Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines

MASCC ISOO, Yehuda Zadik, Praveen R. Arany, Eduardo Rodrigues Fregnani, Paolo Bossi, Heliton Spindola Antunes, Rene-Jean Bensadoun, Luiz Alcino Gueiros, Alessandra Majorana, Raj G. Nair, Vinisha Ranna, Wim J. E. Tissing, Anusha Vaddi, Rachel Lubart, Cesar Augusto Migliorati, Rajesh V. Lalla, Karis Kin Fong Cheng, Sharon Elad

Research output: Contribution to journalReview articlepeer-review

68 Citations (Scopus)

Abstract

Purpose To systematically review the literature and update the evidence-based clinical practice guidelines for the use of photobiomodulation (PBM), such as laser and other light therapies, for the prevention and/or treatment of oral mucositis (OM). Methods A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) using PubMed and Web of Science. We followed the MASCC methods for systematic review and guidelines development. The rigorously evaluated evidence for each intervention, in each cancer treatment setting, was assigned a level-of-evidence (LoE). Based on the LoE, one of the following guidelines was determined: Recommendation, Suggestion, or No Guideline Possible. Results Recommendations are made for the prevention of OM and related pain with PBM therapy in cancer patients treated with one of the following modalities: hematopoietic stem cell transplantation, head and neck (H&N) radiotherapy (without chemotherapy), and H&N radiotherapy with chemotherapy. For each of these modalities, we recommend 1-2 clinically effective protocols; the clinician should adhere to all parameters of the protocol selected. Due to inadequate evidence, currently, No Guideline Possible for treatment of established OM or for management of chemotherapy-related OM. The reported clinical settings were extremely variable, limiting data integration. Conclusions The evidence supports the use of specific settings of PBM therapy for the prevention of OM in specific patient populations. Under these circumstances, PBM is recommended for the prevention of OM. The guidelines are subject to continuous update based on new published data.

Original languageEnglish
Pages (from-to)3969-3983
Number of pages15
JournalSupportive Care in Cancer
Volume27
Issue number10
DOIs
Publication statusPublished - Oct-2019

Keywords

  • Cancer
  • Chemotherapy
  • Laser therapy
  • LED
  • LLLT
  • Low-level laser therapy
  • Prevention
  • Treatment
  • Oral complications of cancer therapy
  • Oral mucositis
  • Pain
  • Photobiomodulation
  • Photobiostimulation
  • Radiotherapy
  • Stomatitis
  • Evidence-based
  • Guidelines
  • LOW-LEVEL LASER
  • STEM-CELL TRANSPLANTATION
  • RADIATION-INDUCED MUCOSITIS
  • LOW-ENERGY LASER
  • QUALITY-OF-LIFE
  • LOW-POWER LASER
  • HE-NE-LASER
  • PHASE-III TRIAL
  • PEDIATRIC-PATIENTS
  • ECONOMIC OUTCOMES

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