Update of photobiomodulation in oral mucositis: a systematic review

Introduction : Oral mucositis (OM) is a common side effect of radiotherapy (RT) or radio-chemotherapy (RT/CT) for head and neck cancers. It causes lesions leading to impairment the quality life, dysphagia, pain, in up 20% cases, dosimetry concession, decreasing local tumor control, thereby impacting survival rate. Positive results photobiomodulation (PBM) treat it have been reported literature. PBM has multiple parameters (type laser, emission mode, number sessions be performed, wavelength, power, energy, fluence, exposure time, points) making difficult implement clinical practice. Materials methods A literature search strategy was applied Medline by selecting articles published between 2010 2020 answer following research question: “In patients treated with RT RT/CT, what place management OM?”, accordance PICO (patient, intervention, comparison outcomes) criteria. The inclusion criteria were all original (clinical cases studies) which answered question. Meta-analyses, systematic reviews journals, animal vitro studies, studies language other than French English, full-text not accessible via inter-university credits excluded. Results Seventeen included, representing 1576 patients. intraoral 16 papers combined intra- extra-oral 1 paper. InGaAlP diode laser HeNe significantly reduced OM compared placebo 62.5% 75% respectively. Pain reduction poorly documented when was, did correlate analgesics. Temporary permanent interruption also documented. Discussion MASCC/ISOO (2019) report an important step forward establish reproducible protocol PBM, as our show, heterogeneous use. Our showed that started on first day RT, using wavelength 660 nm 632.8 laser. However, there no scientific evidence vis-à-vis values points. Although appears effective reducing scores, its effectiveness improving patient painkiller consumption, compliance treatment occurrence complications remains defined. relationship rate objective this work. We found 17 articles, 15 stated they illuminate site during sessions. Conclusion main work determine OM. Overall, scores favorable almost ¾ studies. Despite efficacy, questions adjustment harmonization scale safety carcinologic recurrence remain studied. In view lack comparability data, harmonize endpoints follow-up are needed standard protocol.