Low-level Infrared Laser Therapy in Chemotherapy-induced Oral Mucositis A Randomized Placebo-controlled Trial in Children

Background: Oral mucositis (OM) is one of the most frequent complication, of chemotherapy for which there is no standard therapy: treatment is mostly conservative. This study was conducted to determine whether low-intensity laser therapy (LLLT) can reduce the duration of chemotherapy-induced OM. Procedure: A placebo-controlled randomized trial was carried out using LLLT Or placebo (sham treatment). Children and adolescents with cancer receiving chemotherapy or hematopoietic stern-cell transplantation between October 2005 and May 2006 were eligible as soon as they developed OM. Patients received intervention for 5 days. The LLLT group was treated with laser GaAlAs. wavelenght (lambda): 830 nm (infrared), power: 100 mW, dose: 4 J/cm(2). and placebo group underwent sham treatment. The grade of OM was Clinically assessed by the National Cancer Institute, Common Toxicity Criteria scale. Results: Twenty-one patients developed OM and Were evaluable for analysis: 18 (86%) patients had a diagnosis Of leukemia or lymphoma and 3(14%) had solid tumors. The mean age was 8.2 (+/- 3.1) years. Nine patients were randomized in the laser group and 12 in the placebo-control group. Once OM was diagnosed. the patients had daily OM grading assessments before laser or sham application and thereafter until complete healing of the lesions. Oil day 7 after OM diagnosis, 1/9 of patients remained with lesions in taker group and 9,12 of patients in the placebo-control group (P = 0.029). In the laser group, the mean of OM duration was 5.8 days and in the placebo group was 8.9 +/- 2.4 days (P = 0.004). Conclusions: Our study has shown evidence that laser therapy in addition to oral care can decrease the duration of chemotherapy-induced OM. Our results confirm the promising results observed in adult cancer patients and should encourage pediatric oncologists to use laser therapy as first-line option in children with chemotherapy-induced OM.