High-power laser photobiomodulation therapy for immediate pain relief of refractory oral mucositis

Oral Dis. 2024 May;30(4):2285-2292. doi: 10.1111/odi.14618. Epub 2023 May 19.

Abstract

Purpose: We aimed to evaluate the efficacy of high-power (class IV) laser photobiomodulation (PBM) therapy for immediate pain relief due to oral mucositis (OM) refractory to recommended first-line therapy.

Methods: This retrospective study included 25 cancer patients with refractory chemotherapy- or radiotherapy-induced OM (16 and 9 patients, respectively) that were treated for pain relief with an intraoral InGaAsP diode laser (power density = 1.4 W/cm2). Pain was self-assessed immediately before and after laser treatment using a 0-to-10 numeric rating scale ([NRS], "0" = no pain, "10" = intolerable pain).

Results: Patients reported an immediate decrease in pain following 94% (74 of 79) of the PBM sessions, in 61% (48 sessions) the pain reduction was over 50%, and in 35% (28 sessions) the initial pain was completely eliminated. There were no reports of increased pain post-PBM. For chemotherapy and radiotherapy-treated patients, mean reduction in pain NRS post-PBM was 4.8 ± 2.5 (p < 0.001) and 4.5 ± 2.8 (p = 0.001), indicating a post-PBM reduction of 72% and 60% of the initial pain level, respectively. The analgesic benefit of PBM remained for a mean of 6.0 ± 5.1 days. One patient reported a transient burning sensation after one PBM session.

Conclusions: High-power laser PBM may provide nonpharmacologic, patient-friendly, long-lasting, rapid pain relief for refractory OM.

Keywords: chemotherapy; low‐level laser; oral complications; oral ulcer; palliative therapy; radiotherapy; supportive treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Lasers, Semiconductor* / therapeutic use
  • Low-Level Light Therapy* / methods
  • Male
  • Middle Aged
  • Pain Management / methods
  • Pain Measurement
  • Retrospective Studies
  • Stomatitis* / etiology
  • Stomatitis* / radiotherapy
  • Stomatitis* / therapy
  • Treatment Outcome