4.6 Article

High-power laser photobiomodulation therapy for immediate pain relief of refractory oral mucositis

Journal

ORAL DISEASES
Volume -, Issue -, Pages -

Publisher

WILEY
DOI: 10.1111/odi.14618

Keywords

chemotherapy; low-level laser; oral complications; oral ulcer; palliative therapy; radiotherapy; supportive treatment

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This study aimed to evaluate the efficacy of high-power laser photobiomodulation therapy for immediate pain relief in refractory oral mucositis patients. The results showed that 94% of patients experienced immediate pain reduction following the photobiomodulation therapy, with 61% experiencing a reduction of over 50% and 35% reporting complete elimination of initial pain. The analgesic benefit of the therapy lasted for an average of 6.0 +/- 5.1 days.
Purpose: We aimed to evaluate the efficacy of high-power (class IV) laser photobiomodulation (PBM) therapy for immediate pain relief due to oral mucositis (OM) refractory to recommended first-line therapy. Methods: This retrospective study included 25 cancer patients with refractory chemotherapy- or radiotherapy-induced OM (16 and 9 patients, respectively) that were treated for pain relief with an intraoral InGaAsP diode laser (power density = 1.4 W/cm(2)). Pain was self-assessed immediately before and after laser treatment using a 0-to-10 numeric rating scale ([NRS], 0 = no pain, 10 = intolerable pain). Results: Patients reported an immediate decrease in pain following 94% (74 of 79) of the PBM sessions, in 61% (48 sessions) the pain reduction was over 50%, and in 35% (28 sessions) the initial pain was completely eliminated. There were no reports of increased pain post-PBM. For chemotherapy and radiotherapy-treated patients, mean reduction in pain NRS post-PBM was 4.8 +/- 2.5 (p < 0.001) and 4.5 +/- 2.8 (p = 0.001), indicating a post-PBM reduction of 72% and 60% of the initial pain level, respectively. The analgesic benefit of PBM remained for a mean of 6.0 +/- 5.1 days. One patient reported a transient burning sensation after one PBM session. Conclusions: High-power laser PBM may provide nonpharmacologic, patient-friendly, long-lasting, rapid pain relief for refractory OM.

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