Kuhn, A., Porto, F.A., Miraglia, P., & Brunetto, A.L. (2009). Low-level infrared laser therapy in chemotherapy-induced oral mucositis: A randomized placebo-controlled trial in children. Journal of Pediatric Hematology/Oncology, 31, 33–37.

To evaluate the efficacy of low level laser therapy (LLLT) for the treatment of chemotherapy-induced oral mucositis (OM) in pediatric patients undergoing chemotherapy or stem cell transplant

Children and adolescents with cancer receiving chemotherapy or hematopoietic stem cell transplantation (HSCT) who developed grade II OM were included. OM was scored daily by the same investigator. In the experimental group, the treatment was applied to each OM lesion for five consecutive days. The control group received sham treatments to each OM lesion for five consecutive days also.

• The study reported on 14 patients with an age range of 4.8–12.3 years.
• The sample was 19% female and 81% male.
• The sample had three patients diagnosed with solid tumors, 15 patients with lymphoma/leukemia, and three patients undergoing stem cell transplant.

This was a single site, inpatient study conducted in the Pediatric Oncology Unit of the Hospital de Clinicas de Porto Alegre at Federal University of Rio Grande do Sul, Brazil.

The study was a randomized, placebo-controlled trial.

• The National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 2.0 was used.
• One examinator assessed mean, standard deviation, and percentiles for age, localization and grade of mucositis, and mucositis severity daily.

No differences were found in grades of mucositis as a function of the LLLT protocol. Mucositis was diagnosed 5.0 to 7.5 days postchemotherapy. On the seventh day after the diagnosis of mucositis, 1 out of 9 patients in the laser group and 9 out of 12 patients in the sham group had grade II or greater OM (p = 0.029). The mean OM duration in the laser group as compared to the sham group was 3.1 days less (p = 0.004).

LLLT can significantly reduce the duration of chemotherapy-induced OM in children.

• The sample size was small with fewer than 30 patients.
• The study did not evaluate pain or functional impairment.

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