Simoes, A., Eduardo, F.P., Luiz, A.C., Campos, L., Sa, P.H., Cristofaro, M., … Eduardo, C.P. (2009). Laser phototherapy as topical prophylaxis against head and neck cancer radiotherapy-induced oral mucositis: Comparison between low and high/low power lasers. Lasers in Surgery and Medicine, 41(4), 264–270.

To analyze the effect of different protocols of laser phototherapy (LPT) on the grade of mucositis and the degree of pain in patients undergoing radiation therapy

Patients were divided into three groups. One group was treated with low-dose laser therapy three times per week. Group 2 received combined high and low powered lasers used three times per week. The third group received low-level laser therapy (LLLT) once weekly. Oral mucositis and pain were assessed at the first visit and at each LPT visit.

• The study consisted of 39 patients whose ages ranged from 15–79 years.
• The sample was 38% female and 62% male.
• Patients had been diagnosed with head and neck cancer and were receiving radiation therapy, chemotherapy, or both.

This was a single-site study conducted at the Cancer Hospital of Mato-Grasso, Brazil.

This was a prospective clinical trial.

• A visual analog scale (VAS) was used to measure severity of oral pain.
• The National Cancer Institute (NCI) Common Toxicity Criteria (CTC) for radiation-induced oral mucositis scale was used.

No differences were found between groups in overall grades of mucositis. Pain increased in the patients that received LPT weekly (p = 0.01), while pain severity remained about the same over time in other groups. Patients who received combined high and low power laser took significantly more time to heal (p = 0.04).

LPT using low power laser alone or in combination with high powered lasers when applied three times weekly maintained the mucositis grades at levels I and II and prevented increased pain. Combination low and high power laser treatment was associated with a longer time to healing mucositis.

• The sample size was small with fewer than 100 patients.
• No control group was included.

This study provides an initial look at differences in outcomes with LPT based on different dosages and types of LPT treatment. Further research in this area, as well as studies looking at timing differences in the phase of care, are necessary to determine the most effective use of this treatment modality.