Photobiomodulation as a preventive strategy for oral mucositis in pediatric oncology: a systematic review and meta-analysis

Abstract

Objectives: Oral mucositis (OM) is one of the most frequent and debilitating complications in children undergoing treatment for hematologic malignancies. Current management strategies focus on minimizing OM severity and alleviating symptoms. This systematic review aimed to evaluate the effectiveness of photobiomodulation (PBM) in preventing OM in pediatric patients with hematologic malignancies receiving chemotherapy.

Data/sources: Guided by the PICOS framework, this review addressed the following research question: Is PBM therapy effective in reducing the incidence and severity of oral mucositis in children and adolescents with hematologic malignancies undergoing chemotherapy? A comprehensive search was conducted in PubMed, Scopus, Web of Science, Embase and The Cochrane databases through February 2025. Eligible studies were randomized clinical trials involving patients aged 0-22 years diagnosed with hematologic malignancies treated by means of chemotherapy, and undergoing preventive PBM therapy for OM.

Study selection: Five randomized controlled trials were included, encompassing patients aged 4 months to 22 years. Of these, 97 received low-level laser therapy (LLLT) and 80 received light-emitting diode therapy (LEDT). PBM was consistently reported as effective in preventing the onset and reducing the severity of OM in these populations. Three studies were eligible for meta-analysis, which demonstrated a statistically significant benefit of PBM therapy (p = 0.04), with a 95% confidence interval ranging from 0.01 to 0.84.

Conclusions: PBM therapy appears to be an effective preventive strategy for oral mucositis in pediatric patients undergoing chemotherapy for hematologic malignancies. Further large-scale trials are warranted to establish standardized protocols and optimize treatment outcomes.

Clinical significance: PBM therapy significantly reduces the incidence and severity of oral mucositis in pediatric patients undergoing chemotherapy for hematologic malignancies. This non-invasive intervention offers an emerging preventive strategy, improving patient comfort and treatment adherence. Standardized PBM protocols may enhance supportive care in pediatric oncology settings.

Keywords: Cancer; Photobiomodulation, children, low-level laser therapy, oral mucositis.