Medical Lasers

Korean Society for Laser Medicine and Surgery (대한의학레이저학회)
권호 표지
DOI QR코드

DOI QR Code

Decade Long Survey of Low-level Laser Therapy/Photobiomodulation (LLLT/PBM) Therapy for Oral Mucositis Treatment

  • Received : 2021.04.05
  • Accepted : 2021.06.07
  • Published : 2021.09.30
⟨ Previous Next ⟩

Abstract

Low-level laser therapy or photobiomodulation (LLLT/PBM) therapy has been widely applied to enhance and accelerate the recovery of oral mucositis. This study investigates the documented effect of LLLT on oral mucositis caused by chemotherapy. This review appraises 6 animal studies and 12 clinical studies published in the Pubmed database during the past 10 years, related to the application of LLLT for the treatment of mucositis. Despite varied parameters and diverse conditions, the assessed articles indicate that application of LLLT on oral mucositis using near-infrared wavelengths is prophylactic, reduces pain, and enables a rapid recovery. Various combined treatments were also identified among the published papers, which further establishes the efficacy of LLLT as a viable treatment.

Keywords

References

  1. Gautam AP, Fernandes DJ, Vidyasagar MS, Maiya AG, Guddattu V. Low level laser therapy against radiation induced oral mucositis in elderly head and neck cancer patients-a randomized placebo controlled trial. J Photochem Photobiol B 2015;144:51-6. https://doi.org/10.1016/j.jphotobiol.2015.01.011
  2. Lalla RV, Brennan M, Schubert M. Oral complications of cancer therapy. In: Yagiela J, Dowd F, Johnson B, Mariotti A, Neidle E, editors. Pharmacology and therapeutics for dentistry. 6th ed. St Louis: Mosby Elsevier; 2011. p.782-98.
  3. Manas A, Cerezo L, de la Torre A, Garcia M, Alburquerque H, Ludena B, et al. Epidemiology and prevalence of oropharyngeal candidiasis in Spanish patients with head and neck tumors undergoing radiotherapy treatment alone or in combination with chemotherapy. Clin Transl Oncol 2012;14:740-6. https://doi.org/10.1007/s12094-012-0861-8
  4. Gautam AP, Fernandes DJ, Vidyasagar MS, Maiya GA. Low level helium neon laser therapy for chemoradiotherapy induced oral mucositis in oral cancer patients - a randomized controlled trial. Oral Oncol 2012;48:893-7. https://doi.org/10.1016/j.oraloncology.2012.03.008
  5. Sonis ST. The pathobiology of mucositis. Nat Rev Cancer 2004;4:277-84. https://doi.org/10.1038/nrc1318
  6. Cruz LB, Ribeiro AS, Rech A, Rosa LG, Castro CG Jr, Brunetto AL. Influence of low-energy laser in the prevention of oral mucositis in children with cancer receiving chemotherapy. Pediatr Blood Cancer 2007;48:435-40. https://doi.org/10.1002/pbc.20943
  7. Gouvea de Lima A, Villar RC, de Castro G Jr, Antequera R, Gil E, Rosalmeida MC, et al. Oral mucositis prevention by low-level laser therapy in head-and-neck cancer patients undergoing concurrent chemoradiotherapy: a phase III randomized study. Int J Radiat Oncol Biol Phys 2012;82:270-5. https://doi.org/10.1016/j.ijrobp.2010.10.012
  8. Jensen SB, Jarvis V, Zadik Y, Barasch A, Ariyawardana A, Hovan A, et al. Systematic review of miscellaneous agents for the management of oral mucositis in cancer patients. Support Care Cancer 2013;21:3223-32. https://doi.org/10.1007/s00520-013-1884-6
  9. Saunders DP, Epstein JB, Elad S, Allemano J, Bossi P, van de Wetering MD, et al. Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients. Support Care Cancer 2013;21:3191-207. https://doi.org/10.1007/s00520-013-1871-y
  10. Peng H, Chen BB, Chen L, Chen YP, Liu X, Tang LL, et al. A network meta-analysis in comparing prophylactic treatments of radiotherapy-induced oral mucositis for patients with head and neck cancers receiving radiotherapy. Oral Oncol 2017;75:89-94. https://doi.org/10.1016/j.oraloncology.2017.11.001
  11. Sonis ST, Hashemi S, Epstein JB, Nair RG, Raber-Durlacher JE. Could the biological robustness of low level laser therapy (photobiomodulation) impact its use in the management of mucositis in head and neck cancer patients. Oral Oncol 2016;54:7-14. https://doi.org/10.1016/j.oraloncology.2016.01.005
  12. Rodriguez-Caballero A, Torres-Lagares D, Robles-Garcia M, Pachon-Ibanez J, Gonzalez-Padilla D, Gutierrez-Perez JL. Cancer treatment-induced oral mucositis: a critical review. Int J Oral Maxillofac Surg 2012;41:225-38. https://doi.org/10.1016/j.ijom.2011.10.011
  13. Mallick S, Benson R, Rath GK. Radiation induced oral mucositis: a review of current literature on prevention and management. Eur Arch Otorhinolaryngol 2016;273:2285-93. https://doi.org/10.1007/s00405-015-3694-6
  14. Spanemberg JC, Figueiredo MA, Cherubini K, Salum FG. Low-level laser therapy: a review of its applications in the management of oral mucosal disorders. Altern Ther Health Med 2016;22:24-31.
  15. Rhee YH, Cho KJ, Ahn JC, Chung PS. Effect of photobiomodulation on wound healing of the corneal epithelium through Rho-GTPase. Med Laser 2017;6:67-76. https://doi.org/10.25289/ml.2017.6.2.67
  16. Choi JE. Photobiomodulation therapy in recovery of peripheral facial nerve damage. Med Laser 2020;9:89-94. https://doi.org/10.25289/ML.2020.9.2.89
  17. Kim JW, Kwon YS, Chang YY, Hong SH, Shin JW, Na JI, et al. Low-level laser therapy with novel array of light source and individualized program for treatment of androgenetic alopecia: a 16-week, randomized, double-blind, sham device-controlled study. Med Laser 2020;9:150-8. https://doi.org/10.25289/ML.2020.9.2.150
  18. Tuner J, Hode L. It's all in the parameters: a critical analysis of some well-known negative studies on low-level laser therapy. J Clin Laser Med Surg 1998;16:245-8. https://doi.org/10.1089/clm.1998.16.245
  19. Zecha JA, Raber-Durlacher JE, Nair RG, Epstein JB, Sonis ST, Elad S, et al. Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations. Support Care Cancer 2016;24:2781-92. https://doi.org/10.1007/s00520-016-3152-z
  20. Basso FG, Soares DG, Pansani TN, Cardoso LM, Scheffel DL, de Souza Costa CA, et al. Proliferation, migration, and expression of oral-mucosal-healing-related genes by oral fibroblasts receiving low-level laser therapy after inflammatory cytokines challenge. Lasers Surg Med 2016;48:1006-14. https://doi.org/10.1002/lsm.22553
  21. Goo H, Kim H, Ahn JC, Cho KJ. Effects of low-level light therapy at 740 nm on dry eye disease in vivo. Med Laser 2019;8:50-8. https://doi.org/10.25289/ML.2019.8.2.50
  22. Lee JH, Jung JY. Application of photobiomodulation in hearing research: animal study. Med Laser 2020;9:1-5. https://doi.org/10.25289/ml.2020.9.1.1
  23. Bensadoun RJ, Franquin JC, Ciais G, Darcourt V, Schubert MM, Viot M, et al. Low-energy He/Ne laser in the prevention of radiation-induced mucositis. A multicenter phase III randomized study in patients with head and neck cancer. Support Care Cancer 1999;7:244-52. https://doi.org/10.1007/s005200050256
  24. Abramoff MM, Lopes NN, Lopes LA, Dib LL, Guilherme A, Caran EM, et al. Low-level laser therapy in the prevention and treatment of chemotherapy-induced oral mucositis in young patients. Photomed Laser Surg 2008;26:393-400. https://doi.org/10.1089/pho.2007.2144
  25. Kuhn A, Porto FA, Miraglia P, Brunetto AL. Low-level infrared laser therapy in chemotherapy-induced oral mucositis: a randomized placebo-controlled trial in children. J Pediatr Hematol Oncol 2009;31:33-7. https://doi.org/10.1097/MPH.0b013e318192cb8e
  26. Bezinelli LM, de Paula Eduardo F, da Graca Lopes RM, Biazevic MG, de Paula Eduardo C, Correa L, et al. Cost-effectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation. Hematol Oncol 2014;32:31-9. https://doi.org/10.1002/hon.2050
  27. Vitale MC, Modaffari C, Decembrino N, Zhou FX, Zecca M, Defabianis P. Preliminary study in a new protocol for the treatment of oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation (HSCT) and chemotherapy (CT). Lasers Med Sci 2017;32:1423-8. https://doi.org/10.1007/s10103-017-2266-y
  28. de Castro JF, Abreu EG, Correia AV, da Mota Vasconcelos Brasil C, da Cruz Perez DE, 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 2013;31:613-8. https://doi.org/10.1089/pho.2012.3327
  29. Clarkson JE, Worthington HV, Furness S, McCabe M, Khalid T, Meyer S. Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev 2010;2010:CD001973.
  30. Pandeshwar P, Roa MD, Das R, Shastry SP, Kaul R, Srinivasreddy MB. Photobiomodulation in oral medicine: a review. J Investig Clin Dent 2016;7:114-26. https://doi.org/10.1111/jicd.12148
  31. Bjordal JM, Bensadoun RJ, Tuner J, Frigo L, Gjerde K, Lopes-Martins RA. A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis. Support Care Cancer 2011;19:1069-77. https://doi.org/10.1007/s00520-011-1202-0
  32. Anschau F, Webster J, Capra MEZ, de Azeredo da Silva ALF, Stein AT. Efficacy of low-level laser for treatment of cancer oral mucositis: a systematic review and meta-analysis. Lasers Med Sci 2019;34:1053-62. https://doi.org/10.1007/s10103-019-02722-7
  33. Carneiro-Neto JN, de-Menezes JD, Moura LB, Massucato EM, de-Andrade CR. Protocols for management of oral complications of chemotherapy and/or radiotherapy for oral cancer: systematic review and meta-analysis current. Med Oral Patol Oral Cir Bucal 2017;22:e15-23.
  34. Zadik Y, Arany PR, Fregnani ER, Bossi P, Antunes HS, Bensadoun RJ, et al. Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer 2019;27:3969-83. https://doi.org/10.1007/s00520-019-04890-2
  35. Freire Mdo R, Freitas R, Colombo F, Valenca A, Marques AM, Sarmento VA. LED and laser photobiomodulation in the prevention and treatment of oral mucositis: experimental study in hamsters. Clin Oral Investig 2014;18:1005-13. https://doi.org/10.1007/s00784-013-1058-4
  36. Campos L, Cruz EP, Pereira FS, Arana-Chavez VE, Simoes A. Comparative study among three different phototherapy protocols to treat chemotherapy-induced oral mucositis in hamsters. J Biophotonics 2016;9:1236-45. https://doi.org/10.1002/jbio.201600014
  37. Bayer S, Kazancioglu HO, Acar AH, Demirtas N, Kandas NO. Comparison of laser and ozone treatments on oral mucositis in an experimental model. Lasers Med Sci 2017;32:673-7. https://doi.org/10.1007/s10103-017-2166-1
  38. Cotomacio CC, Campos L, Nesadal de Souza D, Arana-Chavez VE, Simoes A. Dosimetric study of photobiomodulation therapy in 5-FU-induced oral mucositis in hamsters. J Biomed Opt 2017;22:18003. https://doi.org/10.1117/1.JBO.22.1.018003
  39. Thieme S, Ribeiro JT, Dos Santos BG, de Almeida Zieger R, Severo MLB, Martins MAT, et al. Comparison of photobiomodulation using either an intraoral or an extraoral laser on oral mucositis induced by chemotherapy in rats. Support Care Cancer 2020;28:867-76. https://doi.org/10.1007/s00520-019-04889-9
  40. Alinca SB, Saglam E, Kandas NO, Okcu O, Yilmaz N, Goncu B, et al. Comparison of the efficacy of low-level laser therapy and photodynamic therapy on oral mucositis in rats. Lasers Med Sci 2019;34:1483-91. https://doi.org/10.1007/s10103-019-02757-w
  41. Antunes HS, Herchenhorn D, Small IA, Araujo CM, Viegas CM, Cabral E, et al. Phase III trial of low-level laser therapy to prevent oral mucositis in head and neck cancer patients treated with concurrent chemoradiation. Radiother Oncol 2013;109:297-302. https://doi.org/10.1016/j.radonc.2013.08.010
  42. Silva LC, Sacono NT, Freire Mdo C, Costa LR, Batista AC, Silva GB. The impact of low-level laser therapy on oral mucositis and quality of life in patients undergoing hematopoietic stem cell transplantation using the Oral Health Impact Profile and the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation questionnaires. Photomed Laser Surg 2015;33:357-63. https://doi.org/10.1089/pho.2015.3911
  43. Amadori F, Bardellini E, Conti G, Pedrini N, Schumacher RF, Majorana A. Low-level laser therapy for treatment of chemotherapy-induced oral mucositis in childhood: a randomized double-blind controlled study. Lasers Med Sci 2016;31:1231-6. https://doi.org/10.1007/s10103-016-1975-y
  44. Antunes HS, Herchenhorn D, Small IA, Araujo CMM, Viegas CMP, de Assis Ramos G, et al. Long-term survival of a randomized phase III trial of head and neck cancer patients receiving concurrent chemoradiation therapy with or without low-level laser therapy (LLLT) to prevent oral mucositis. Oral Oncol 2017;71:11-5. https://doi.org/10.1016/j.oraloncology.2017.05.018
  45. Gobbo M, Verzegnassi F, Ronfani L, Zanon D, Melchionda F, Bagattoni S, et al. 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 2018;65:e27098. https://doi.org/10.1002/pbc.27098
  46. Noirrit-Esclassan E, Valera MC, Vignes E, Munzer C, Bonal S, Daries M, et al. Photobiomodulation with a combination of two wavelengths in the treatment of oral mucositis in children: the PEDIALASE feasibility study. Arch Pediatr 2019;26:268-74. https://doi.org/10.1016/j.arcped.2019.05.012
  47. Marin-Conde F, Castellanos-Cosano L, Pachon-Ibanez J, Serrera-Figallo MA, Gutierrez-Perez JL, Torres-Lagares D. Photobiomodulation with low-level laser therapy reduces oral mucositis caused by head and neck radio-chemotherapy: prospective randomized controlled trial. Int J Oral Maxillofac Surg 2019;48:917-23. https://doi.org/10.1016/j.ijom.2018.12.006
  48. Medeiros-Filho JB, Maia Filho EM, Ferreira MC. Laser and photochemotherapy for the treatment of oral mucositis in young patients: randomized clinical trial. Photodiagnosis Photodyn Ther 2017;18:39-45. https://doi.org/10.1016/j.pdpdt.2017.01.004
  49. Ribeiro da Silva VC, da Motta Silveira FM, Barbosa Monteiro MG, da Cruz MMD, Caldas Junior AF, Pina Godoy G. Photodynamic therapy for treatment of oral mucositis: pilot study with pediatric patients undergoing chemotherapy. Photodiagnosis Photodyn Ther 2018;21:115-20. https://doi.org/10.1016/j.pdpdt.2017.11.010
  50. Pinheiro SL, Bonadiman AC, Borges Lemos ALDA, Annicchino BM, Segatti B, Pucca DS, et al. Photobiomodulation therapy in cancer patients with mucositis: a clinical evaluation. Photobiomodul Photomed Laser Surg 2019;37:142-50. https://doi.org/10.1089/photob.2018.4526
  51. Rozza-de-Menezes R, Souza PHC, Westphalen FH, Ignacio SA, Moyses ST, Sarmento VA. Behaviour and prevention of 5'fluorouracil and doxorubicin-induced oral mucositis in immunocompetent patients with solid tumors: a randomised trial. Oral Health Prev Dent 2018;16:549-55.
  52. Legoute F, Bensadoun RJ, Seegers V, Pointreau Y, Caron D, Lang P, et al. Low-level laser therapy in treatment of chemoradiotherapy-induced mucositis in head and neck cancer: results of a randomised, triple blind, multicentre phase III trial. Radiat Oncol 2019;14:83. https://doi.org/10.1186/s13014-019-1292-2
  53. Hodgson BD, Margolis DM, Salzman DE, Eastwood D, Tarima S, Williams LD, et al. Amelioration of oral mucositis pain by NASA near-infrared light-emitting diodes in bone marrow transplant patients. Support Care Cancer 2012;20:1405-15. https://doi.org/10.1007/s00520-011-1223-8