J Oral Laser Applications 10 (2010), No. 4 14. June 2011
J Oral Laser Applications 8 (2008), No. 4 (12.01.2009)
Low-level Infrared Laser Therapy to Prevent Radiotherapy-induced Oral Mucositis: A Randomized Placebo-controlled Study
Kuhn, Alessandra / Heinzmann, Gilberto / da Silva, César A. / Stobbe, Julio C. / Knack, Marcos A. / Basualdo, Alexandre / Branda, Fabrício B. / Kuhn, Giana F. / Dall'Magro, Eduardo
Purpose: This study was conducted to evaluate low-level infrared laser therapy (LLLT) for prevention of radiotherapy- induced oral mucositis (OM).
Patients and Methods: The trial was open to patients with carcinoma of the hypopharynx, oropharynx, and oral cavity, who had been treated by external radiotherapy with a total dose of 80 Gy at a rate of 1 fraction of 2 Gy/day, 5 days a week, from a linear photon accelerator between Oct. 2006 and Oct. 2007. A placebo-controlled randomized trial was carried out using LLLT (GaAlAs) or placebo (sham treatment) daily for five consecutive days during the weeks of head and neck radiotherapy. The 30 treatment areas included: buccal mucosa, palate, tonsilar pillars, tongue, and neck. The LLLT group was treated with GaAIAs laser, wavelength (λ): 830 nm (infrared), power: 100 mW, dose: 4 J/cm2, and the placebo group underwent sham treatment. OM was clinically assessed by the WHO scale and a segmented visual analog scale (VAS) for pain (patient self-evaluation).
Results: Thirty patients were eligible for the study but only 23 completed the treatment and were available for analysis. The mean age was 54 (± 17) years. Eleven patients were randomized in the laser group and twelve patients in the placebo-control group. Patients had daily OM grading assessments and pain measurement before laser or sham application. During the 6 weeks of radiotherapy, the mean grade of OM in laser group was significantly lower (p < 0.002) than the mean grade in the placebo group. The pain score after each laser or placebo application was significantly lower (p < 0.006) in the laser group during the same period.
Conclusion: Our study has shown evidence that laser therapy in addition to oral care can decrease the severity of radiotherapy-induced OM and pain. It should encourage clinicians to use this technique to improve quality of life of cancer patients during oncology treatment.
Keywords: mucositis, radiotherapy, head and neck cancer, low-level laser therapy