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01.12.2023 | Research

Efficacy of photobiomodulation in the treatment of oral mucositis in patients undergoing antineoplastic therapy: systematic review and meta-analysis

verfasst von: Adriana Regina Cruz, Eliana Maria Minicucci, Marluci Betini, Luciana Almeida-Lopes, Victor Tieghi Neto, Antonio José Maria Cataneo

Erschienen in: Supportive Care in Cancer | Ausgabe 12/2023

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Abstract

Purpose

To evaluate the effectiveness of photobiomodulation in the treatment of oral mucositis.

Methods

Systematic review and meta-analysis encompassing in the electronic databases: LILACS, MEDLINE, EMBASE, COCHRANE, SCOPUS, WEB OF SCIENCE, and CINAHL and in http://clinicaltrials.gov. Eligibility criteria were randomized, non-randomized, and observational studies that used photobiomodulation for the treatment of oral mucositis. The endpoints were reduction in the severity of oral mucositis, duration of lesions, and pain reduction. For data analysis, the Review Manager 5.4 program was used.

Results

A total of 316 studies were identified, 297 in the electronic databases and 19 in http://clinicaltrials.gov. After removing duplicates, 260 studies were selected for title and abstract reading, of which 223 were excluded. A total of 37 studies were chosen for full reading, of which 6 were included in the review, totaling 299 patients. The treatment used was photobiomodulation. The patients were divided into two groups: the laser group used only photobiomodulation or associated with other therapies, and the control group did not use photobiomodulation. For the endpoint reduction in the severity of oral mucositis (OM), the chance of reduction of the OM was greater in the laser group as compared to the control group. For the endpoints duration of OM lesions and pain reduction, it was not possible to carry out a meta-analysis due to the high heterogeneity between studies. In the interpretation of the meta-analysis, the reduction in the severity of oral mucositis was greater in the group that received photobiomodulation.

Conclusion

Photobiomodulation was effective in the treatment of oral mucositis.

Amadori F, Bardellini E, Conti G, Pedrini N, Schumacher RF, Majorana A (2016) Low-level laser therapy for treatment of chemotherapy-induced oral mucositis in childhood: a randomized double blind controlled study. Lasers Med Sci 31:1231–1236CrossRefPubMed

Anschau F, Webster J, Capra MEZ, Silva A, Stein AT (2018) Efetividade da terapia com laser de baixa dose para o tratamento da mucosite em pacientes oncológicos: uma revisão sistemática e metanálise. Saberes Plurais: Educação na saúde, v.2, supl 1:18

Antunes HS, Ferreira EMS, VD’A M, Pinheiro CT, Ferreira CG (2017) 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 Oncology 71:11–15CrossRefPubMed

Bensadoun RJ, Nair RG (2015) Low-level laser therapy in the management of mucositis and dermatitis induced by cancer therapy. Photomed Laser Surg 33:487–491CrossRefPubMed

Bensadoun RJ (2018) Photobiomodulation or lowlevel laser therapy in the management of cancer therapy-induced mucositis, dermatites and lymphedema. Curr Opin Oncol 30(4):226–232CrossRefPubMed

Bowen JM, Elad S, Hutchins RD, Lalla RV (2013) Methodology for the MASCC/ISOO Mucositis Clinical Practice Guidelines Update.; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Support Care Cancer 21(1):303–8. https://doi.org/10.1007/s00520-012-1592-7CrossRefPubMed

Bowen JM, Wardill HR (2017) Advances in the understanding and management of mucositis during stem cell transplantation. Curr Opin Support Palliat Care 11(4):341–334CrossRefPubMed

Caballero R, Lagares T, Garcia R (2012) Cancer treatment-induced oral mucositis: a critical review. Int J Oral Maxillofac Surg 41:225–238CrossRef

Campos L, Simões A, Sá PHN, Eduardo CP (2009) Improvement in quality life of on oncological patient by laser phototherapy: a case report. Photomed Laser Surg 27(2):371–374CrossRefPubMed

10.

Catão MHCV (2004) Os benefícios do laser de baixa intensidade na clínica odontológica e na estomatologia. Rev Bras Patol Oral 3:214–218

11.

Cavalcanti AL, Macêdo DJ, Dantas FSB, Menezes KS, Silva DFB, Junior WAM, Cavalcanti AFC (2018) Evaluation of oral mucositis occurrence in oncologic patients under antineoplastic therapy submitted to the lowlevel laser coadjuvant therapy. J Clin Med 7(5) pii:e90

12.

Chakrabarti S, Mishra A, Agarwal JP, Garg A, Nair D, Chaturvedi P (2016) Acute toxicities of adjuvant treatment in patients of oral squamous cell carcinoma with and without submucous fibrosis: a retrospective audit. J Cancer Res Ther 12(2):932–937. https://doi.org/10.4103/0973-1482.174187CrossRefPubMed

13.

Cruz LB, Ribeiro AS, Rech A, Rosa LGN (2007) Influence of low-energy laser in the prevention of oral mucositis in children with cancer receiving chemotherapy. Pediatr Blood Cancer Apr 48(4):435–440. https://doi.org/10.1002/pbc.20943CrossRef

14.

Cunha CB, Eduardo FP, Zezell DM, Bezinelli LM, Shitara PPL, Correa L (2012) Effect of irradiation with red and infrared laser in the treatment of oral mucositis. A pilot study with patients undergoing chemotherapy with 5-FU. Lasers Med Sci 27:1233–1124CrossRefPubMed

15.

Eduardo FP, Bezinelli L, Luiz AC, Correa L, Vogel C, Eduardo CP (2008) Severity of oral mucositis in patients undergoing hematopoietic cell transplantation and an oral laser phototherapy protocol: a survery of 30 patients. Photomed Laser Surg 26:1–7

16.

Elad S, Cheng KKF, Lalla RV, Yarom N, Hong C, Logan R, Bowen J, Gibson R, Saunders DP, Zadik Y, Ariyawardana A, Correa ME, Ranna V, Bossi P (2020) MASCC/ISOO Clinical Practice Guidelines for the management of mucositis secondary to cancer therapy. Cancer. https://onlinelibrary.wiley.com/action/doSearch?AllField=MASCC%2FISOO+Clinical+practice+guidelines+for+the+management. Accessed 22 Aug 2023

17.

Elad S, Cheng KKF, Lalla RV, Yarom N, Hong C, Logan RM, Bowen J, Gibson R, Saunders DP, Zadik Y, Ariyawardana A, Correa ME, Ranna V, Bossi P (2020) Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO). Cancer 126(19):4423–4431. https://doi.org/10.1002/cncr.33100CrossRefPubMed

18.

Gobbo M, Ottaviani G, Perinetti G, Ciriello F, Beorchia A et al (2014) Evaluation of nutritional status in head and neck radio-treated patients affected by oral mucositis: efficacy of class IV laser therapy. Support Care Cancer 22:1851–1856CrossRefPubMed

19.

Gobbo M, Verzegnassi F, Ronfani L, Zanon D, Melchionda F, Bagattoni S et al (2018) 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 65(8):e27098CrossRefPubMed

20.

Guedes CCFV, de Freitas Filho SAJ, de Faria PR, Loyola AM, Sabino-Silva R, Cardoso SV (2018) Variation of energy in photobiomodulation for the control of radiotherapy-induced oral mucositis: a clinical study in head and neck cancer patients. Int J Dent Int J Dent Feb 22:4579279. https://doi.org/10.1155/2018/4579279CrossRef

21.

He M, Zhang B, Shen N, Wu N, Sun J (2018) A systematic review and meta-analysis of the effect of low-level laser therapy (LLLT) on chemotherapy-induced oral mucositis in pediatric and young patients. Eur J Pediatr 177(1):7–17CrossRefPubMed

22.

Higgins J, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savović J, Schulz KF, Weeks L, Sterne JAC (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Cochrane Bias Methods Group, Cochrane Statistical Methods Group. Res Methods Rep 343. https://doi.org/10.1136/bmj.d5928

23.

Higgins JPT, Green S (2011) Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. http://www.cochrane-handbook.org. Accessed 13 Apr 2022

24.

Kate R, Rubatt S, Enwemeka C, Huddleston W (2018) Optimal laser phototherapy parameters for pain relief. Photomed Laser Surg 36:354–362CrossRefPubMed

25.

Khouri VY, Stracieri ABPL, Rodrigues MC, Moraes DA, Pieroni F, Simões BP et al (2009) Use of therapeutic laser for prevention and treatment of oral mucositis. Braz Dent J 20(3):215–220CrossRefPubMed

26.

Lacerda-Santos JT, Fernandes Neto JA, Catão HCV (2019) Fototerapia no tratamento da mucosite oral: uma revisão de literatura. Arq Odontol 55:e11CrossRef

27.

Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, McGuire DB, Migliorati C, Nicolatou-Galitis O, Peterson DE, Raber-Durlacher JE, Sonis ST, Elad S (2014) Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO). Cancer 120(10):1453–1461. https://doi.org/10.1002/cncr.28592CrossRefPubMed

28.

Levedag PC, Tegud DN, Voet P, Est HVD, Noever I, Kruijf WJM, Deurloo IKK, Prevost GB, Poll J, Schmitz PIM, Heijmen BJ (2007) Dysphagia disorder in patients with cancer of the oropharynx are significantly affect by the radiation therapy dose to the superior and middle constrictor muscle: a dose effect relationship. Radiother Oncol 85:64–73CrossRef

29.

Mantel N, Haenszel W (1959) Statistical aspects of the analysis of data from retrospective studies of disease. J Nat Cancer Inst 22:719–748PubMed

30.

Marín-Conde F, Castellyears-Cosano L, Pachón-Ibañez J, Serrera-Figallo MA, Gutiérrez-Pérez JL, Torres-Lagares D (2019) 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 48(7):917–923CrossRefPubMed

31.

Menezes AC, Rosmaninho E, Raposo B, Alencar MJS (2014) Clinical and therapeutic approach of radiotherapy and chemotherapy induced oral mucositis in cancer patients. Rev Bras Odontol 71(1):35–38CrossRef

32.

Miranda-Silva W, Gomes-Silva W, Zadik Y, Yarom N, Al-Azri AR et al (2021) Mucositis Study Group of the Multinational Association of Supportive Care in Cancer / International Society for Oral Oncology (MASCC/ISOO). MASCC/ISOO clinical practice guidelines for the management of mucositis: sub-analysis of current interventions for the management of oral mucositis in pediatric cancer patients. Support Care Cancer 29(7):3539–3562. https://doi.org/10.1007/s00520-020-05803-4CrossRefPubMed

33.

Montsserat VL, Oster G, Ford MC, Lu J, Sonis S (2007) Oral mucositis and outcomes of autologes hematopoietic stem-cells transplantation following high dose melphalan conditioning for multiple myleoma. J Support Oncol May 5(5):231–235

34.

Nair R, Bensadoun RJ (2016) Mitigation of cancer therapy side effects with light (IOP Concise Physics). A short book that reviews all the potential possibilities of PBM use for cancer therapy side effects. Morgan & Claypool Publishers

35.

Peterson DE, Ohrn K, Bowen J, Fliedner M, Lees J, Loprinzi C, Mori T, Osaguona A, Weikel DS, Elad S, Lalla RV (2013) Systematic review of oral cryotherapy for management of oral mucositis caused by cancer therapy. Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Support Care Cancer 21(1):327–332. https://doi.org/10.1007/s00520-012-1562-0CrossRefPubMed

36.

Pinheiro SL, Bonadiman AC, Lemos ALAB, Annicchino BM, Segatti B, Pucca DS et al (2019) Photobiomodulation therapy in cancer patients with mucositis: a clinical evaluation. Photobiomodul Photomed Laser Surg 37(3):142–150PubMed

37.

Ranna V, Cheng KKF, Castillo DA, Porcello L, Vaddi A, Lalla RV, Bossi P, Elad S (2019) Development of the MASCC/ISOO clinical practice guidelines for mucositis: an overview of the methods. Mucositis Study group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO). Support Care Cancer 27(10):3933–3948. https://doi.org/10.1007/s00520-019-04891-1CrossRefPubMed

38.

Rosenthal DI, Trotti A (2009) Strategies for managing radiation. Induced mucositis in head and neck cancer. Semin Radiat Oncol 19:29–34CrossRefPubMed

39.

Santos P, Messaggi AC, Mantesso A, Magalhães MHCG (2009) Mucosite oral: perspectivas atuais na prevenção e tratamento. Rev Gauch Odontol 57:1

40.

Scully C, Sonis ST, Diz PD (2006) Oral mucositis. Oral Dis 12(3):229–241CrossRefPubMed

41.

Simoes A, Eduardo F, Luiz A, Campos L, Henrique P, Sá R, Marques M, Eduardo C (2009) Laser phototherapy as topical prophylaxis against head and neck cancer radiotherapy induced oral mucositis: Comparison between low and high/low power lasers. Lasers Surg Med 41:264–270CrossRefPubMed

42.

Soares RG, Farias LC, Menezes ASS, Silva CSO, Tabosa ATL, Chagas PVF et al (2018) Treatment of mucositis with combined 660nm and 808nm wavelength low-level laser therapy reduced mucositis grade, pain, and use of analgesics: a parallel, single-blind, two-arm controlled study. Lasers Med Sci 33(8):1813–1819CrossRefPubMed

43.

Sonis ST, Eilers JP, Epstein JB, Le Veque FG, Liggett WH Jr, Mulagha MT et al (1999) Validation of a new scoring system for the assessement of clinical trial research of oral mucositis induced by radiation or chemotherapy.Mucositis Study Group. Cancer 85:2103–2113CrossRefPubMed

44.

Sonis ST, O’Donnell KE, Popat R (2004) The relationship between mucosal cyclooxygenase-2 (COX-2) expression and experimental radiation-induced mucositis. Oral Oncology 40:170–176CrossRefPubMed

45.

Sonis ST (2009) Mucositis: the impact, biology and therapeutic opportunities of oral mucositis. Oral Oncology 45(12):1015–1020. https://doi.org/10.1016/j.oraloncology.2009.08.006

46.

Vitale MC, Modaffari C, Decembrino N, Zhou FX, Zecca M, Deabianis P (2017) 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 32:1423–1428CrossRefPubMed

47.

World Health Organization (1979) Handbook for reporting results of cancer treatment Geneve. World Health Org:15–22

48.

Zadik Y, Arany PR, Fregnani ER, Bossi P, Antunes HS, Bensadoun RJ, Gueiros LA, Majorana A, Nair RG, Ranna V, WJE T, Vaddi A, Lubart R, Migliorati CA, Lalla RV, KKF C, Elad S (2019) Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines. Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Support Care Cancer 27(10):3969–3983. https://doi.org/10.1007/s00520-019-04890-2CrossRefPubMed

Titel: Efficacy of photobiomodulation in the treatment of oral mucositis in patients undergoing antineoplastic therapy: systematic review and meta-analysis
verfasst von: Adriana Regina Cruz
Eliana Maria Minicucci
Marluci Betini
Luciana Almeida-Lopes
Victor Tieghi Neto
Antonio José Maria Cataneo
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 12/2023
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-023-08105-7

Springer Medizin

Efficacy of photobiomodulation in the treatment of oral mucositis in patients undergoing antineoplastic therapy: systematic review and meta-analysis