title: A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis.
abstract: OBJECTIVE
  The purpose of this study is to review the effects of low-level laser therapy (LLLT) in the prevention and treatment of cancer therapy-induced oral mucositis (OM).
  
  
  METHODS
  A systematic review and meta-analysis of randomised placebo-controlled trials of LLLT performed during chemotherapy or radiation therapy in head and neck cancer patients.
  
  
  RESULTS
  We found 11 randomised placebo-controlled trials with a total of 415 patients; methodological quality was acceptable at 4.10 (SD ± 0.74) on the 5-point Jadad scale. The relative risk (RR) for developing OM was significantly (p = 0.02) reduced after LLLT compared with placebo LLLT (RR = 2.03 (95% CI, 1.11 to 3.69)). This preventive effect of LLLT improved to RR = 2.72 (95% CI, 1.98 to 3.74) when only trials with adequate doses above 1 J were included. For treatment of OM ulcers, the number of days with OM grade 2 or worse was significantly reduced after LLLT to 4.38 (95% CI, 3.35 to 5.40) days less than placebo LLLT. Oral mucositis severity was also reduced after LLLT with a standardised mean difference of 1.33 (95% CI, 0.68 to 1.98) over placebo LLLT. All studies registered possible side-effects, but they were not significantly different from placebo LLLT.
  
  
  CONCLUSIONS
  There is consistent evidence from small high-quality studies that red and infrared LLLT can partly prevent development of cancer therapy-induced OM. LLLT also significantly reduced pain, severity and duration of symptoms in patients with cancer therapy-induced OM.
authors.affiliation: Centre for Evidence-Based Practice, Bergen University College-HiB, Moellendalsvn. 6, 5009, Bergen, Norway. jmb@hib.no
authors.forename: Jan Magnus
authors.initials: JM
authors.lastname: Bjordal
authors.forename: Rene-Jean
authors.initials: RJ
authors.lastname: Bensadoun
authors.forename: Jan
authors.initials: J
authors.lastname: Tunèr
authors.forename: Lucio
authors.initials: L
authors.lastname: Frigo
authors.forename: Kjersti
authors.initials: K
authors.lastname: Gjerde
authors.forename: Rodrigo Ab
authors.initials: RA
authors.lastname: Lopes-Martins
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D016001:Confidence Intervals; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000473:pathology; D006305:Health Status Indicators; D006801:Humans; D028022:Low-Level Light Therapy / Q000295:instrumentation*; D012306:Risk; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013280:Stomatitis / Q000209:etiology / Q000532:radiotherapy*
chemical_list: D000970:Antineoplastic Agents