Therapeutic Outcomes of Photobiomodulation in Cancer Treatment-induced Oral Mucositis: A Systematic Review

Abstract

Background: This systematic review was performed to analyze the therapeutic efficacy of photobiomodulation (PBM) in managing oral mucositis (OM) that appears in this context. Material and Methods: The search strategy of the systematic review was conducted according to PRISMA guide lines. The eligibility criteria according to PICO process has been defined as follows: Population (P): adult patients with head and neck cancer; Intervention (I): PBM; Comparison (C): placebo group; Outcome (O): pain, oral quality of life (QoL), evolution of the grade OM and pain. The set criteria for inclusion were peer-reviewed articles. Results: The following database were searched from November 2021 to February 2022, for clinical trials: Pubmed, Scopus and Cochrane. From 296 records, 10 studies were included involving in the systematic review. Data from 759 patients who received chemoradiotherapy were analyzed. These studies used different classifications for oral mucositis (WHO, NCI, RTOF/EORTC), pain (VAS) and quality of life (EORTC QLQ-C30, UW-QOL (v4), FACT HN). PBM therapy protocol used five different lasers (GaAlAs, InGaAlP, He-Ne, diode laser, red and near-IR LED probe) with wavelengths ranging from 632,8nm to 850nm. Pain evaluation in was based on the visual analogue scale (VAS) mainly. Prophylactic PBM was effective as it reduced the incidence of grades 3-4 and reduced the overall mean grade of OM during the chemoradiotherapy course compared to the control group. On the other hand, when PBM was used for treatment purposes, it decreased the mean duration of OM compared to the placebo arm. Conclusions: PBM reduced the incidence of more severe grade of OM induced by chemoradiotherapy. Also, PBM therapy reduced the mean duration of severe OM, mean pain scores and subsequently improved QoL