Photobiomodulation (low-level laser) for oral mucositis
Shining low-power red or near-infrared light on the inside of the mouth before and during treatment prevents severe mouth ulcers in people having head and neck radiotherapy or high-dose chemotherapy for transplant. Mucositis guidelines recommend it, though few centres yet have the equipment.
Overview
Photobiomodulation delivers non-thermal red or near-infrared light (typically 630-680 nm or 780-830 nm) to oral mucosa, stimulating mitochondrial cytochrome c oxidase, reducing inflammatory signalling and speeding epithelial repair. Randomised trials in haematopoietic stem cell transplantation and in head and neck chemoradiation consistently show lower incidence and severity of grade 3-4 oral mucositis, less pain and fewer feeding-tube placements. The 2019 MASCC/ISOO systematic review and 2020 guidelines recommend intraoral photobiomodulation for prevention of oral mucositis in both settings, with specified device parameters. It is painless and quick but requires daily attendance and a trained operator; the theoretical concern of stimulating residual tumour has not been borne out in follow-up of irradiated patients.
How it works
Photon absorption by mitochondrial chromophores raises ATP production and modulates reactive oxygen species and NF-kB signalling, reducing inflammation and promoting healing.
- Randomised evidence in two settings
- MASCC/ISOO recommendation with device parameters
- Painless, no drug interactions
- Equipment and daily visits
- Operator training
- Long-term safety in tumour beds still being followed
Latest papers
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