In Head and Neck Cancer, Low-Level Laser Therapy Reduces Mucositis
Patients with head and neck cancer can experience a better quality of life during treatment, thanks to low-level laser therapy. According to a recent study discussed in Clinical Oncology, LLLT is effective in reducing the rate and severity of oropharyngeal mucositis, a common and uncomfortable side effect of chemoradiation.
Low-level laser therapy (LLLT) reduces the rate and severity of oropharyngeal mucositis (OM) in patients with squamous cell carcinoma of the head and neck (SCCHN) who are undergoing chemoradiation.
Investigators from the Brazilian National Cancer Institute enrolled 94 patients with SCCHN into this randomized double-blind, placebo-controlled, prospective Phase III study. All had been diagnosed with HNSCC of the nasopharynx, oropharynx or hypopharynx, and were not surgical candidates. Before the commencement of the study, all of the patients had received necessary dental treatments. Daily oral hygiene, including fluconazole, was included in the protocol.
Before every radiation therapy treatment, study participants were evaluated by trained nurses and treated by a dentist. The diode laser emitted continuous light at 660 nm. The tip would touch nine points in the mouth, buccal space and tongue; total treatment time was 12 minutes. For placebo patients, the procedure was the same, but the laser tip was inactive. Patients would be evaluated daily by nurses who were blinded and who used the World Health Organization’s 5-point mucositis scale.
There was a six-fold decrease in the incidence of severe (grades 3 and 4) OM in the LLLT group versus placebo (6.4% vs. 40.5%). In the LLLT group, 28 of 47 (59.6%) patients had no oral ulcers (grades 0 and 1). In the placebo group, 10 of 47 (21.3%; P<0.001) patients had grade 0 and 1 OM. The protocol had predetermined that placebo patients who suffered oral cavity ulcers of at least 6 cm or grades 3 or 4 OM would be treated with LLLT; 22 of 47 (47%) placebo patients crossed over during treatment. Heliton S. Antunes and co-authors published their results in Radiotherapy and Oncology (2013;109:297-302, PMID: 24044799).
LLLT participants had fewer complaints of oral pain, fatigue, weight loss and difficulty swallowing, and these study participants used fewer opioid analgesics and had better emotional functioning than the patients in the placebo group.
Severe OM is a common morbidity of patients receiving chemoradiotherapy. This study showed that LLLT is effective in preventing grades 3 and 4 OM and improving quality of life (QoL) in patients with SCCHN.
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