Pilot study on the efficacy of combined intraoral and extraoral low-level laser therapy for prevention of oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation.
OBJECTIVE
Studies suggest that intraoral low-level laser therapy (LLLT) can ameliorate oral mucositis in adult patients receiving high-dose chemotherapy. The objective of this study was to evaluate the use of a combined protocol of intraoral and extraoral LLLT in children undergoing hematopoietic stem cell transplantation (HSCT).


METHODS
Twelve children undergoing HSCT were treated four times a week with a combined protocol of intraoral and extraoral LLLT, for a mean duration of 22 days. Clinical and functional mucositis scores were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE). These scores were compared with a matched retrospective control group of 12 children who did not receive LLLT during HSCT.


RESULTS
Clinical mucositis scores were significantly lower in the LLLT group than in the control group (p = 0.004). Incidence of ulcerative oral mucositis was also significantly lower in the LLLT group (p = 0.027). Functional limitation associated with diet/swallowing was less severe in the LLLT group; however, this was not statistically significant.


CONCLUSIONS
This study indicates that a combined protocol of intraoral and extraoral application of LLLT can reduce the severity of oral mucositis in pediatric patients undergoing HSCT. Randomized double-blind clinical trials with a larger number of subjects are needed to further test such combined protocols.
1 Pediatric Oncology Institute, GRAACC, Universidade Federal de São Paulo , São Paulo, Brazil .
Marcos
M
Soto
2 Section of Oral Medicine, University of Connecticut Health Center , Farmington, Connecticut.
Rajesh V
RV
Lalla
1 Pediatric Oncology Institute, GRAACC, Universidade Federal de São Paulo , São Paulo, Brazil .
Roseane Vasconcelos
RV
Gouveia
1 Pediatric Oncology Institute, GRAACC, Universidade Federal de São Paulo , São Paulo, Brazil .
Victor Gattardello
VG
Zecchin
1 Pediatric Oncology Institute, GRAACC, Universidade Federal de São Paulo , São Paulo, Brazil .
Adriana
A
Seber
3 Division of Dentistry, Pediatric Oncology Institute, GRAACC, Universidade Federal de São Paulo , São Paulo, Brazil .
Nilza Nelly Fontana
NN
Lopes
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D052016:Mucositis / Q000517:prevention & control*; D010865:Pilot Projects