The Path to an Evidence-Based Treatment Protocol for Extraoral Photobiomodulation Therapy for the Prevention of Oral Mucositis

Ather Adnan; Anna N Yaroslavsky; James D Carroll; Wayne Selting; Amy F Juliano; Wendy B London; Stephen T Sonis; Christine N Duncan; Nathaniel S Treister

doi:10.3389/froh.2021.689386

The Path to an Evidence-Based Treatment Protocol for Extraoral Photobiomodulation Therapy for the Prevention of Oral Mucositis

Front Oral Health. 2021 Jul 16:2:689386. doi: 10.3389/froh.2021.689386. eCollection 2021.

Authors

Ather Adnan¹, Anna N Yaroslavsky^{2

3}, James D Carroll⁴, Wayne Selting⁵, Amy F Juliano⁶, Wendy B London⁷, Stephen T Sonis^{8

9

10}, Christine N Duncan⁷, Nathaniel S Treister^{8

9}

Affiliations

¹ Texas A&M University Health Science Center, College of Medicine, Houston, TX, United States.
² Advanced Biophotonics Laboratory, Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, MA, United States.
³ Department of Dermatology, Massachusetts General Hospital, Boston, MA, United States.
⁴ THOR Photomedicine, Chesham, United Kingdom.
⁵ Department of Surgical Science and Integrated Diagnostics, University of Genoa, Genoa, Italy.
⁶ Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States.
⁷ Department of Pediatrics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, United States.
⁸ Department of Surgery, Divisions of Oral Medicine and Dentistry, Brigham and Women's Hospital and the Dana-Farber Cancer Institute, Boston, MA, United States.
⁹ Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, United States.
¹⁰ Biomodels LLC., Waltham, MA, United States.

Abstract

Oral mucositis is a painful complication of hematopoietic stem cell transplantation for which photobiomodulation therapy (PBMT) is a safe and effective intervention. Extraoral delivery of PBMT has clinical advantages over intraoral delivery but requires additional dosimetric considerations due to the external tissue layers through which the light must propagate before reaching the oral mucosa. Additionally, to date there has been no dose modeling study, a task essential to developing a justified treatment protocol. We review here some of the complexities surrounding extraoral photobiomodulation therapy and offer that may help guide researchers toward an evidence-based treatment protocol for the prevention of oral mucositis.

Keywords: hematopoietic stem cell transplant; low level light therapy; monte carlo; oral mucositis; photobiomodulation therapy.

Publication types

Review