–1236
Reyad FA, Elsayed NM, El Chazli Y (2023) Photobiomodulation for chemotherapy-induced oral mucositis in leukemic children: a randomized controlled clinical trial. Oral Dis 29(5):2239–2247
Gobbo M, Verzegnassi F, Ronfani L, Zanon D, Melchionda F, Bagattoni S et al (2018) Multicenter randomized, double-blind controlled trial to evaluate the efficacy of laser therapy for the treatment of severe oral mucositis induced by chemotherapy in children: laMPO RCT. Pediatr Blood Cancer. ;65(8)
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All authors have contributed to the final version of the manuscript. E.G.and A.F.carried out the search and selection of the articles, C.C.V. reviewed the selected articles and the discrepancies, L.S.L. and F.P.G. collaborated in the final writing of the manuscript, C.M.G. led the investigation.
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de Górgolas Fernández-Chacón, E., Fernández-Juárez, A., Cobo-Vázquez, C.M. et al. Treatment of oral mucositis in pediatric oncological patients using low power laser: a systematic review. Laser Dent Sci 8, 34 (2024). https://doi.org/10.1007/s41547-024-00249-x
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DOI: https://doi.org/10.1007/s41547-024-00249-x