Chemotherapy-induced oral mucositis: effect of LED and laser phototherapy treatment protocols.

BACKGROUND AND OBJECTIVE: Over the last few decades, many studies have focused on the effect of lasers on the management of oral mucositis in oncologic patients treated with chemotherapy and/or radiotherapy. However, the effect of light-emitting diode (LED) has been poorly studied, and was not compared with that of laser phototherapy (LPT). For this reason, the aim of the present study was to clinically compare the effect of these two therapies on chemotherapy-induced oral mucositis (CIOM) and pain. METHODS: Forty patients with CIOM were divided into two groups: G1, patients treated with LPT; G2, patients treated with LED. The treatment was administered during 10 consecutive days, with exception of weekends. LPT was applied using an InGaAlP laser (660 nm/40 mW/6.6 J cm-(2)/0.24 J per point/0.036 cm(2) of spot size). LED phototherapy was applied using 0.24 J per point/80 mW/630 nm/1 cm(2) of spot size. CIOM was assessed during each session in accordance to the World Health Organization (WHO) score. The patient self-assessed pain was scored on a visual analog scale (VAS). RESULTS: The mean VAS and WHO scores were significantly smaller in the LED group (p<0.05). However, both groups required the same number of days to reach score zero for mucositis and pain (p>0.05). Moreover, in the group with severe mucositis (score III), there was a lower frequency of patients with complete healing and pain relief, with the exception of analgesia in G2, in which almost all patients were completely relieved from pain. CONCLUSIONS: These findings suggest that LED therapy is more effective than LPT in the treatment of COIM, with the parameters used in the present study.

Laser phototherapy as topical prophylaxis against head and neck cancer radiotherapy-induced oral mucositis: comparison between low and high/low power lasers.

BACKGROUND AND OBJECTIVE: Oral mucositis is a dose-limiting and painful side effect of radiotherapy (RT) and/or chemotherapy in cancer patients. The purpose of the present study was to analyze the effect of different protocols of laser phototherapy (LPT) on the grade of mucositis and degree of pain in patients under RT. PATIENTS AND METHODS: Thirty-nine patients were divided into three groups: G1, where the irradiations were done three times a week using low power laser; G2, where combined high and low power lasers were used three time a week; and G3, where patients received low power laser irradiation once a week. The low power LPT was done using an InGaAlP laser (660 nm/40 mW/6 J cm(-2)/0.24 J per point). In the combined protocol, the high power LPT was done using a GaAlAs laser (808 nm, 1 W/cm(2)). Oral mucositis was assessed at each LPT session in accordance to the oral-mucositis scale of the National Institute of the Cancer-Common Toxicity criteria (NIC-CTC). The patient self-assessed pain was measured by means of the visual analogue scale. RESULTS: All protocols of LPT led to the maintenance of oral mucositis scores in the same levels until the last RT session. Moreover, LPT three times a week also maintained the pain levels. However, the patients submitted to the once a week LPT had significant pain increase; and the association of low/high LPT led to increased healing time. CONCLUSIONS: These findings are desired when dealing with oncologic patients under RT avoiding unplanned radiation treatment breaks and additional hospital costs.