Figueiredo, A.L., Lins, L., Cattony, A.C., & Falcao, A.F. (2013). Laser therapy in the control of oral mucositis: A meta-analysis. [Laser terapia no controle da mucosite oral: um estudo de metanalise]. Revista Da Associacao Medica Brasileira, 59, 467–474. 

DOI Link

Purpose

STUDY PURPOSE: To conduct a meta-analysis and systematic review to determine if laser therapy (LT) is effective in preventing oral mucositis (OM) during oncotherapy

TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: LILACS, MEDLINE, Cochrane electronic

KEYWORDS: “laser therapy”, “oral mucositis” used in all databases

INCLUSION CRITERIA: Oncotherapy-induced and diagnosed OM, low-intensity laser was the form of treatment with specific wavelength between 632 and 1,064 nm, randomized trial with control group

EXCLUSION CRITERIA: No specific exclusion criteria referenced; however, OM grade ≥ 3 was used as a cutoff in all the scales to properly evaluate the preventative value of LT.

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 12 prospective, randomized studies met criteria out of 149 initial retrieved studies

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Jadad scale was used to evaluate the methodology of the studies included. BioEstat 5.0 was used for the meta-analysis. Literature was further evaluated using a standardized form that included study design, country of origin, year of publication, and authors. The patients’ data were analyzed for gender and age, type of cancer treatment, control group treatment, and LT specifics (e.g., wavelength, power, dose, irradiation time, and number of sessions per week).

Sample Characteristics

FINAL NUMBER STUDIES INCLUDED =  12

SAMPLE RANGE ACROSS STUDIES, TOTAL PATIENTS INCLUDED IN REVIEW: Total sample of 527 patients; 276 of these patients underwent LT, and 251 patients were in the control group. Final meta-analysis resulted in a total sample of 293 patients.

KEY SAMPLE CHARACTERISTICS: 53% of the patients had hematologic malignancy; 47% had head and neck cancer.

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care

Results

Out of the 12 studies included for review, 7 of them showed (through meta-analysis) that LT is almost 10 times more effective in preventing OM ≥ grade 3 than treatment without the use of LT.

Conclusions

The authors determined that the data supported the effectiveness of LT in the prevention of OM ≥ grade 3. They note that additional studies with larger sample sizes are still required to fully evaluate the total effectiveness of this intervention.

Limitations

Age range was not listed in this review, nor was prior radiation or chemotherapy exposure. Dental health and evaluation prior to oncotherapy and LT were not referenced in this review. Due to multiple variances in the control group's non-LT prevention measures, the number of studies was much smaller than the number the initial search results returned.

Nursing Implications

This study, even with the limitations of its size and characteristics, is a good starting point for further investigation into LT to prevent severe OM in patients with cancer undergoing chemotherapy, radiation, or both. LT appears to be a promising intervention. If severe OM can be prevented, then pain and infection, which quickly result from OM, can be prevented, too. Thus, this study has larger implications in overall care and quality of life in patients with cancer. Nurses can begin to address the study and the use of LT in their own institutions.

Legacy ID

4084