title: Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients.
abstract: BACKGROUND
  The aim of this study was to review the available literature and define clinical practice guidelines for the use of laser and other light therapies for the prevention and treatment of oral mucositis.
  
  
  METHODS
  A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, and no guideline possible.
  
  
  RESULTS
  A new recommendation was made for low-level laser (wavelength at 650 nm, power of 40 mW, and each square centimeter treated with the required time to a tissue energy dose of 2 J/cm(2) (2 s/point)) for the prevention of oral mucositis in adult patients receiving hematopoietic stem cell transplantation conditioned with high-dose chemotherapy, with or without total body irradiation. A new suggestion was made for low-level laser (wavelength around 632.8 nm) for the prevention of oral mucositis in patients undergoing radiotherapy, without concomitant chemotherapy, for head and neck cancer. No guideline was possible in other populations and for other light sources due to insufficient evidence.
  
  
  CONCLUSIONS
  The increasing evidence in favor of low-level laser therapy allowed for the development of two new guidelines supporting this modality in the populations listed above. Evidence for other populations was also generally encouraging over a range of wavelengths and intensities. However, additional well-designed research is needed to evaluate the efficacy of laser and other light therapies in various cancer treatment settings.
authors.affiliation: Department of Diagnostic Sciences and Oral Medicine, College of Dentistry, University of Tennessee Health Sciences Center, 875 Union Avenue, suite N231, Memphis, TN 38163, USA. migliorati@uthsc.edu
authors.forename: Cesar
authors.initials: C
authors.lastname: Migliorati
authors.forename: Ian
authors.initials: I
authors.lastname: Hewson
authors.forename: Rajesh V
authors.initials: RV
authors.lastname: Lalla
authors.forename: Heliton Spindola
authors.initials: HS
authors.lastname: Antunes
authors.forename: Cherry L
authors.initials: CL
authors.lastname: Estilo
authors.forename: Brian
authors.initials: B
authors.lastname: Hodgson
authors.forename: Nilza Nelly Fontana
authors.initials: NN
authors.lastname: Lopes
authors.forename: Mark M
authors.initials: MM
authors.lastname: Schubert
authors.forename: Joanne
authors.initials: J
authors.lastname: Bowen
authors.forename: Sharon
authors.initials: S
authors.lastname: Elad
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D007259:Infrared Rays / Q000627:therapeutic use; D054020:Lasers, Gas / Q000627:therapeutic use; D054023:Lasers, Semiconductor / Q000627:therapeutic use; D028022:Low-Level Light Therapy / Q000379:methods*; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D010789:Phototherapy / Q000379:methods*; D017410:Practice Guidelines as Topic; D013280:Stomatitis / Q000209:etiology / Q000517:prevention & control / Q000532:radiotherapy / Q000628:therapy*