Low-level laser therapy in the prevention and treatment of cancer therapy-induced mucositis

2012 state of the art based on literature review and meta-analysis

Abstract

Purpose of review 

To discuss the promising state of the art low-level laser therapy (LLLT) for preventive and therapeutic usage in oral mucositis due to cancer therapy.

Recent findings 

Photomedicine using LLLT is very effective with intraoral and extraoral devices in the management of oral mucositis, based on several studies including randomized control studies. A systematic review identified 33 relevant articles that were subjected to meta-analysis based on which laser parameters in routine practice are being defined. Meta-analysis showed that LLLT reduced risk of oral mucositis with relative risk (RR) 2.45 [confidence interval (CI) 1.85–3.18], reduced duration, severity of oral mucositis and reduced number of days with oral mucositis (4.38 days, P = 0.0009). RR was similar between the red (630–670 nm) and infrared (780–830 nm) LLLT. Pain-relieving effect based on the Cohen scale was at 1.22 (CI 0.19–2.25).

Summary 

No adverse side effects of LLLT were reported; hence, we recommend red or infrared LLLT with diode output between 10–100 mW, dose of 2–3 J/cm²/cm² for prophylaxis and 4 J/cm² (maximum limit) for therapeutic effect, application on single spot rather than scanning motion. Lesions must be evaluated by a trained clinician and therapy should be repeated daily or every other day or a minimum of three times per week until resolution. There is moderate-to-strong evidence in favor of LLLT at optimal doses as a well tolerated, relatively inexpensive intervention for cancer therapy-induced oral mucositis. It is envisaged that LLLT will soon become part of routine oral supportive care in cancer.