Influence of low-energy laser in the prevention of oral mucositis in children with cancer receiving chemotherapy.
BACKGROUND
This study assessed the use of low-energy laser in the prevention or reduction of the severity of oral mucositis.


METHODS
A randomized clinical trial was carried out. Patients from 3 to 18 years of age treated with chemotherapy or hematopoietic stem-cell transplantation between May, 2003 and February, 2005 were eligible. The intervention group received laser application for 5 days following the start of chemotherapy. The grade of oral mucositis was assessed by the WHO per NCI-CTC common toxicity criteria and the assessments were made on days 1, 8 and 15 by a trained examiner blind to the intervention.


RESULTS
Sixty patients were evaluable for analysis; thirty-nine (65%) were males, 35 (58%) patients had a diagnosis of leukemia or lymphoma, and 25 (42%) had solid tumors. The mean age was 8.7 +/- 4.3 years. Twenty-nine patients were randomized in the laser group and 31 in the control group. On day 1, no patients presented with mucositis. On day 8, of 20 patients (36%) who developed mucositis, 13 of them were from the laser group and 7 from the control group. On day 15, of 24 patients (41%) who developed mucositis, 13 of them were from the laser group and 11 from the control group. There was no significant difference between groups concerning the grades of mucositis on day 8 (P = 0.234) or on day 15 (P = 0.208).


CONCLUSIONS
This study showed no evidence of benefit from the prophylactic use of low-energy laser in children and adolescents with cancer treated with chemotherapy when optimal dental and oral care was provided.
Cruz
Luciane B
LB
Pediatric Oncology Unit, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. lcruz@hcpa.ufrgs.br
Ribeiro
Anelise S
AS
Rech
Angela
A
Rosa
Lauro G N
LG
Castro
Cláudio G
CG
Brunetto
Algemir L
AL
D000293:Adolescent; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D000077146:Irinotecan; D028022:Low-Level Light Therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D009061:Mouth Mucosa / Q000473:pathology; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D009752:Nutritional Status; D009910:Oral Hygiene; D012720:Severity of Illness Index; D013280:Stomatitis / Q000139:chemically induced / Q000473:pathology / Q000517:prevention & control*; D016896:Treatment Outcome
D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D000077146:Irinotecan; D016190:Carboplatin; D007069:Ifosfamide; D002166:Camptothecin; D008727:Methotrexate