ROLE OF LOW LEVEL LASER THERAPY IN ORAL MUCOSITIS IN PATIENTS UNDERGOING CONCURRENT CHEMORADIATION

2021 ◽  
pp. 39-41
Author(s):  
Jyoti Mehta ◽  
Janaki MG ◽  
Kirthi Koushik ◽  
Rakesh Rakesh ◽  
Deepak Angamuthu

Background: Radiotherapy (RT) has been the traditional treatment approach for head and neck carcinoma (HNC) and has resulted in both excellent control rates and function preservation. Oral mucositis (OM) is a frequent, severe toxicity in patients treated with RT and may lead to hospitalization and the treatment interruptions, which inuences quality of life. The aim of our study is to assess effect of low level laser therapy (LLLT) in the treatment of OM. Materials And Methods: A prospective single arm study was conducted on 23 patients of locally advanced HNC undergoing chemoradiation.Grade 2 mucositis onwards (RTOG grading) were exposed to low LLLT in a scanning motion 3-5 times weekly for 4 weeks Patients were assessed with intra oral photographs and Visual Analogue Score (VAS) questionnaire was used before and after LLLTto assess pain. Results: Eleven patients (47%) received 7 to 10 sessions of LLLT. Fifteen (65%) patients had grade three and seven (30%) had grade 2 before LLLT. Eleven and eight patients had grade 2 and 1 respectively after LLLT (p=0.007). Mean VAS score before and after LLLT was 6.32 and 3.32 respectively (p <0.01) Conclusion:LLLTis an effective intervention in patients with Grade 2 and 3 OM, both in terms of subjective and objective improvement

2013 ◽  
Vol 19 (3) ◽  
pp. 195 ◽  
Author(s):  
SenthilP Kumar ◽  
Krishna Prasad ◽  
Kamalaksha Shenoy ◽  
Mariella D′Souza ◽  
VijayaK Kumar

2011 ◽  
Vol 29 (18_suppl) ◽  
pp. LBA5524-LBA5524 ◽  
Author(s):  
H. S. Antunes ◽  
D. Herchenhorn ◽  
C. M. Araujo ◽  
E. Cabral ◽  
E. M. d. S. Ferreira ◽  
...  

LBA5524 Background: Oral mucositis (OM) remains a limiting factor in in head and neck squamous cell carcinomas (HNSCC) patients (pts) treated with chemoradiation (CRT) leading to pain, dysphagia, and weight loss. Low-level laser therapy (LLLT) emerges as a promising, preventive therapy of CRT-induced OM. Yet, a definitive randomized trial supporting its use is lacking. This study was designed to assess the efficacy of LLLT in reducing the incidence and/or severity of OM. Methods: Assuming OM grade (G3) for placebo 0.4 (P0); LLLT 0.15 (P1) ; β=0.2; α=0.05, sample size was 94 pts. From Jun 2007 to Dec 2010, 47 LLLT and 47 placebo pts bearer of HNSCC of nasopharynx, oropharynx and hipopharynx entered a prospective, randomized, double blind, placebo-controlled, phase III trial. CRT consisted of conventional RT 70.2 Gy (1.8Gy/d, 5 times/wk) + concurrent cisplatin 100 mg/m2 every 3 wks. Main endpoints were OM incidence and severity, RT interruptions due to OM and pain intensity. The LLLT used daily was a diode InGaAlP (660nm-100mW-4J/cm²). OM evaluation was done by WHO and OMAS scale. Results: Mean age was 54.6 and 87.2% of pts were male. Primary site: oropharynx (74 pts), nasopharynx (9 pts), hypopharynx (11 pts). In the LLLT arm the incidence of OM G 3/4 was only 6.4% versus 48% in the placebo arm; HR of 0.13 (IC 95%, p<0.001). Besides in the LLLT arm 51% of pts did not have ulcers versus 17% in placebo arm (p<0.001). LLLT pts had less severe pain (p=0.012), used less narcotic analgesic, HR 0.33 (IC 95%, p<0.001) and required less gastrostomia, HR 0.037 (IC 95%, p= 0.005). No LLLT pts had RT interrupted due to OM. EORTC QLQ-C30 and its specific head and neck module QLQ-H&N35 were applied. Results clearly favored the LLLT arm. In QLQ-C30 benefit was seen in both physical and emotional functioning (p=0.037), fatigue (p=0.011), pain (p=0.043); and in QLQ-H&N35, pain (p=0.007), swallowing (p=0.001) and trouble with social eating (p=0.026). Conclusions: Our results indicate that upfront LLLT in HNSCC pts submitted to CRT is an effective tool in reducing G 3/4 OM, oral pain, use of narcotic and gastrostomia. QoL data supports the efficacy findings. Thereby LLLT should be the new standard of care in this setting.


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