Khouri, V.Y., Stracieri, A.B., Rodrigues, M.C., Moraes, D.A., Pieroni, F., Simoes, B.P., & Voltarelli, J.C. (2009). Use of therapeutic laser for prevention and treatment of oral mucositis. Brazilian Dental Journal, 20(3), 215–220.

DOI Link

Study Purpose

To evaluate the frequency and evolution of oral mucositis (OM) among stem cell transplant recipients subjected to therapeutic laser versus mucositis formula

Intervention Characteristics/Basic Study Process

Patients (n = 22) were randomly assigned to control or low level laser therapy (LLLT) daily. The treatment phase for both groups began with the initial clinical manifestations of mucositis with follow up until day +15 after transplant. Two types of laser were used on alternate days, one indicated for tissue repair and the other for analgesia.

Sample Characteristics

  • The study reported on 22 patients with a mean age of 27.5–32.7 years.
  • The sample was 23% female and 77% male.
  • Patients had hematologic malignancies and were receiving the myeloablative conditioning regimen and allogeneic stem cell transplant.
  • All patients were given preventive treatment consisting of soft-bristled toothbushes and saline rinses four times daily followed by benzidamine solution, which was replaced with a 0.12% chlorhexidine gluconate solution toward the end of the study.
  • The control group received the standard of care with the mucositis formula (antiinflammatory [benzidamine], antifungal [nistatin], and anesthetic [neututocain] with distilled water).

Setting

This was a single-site conducted in the bone marrow transplant unit (BMTU) of the University Hospital School of Medicine of Ribeirao Preto (UHSMRP) at the University of São Paulo in Brazil.

Study Design

The study was a randomized controlled trial.

Measurement Instruments/Methods

  • The World Health Organization (WHO) Oral Toxicity Scale and Oral Mucositis Assessment Scale (OMAS) were used.
  • Patients in the laser group completed questionnaires about laser therapy.

Results

The laser treatment group had lower frequency of oral mucositis (p = 0.02) and a lower mean grade of mucositis (p < 0.01).

Conclusions

The inclusion of LLLT was effective in lowering the frequency and treating oral mucositis in patients being treated with high dose myeloablative chemotherapy in preparation for stem cell transplant.

Limitations

  • The sample size was small with fewer than 30 patients.
  • The control group did not receive sham treatment, so the study was not blinded.
  • Authors did not describe the areas that were treated with lasers.

Nursing Implications

Laser therapy is effective in the treatment of mucositis, but it is very high tech and requires special equipment and highly trained personnel.