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. 2014 Sep 8;9(9):e107418.
doi: 10.1371/journal.pone.0107418. eCollection 2014.

Effect of Prophylactic Low Level Laser Therapy on Oral Mucositis: A Systematic Review and Meta-Analysis

Free PMC article

Effect of Prophylactic Low Level Laser Therapy on Oral Mucositis: A Systematic Review and Meta-Analysis

Sapna Oberoi et al. PLoS One. .
Free PMC article


Background: Objective was to determine whether prophylactic low level laser therapy (LLLT) reduces the risk of severe mucositis as compared to placebo or no therapy.

Methods: MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched until February 2014 for randomized controlled trials (RCTs) comparing prophylactic LLLT with placebo or no therapy in patients with cancer or undergoing hematopoietic stem cell transplantation (HSCT). All analyses used random effects models.

Results: Eighteen RCTs (1144 patients) were included. Prophylactic LLLT reduced the overall risk of severe mucositis (risk ratio (RR) 0.37, 95% confidence interval (CI) 0.20 to 0.67; P = 0.001). LLLT also reduced the following outcomes when compared to placebo/no therapy: severe mucositis at the time of anticipated maximal mucositis (RR 0.34, 95% CI 0.20 to 0.59), overall mean grade of mucositis (standardized mean difference -1.49, 95% CI -2.02 to -0.95), duration of severe mucositis (weighted mean difference -5.32, 95% CI -9.45 to -1.19) and incidence of severe pain (RR 0.26, 95% CI 0.18 to 0.37).

Conclusion: Prophylactic LLLT reduced severe mucositis and pain in patients with cancer and HSCT recipients. Future research should identify the optimal characteristics of LLLT and determine feasibility in the clinical setting.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.


Figure 1
Figure 1. Flow diagram of trial identification and selection.
Figure 2
Figure 2. Forest plot of overall incidence of severe (grade 3 or 4) mucositis.
Squares to the left of the vertical line indicate that low level laser therapy reduces mucositis. Horizontal lines through the squares represent 95% confidence intervals (CIs). The size of the squares reflects each study's relative weight, and the diamond represents the aggregate risk ratio and 95% CI.
Figure 3
Figure 3. Funnel plot “trim and fill” technique assessing publication bias for overall incidence of severe mucositis.
The x-axis represents the risk ratio for the effect of low level laser therapy and the y-axis represents the inverse of the variance of the effect. Estimated number of missing studies on right side = 4.

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The author(s) received no specific funding for this work.