Gouvea de Lima, A., Antequera, R., Peres, M.P., Snitcosky, I.M., Federico, M.H., & Villar, R.C. (2010). Efficacy of low-level laser therapy and aluminum hydroxide in patients with chemotherapy and radiotherapy-induced oral mucositis. Brazilian Dental Journal, 21, 186–192.

Study Purpose

To evaluate the use of low level laser therapy (LLLT) and aluminum hydroxide for the prevention of oral mucositis in patients with head and neck cancer, and to evaluate the impact of LLLT on pain scores.

Intervention Characteristics/Basic Study Process

Group 1 was given LLLT at 830 nm daily since first day of radiotherapy (RT) to end of therapy prior to RT (RT days only). It was applied to 12 areas of the oral cavity. Group 2 received aluminum hydroxide (AH) suspension (310 mg/5 mL) starting on first day of RT and continued throughout, including weekends. Patients used 10 mL of AH 4 times a day and swallowed and had to avoid eating during the first hour after treatment.

Sample Characteristics

  • The sample consisted of 22 patients with an age range of 33–80 years.
  • The sample was 91% male and 9% female.
  • The majority of head and neck cancer (77.27%) was diagnosed as squamous cell.

Setting

This was a single-site, outpatient study conducted in Brazil.

Phase of Care and Clinical Applications

Patients were undergoing the active treatment phase of care.

Study Design

The study was prospective, comparative, and nonrandomized.

Measurement Instruments/Methods

  • The National Cancer Institute (NCI) oral toxicity scale was used to evaluate oral mucositis.
  • A visual analog scale (VAS) was used to evaluate pain.
  • European Organization for Research and Treatment of Cancer's Quality-of-Life Questionnaires (QLQ) (QLQ-c30 and QLQ-H&N35) were used.

Results

Lower oral mucositis (OM) scores were observed in the LLLT group (p = 0.061). More grade III OM was seen in the AH group, and severe OM was delayed in the LLLT group. LLLT pain scores were lower but not statistically significant overall. Quality-of-life (QOL) scores were all higher (i.e., more symptoms) in the AH group.

Conclusions

LLLT was found to be more effective than AH in delaying severe OM; however, more trials are needed.

Limitations

  • The sample size was small with fewer than 30 years.
  • No appropriate control group was included. 

Nursing Implications

Although LLLT was found to be more effective than AH in delaying severe OM, questions exist regrding the best protocols and dosing, as well as how this evidence correlates to other disease types. Additionally, availability of equipment may be an issue.