title: Low level helium neon laser therapy for chemoradiotherapy induced oral mucositis in oral cancer patients - a randomized controlled trial.
abstract: BACKGROUND
  Patients receiving chemoradiotherapy (CRT) for oral cancer (OC) often develop oral mucositis (OM). OM associated pain severely affects oral functions and nutrition of the patient, resulting in narcotic analgesic use and CRT interruption. Laser therapy has shown some promising results in preventing and treating OM caused by cancer therapies. So in this trial we used prophylactic Low Level Helium Neon (He-Ne) Laser for the prevention and treatment of CRT induced OM in OC patients.
  
  
  METHODS
  This double blinded trial block randomized 121 primary OC patients scheduled to undergo CRT [RT dosage=66 Gray/33 fractions for 5 days/week and chemotherapy (3 weekly Cisplatin)] into laser (n=60) and placebo (n=61) group. Laser group received He-Ne Laser (λ=632.8 nm, P=24 mW, ED=3.5 J/cm(2)) while placebo received sham treatment just before radiation for 6.5 weeks. OM (RTOG/EORTC Scale), its associated pain, and total parenteral nutrition (TPN), were assessed on every week by a blinded assessor. Also opioid analgesic use, weight loss and any CRT break were recorded. Data was analyzed using descriptive statistics, t-test and Man Whitney U test. Level of significance was set at p<0.05.
  
  
  RESULTS
  Incidence of severe OM (29% vs. 89%, p<0.001) and its associated pain (18% vs. 71%, p<0.001), opioid analgesic use (7% vs. 21%, p<0.001)and TPN (30% vs. 39% p=0.039) was significantly less in laser than placebo group patients. Also duration of severe OM and pain experienced was less in laser than placebo group. CRT break required only for placebo group (9%) patients.
  
  
  CONCLUSIONS
  Low Level He-Ne Laser decreased the incidence of CRT induced severe OM and its associated pain, opioid analgesics use and TPN.
authors.affiliation: Department of Radiotherapy and Oncology, Kasturba Medical College and Hospital, Manipal University, Manipal, Udupi, Karnataka 576 104, India. ajayphysio@gmail.com
authors.forename: Ajay Prashad
authors.initials: AP
authors.lastname: Gautam
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Fernandes
authors.forename: Mamidipudi S
authors.initials: MS
authors.lastname: Vidyasagar
authors.forename: G Arun
authors.initials: GA
authors.lastname: Maiya
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D010919:Placebos; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects*; D013280:Stomatitis / Q000209:etiology*
chemical_list: D000970:Antineoplastic Agents; D010919:Placebos