Arora, H., Pai, K.M., Maiya, A., Vidyasagar, M.S., & Rajeev, A. (2008). Efficacy of he-ne laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 105(2), 180-186, 186.e1.

To evaluate the efficacy of low level laser therapy (LLLT) for the prevention and treatment of radiotherapy-induced oral mucositis in patients with oral cancer

Patients with primary oral cancer were randomized to the laser group or a control group. All patients had oral prophylaxis before starting radiation therapy, and all had the same oral care during treatment. All patients were evaluated daily for pain severity, functional impairment, and oral mucositis. The clinical exams were performed by a single examiner. All the laser treatments were administered by one operator. The treatment consisted of use of a laser scanner for the first eight days followed by treatment to six areas on the right and left sides of the oral cavity for 25 days.

• The study reported on 24 patients, ages 55–59 years old.
• The sample was 50% female and 50% male.
• Patients were newly diagnosed with primary oral cancer limited to the oral cavity
• Patients received 66 Gy in 33 fractions, 5 days per week for 6.5 weeks. No patients experiencing treatment delays were included in the study.

This was a single site, inpatient and outpatient study conducted at Kasturba Medical College of Manipal University in Karnataka, India.

This was a randomized controlled trial.

• A numeric rating scale was used to measure severity of oral pain.
• To evaluate patient need for supplemental analgesics, the World Health Organization (WHO) analgesic ladder, date of initiation, and  duration of analgesic use were recorded.
• Functional impairment was recorded.
• A scale was used to assess severity of dysphagia.
• Mucositis severity was assessed daily by one examiner using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) scoring system.

Pain increased gradually and was the greatest at the end of seven weeks. The laser group had a statistically significant lower level of pain than did the control group (p < 0.03). In week 3, the laser group had grade I functional impairment, while the control group progressed to grade II and III functional impairment, with one individual having grade IV impairment. Overall, the laser group had lower mucositis severity than the control group (p = 0.033).

Prophylactic laser therapy during radiation therapy can reduce the severity of mucositis, as well as the severity of functional impairment and pain.

• The control group had a small sample size of fewer than 30 patients.
• The article did not state what the control group procedure involved (e.g., sham treatment).

This form of laser therapy is effective in the prevention of severe mucositis, but it is very high tech and requires special equipment and highly trained personnel.