Effectiveness Not Established

Infrared Phototherapy

for Mucositis

Near infrared or infrared phototherapy involves the application of near infrared wavelength light. This approach was studied for its effect on oral mucositis in patients with cancer.

Research Evidence Summaries

Hodgson, B. D., Margolis, D. M., Salzman, D. E., Eastwood, D., Tarima, S., Williams, L. D., et al. (2011). Amelioration of oral mucositis pain by NASA near-infrared light-emitting diodes in bone marrow transplant patients. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 20(7),1405-1415.

Study Purpose

To investigate the use of extra-orally applied near infrared phototherapy for the reduction of oral pain secondary to chemotherapy and radiation therapy induced mucositis in adult and pediatric HSCT patients.  

Intervention Characteristics/Basic Study Process

Eighty HSCT patients were divided into regular and low risk groups, and then into experimental and placebo groups. The experimental groups received gallium-aluminum-arsinide light emitting diode (LED) once daily, while the placebo group also received a similar appearing placebo treatment daily, beginning on day of HSCT (day 0) through day 14. The LED was applied extra-orally, by placing the light source in contact with the cheeks and anterior throat. The blinded evaluators examined the patients three times/week scoring their oral tissues, and patient reported pain assessments.

Sample Characteristics

The sample was comprised of 80 patients age 3-74 years.

Males (%): 55 and Females (%): 45

Key Disease Characteristics: Aplastic anemia, neuroblastoma, AML, NHL, CLL, SLL, ALL, Hodkin’s disease, PNT, MES, Ewing's sarcoma, sickle cell anemia, CML, TC, HLH, WAS, MDS, osteoporosis, lymphoma, multiple myeloma, POEMS, amyloidosis

Other Key Sample Characteristics: All patients received conditioning therapy with melphalan.


Site: Multi-site

Setting Type: Not specified

Location: Children’s Hospital of Wisconsin, University of Alabama - Birmingham, The Children’s Hospital of Alabama

Phase of Care and Clinical Applications

Phase of Care: Active treatment

Study Design

Randomized, double-blinded, placebo-controlled

Measurement Instruments/Methods

  • WHO pain assessment scale
  • NCICT GI Criteria for Adverse Events
  • OMAS erythema or ulceration scale
  • Patient diary form with questions concerning mouth pain -  ADULT - VAS (no pain and most severe pain possible) PEDIATRICS - Wong Baker FACES pain scale
  • Patient diary using the same scales adapted to measure the impact on swallowing from no trouble to unable to swallow anything (including saliva)
  • Patient report regarding eating normally; eat only soft solid foods; consume only liquids; or could not tolerate any food or liquids.


There were no significant differences in the WHO clinical examination scale between any of the groups. The other scales used also did not elicit significant differences.


Although it was not statistically significant, the data suggested a trend for the experimental groups to have general improvements in all of the scales.


Small sample <100

Groups were not split into children versus adults.

Nursing Implications

Inconclusive, would need much more research to demonstrate effectiveness. The positive note was that this treatment is applied extra-orally, making it more tolerable during periods of oral mucositis. This treatment would require education for the healthcare team as well as added cost for the use of the technology.