Radiotherapy

The researches find that the photobiomodulation (PBM); can be use for oral mucositis occurring as a side effect of cancer treatment with radiotherapy. However; PBM is not on the radar of most oncologists in the United States, who tend to use mouthwashes for this adverse event. But that may change now that PBM is recommend in new guidelines for oral mucositis resulting from cancer treatment . Because The new guidelines were draw up by the Multinational Association of Supportive Care in Cancer (MASCC) and International Society of Oral Oncology (ISOO).

Treatment with radiotherapy

They are publish online  in the journal Supportive Care in Cancer. Based on a systematic review of 33 clinical trials, the new guidelines recommend intra-oral PBM therapy for the prevention of oral mucositis in patients with head and neck cancer who are undergoing treatment with radiotherapy alone; or radiotherapy with chemotherapy; it’s also recommended also for patients who are undergoing  hematopoietic stem cell transplant (HSCT). No side effects of PBM therapy are report.

Coauthor Praveen R. Arany, PhD, MDS, MMSc; assistant professor in the department of oral biology and biomedical engineering at the University at Buffalo in New York, said that PBM is often delivered via intra-oral devices that deliver laser or LED light directly into the oral cavity, but there are also extra-oral delivery devices that are placed on the cheeks, lips, and throat of the individual.

Therapy for the prevention

PBM therapy, Arany explained, generally delivers low-level laser therapy; low-level light therapy, light-emitting diodes, and broadband visible light in the near-visible and near-infrared spectrum at very low, non-thermal doses. “At a high power, light is often use to destroy tissue. But at a low power; it has the ability to relieve pain or inflammation and promote healing,” Arany told Medscape Medical News.

“There is a sense of disbelief that light therapy can work,” Arany acknowledged, but emphasized that such PBM therapy can enhance patient care. Therefore “With PBM therapy, the right amount of light in the right place can bring therapeutic benefit,” Arany said. “The therapy could potentially serve as an alternative to opioids; which are often prescribed to alleviate the symptoms of oral mucositis.”

Coauthor Sharon Elad, DMD, professor and chair of the division of oral medicine at the University of Rochester Medical Center’s Eastman Institute for Oral Health in New York, agreed. “These updated guidelines will provide healthcare professionals with better tools to deliver care for cancer patients,” she said in a statement. Many oncologists and related healthcare professionals use mouthwashes in cancer patients who have developed oral mucositis.