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

DOI Link

Study Purpose

To evaluate the efficacy of low-level laser therapy (LLLT) to reduce the severity of chemotherapy-related oral mucositis in children

Intervention Characteristics/Basic Study Process

Patients were randomized to receive LLLT or sham control interventions. Therapy began on day 1 of diagnosis of oral mucositis and was continued daily for the next three days. Study assessments were done immediately before beginning laser therapy, on day 4 after completion of laser therapy, and on day 7. Individuals who applied the laser treatment were not involved in mucositis data collection.

Sample Characteristics

  • N = 123   
  • MEAN AGE = 9.54 years
  • MALES: 45.5%, FEMALES: 54.5%
  • CURRENT TREATMENT: Chemotherapy
  • KEY DISEASE CHARACTERISTICS: Thirty percent were undergoing hematopoietic cell transplantation (HCT), and the majority were being treated for leukemia or lymphoma.

Setting

  • SITE: Single site   
  • SETTING TYPE: Multiple settings    
  • LOCATION: Italy

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment

Study Design

  • Double-blind, sham-controlled, randomized controlled trial

Measurement Instruments/Methods

  • World Health Organization (WHO) Toxicity Scale 
  • Visual analog scale (VAS) faces scale for pain severity
  • Analgesics used

Results

Progressive decline in mucositis severity occurred in both groups, and no significant difference in grading existed between groups. Pain scores were lower in those treated with laser therapy (p < 0.05), and those getting LLLT required less analgesia.

Conclusions

The findings suggested that LLLT may help the management of pain from oral mucositis among children receiving chemotherapy.

Limitations

  • Unintended interventions or applicable interventions not described that would influence results
  • Measurement/methods not well described
  • No subgroup analysis was conducted according to the type of analgesia consumed—some were getting morphine and some were getting Tylenol. No subgroup analysis according to disease type or chemotherapeutic agents was received. No information was provided on chemotherapy used.

Nursing Implications

The findings did not show the efficacy of LLLT among children to reduce the severity of oral mucositis. Further well-designed research is needed to determine if a role exists for LLLT in children receiving chemotherapy.