title: Could the biological robustness of low level laser therapy (Photobiomodulation) impact its use in the management of mucositis in head and neck cancer patients.
abstract: Low level laser therapy (LLLT) has been noted to be effective in mitigating the development of oral mucositis among patients being treated with chemoradiation for cancers of the head and neck. To explain the biological basis for this observation we performed a comprehensive literature search. Our investigation identified a substantial number of LLLT-activated pathways that have been strongly associated with negative tumor outcomes including proliferation, invasion, angiogenesis, metastases and cancer-treatment resistance. In light of these findings, we suggest an investigational strategy to assure that LLLT's anti-mucositis efficacy is independent of its possible potential to enhance threatening tumor behaviors. Included are appropriate pre-clinical modeling, short- and long-term follow-up of LLLT-treated patients, and the requirement for consistency of LLLT parameters.
authors: Division of Oral Medicine, Brigham and Women's Hospital and the Dana-Farber Cancer Institute, Boston, MA, USA; Biomodels, LLC, Watertown, MA, USA. Electronic address: ssonis@partners.org.
authors: Stephen T
authors: ST
authors: Sonis
authors: Harvard School of Dental Medicine, Boston, MA, USA.
authors: Sepehr
authors: S
authors: Hashemi
authors: Samuel Oschin Comprehensive Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Division of Otolaryngology and Head and Neck Surgery, City of Hope National Medical Center, Duarte, CA, USA.
authors: Joel B
authors: JB
authors: Epstein
authors: Discipline of Oral Medicine, Oral Pathology and Human Diseases, Griffith University, Menzies Health Institute Queensland, Australia; Hematology and Oncology, Gold Coast University Hospital, Queensland Health, Australia.
authors: Raj G
authors: RG
authors: Nair
authors: Department of Oral- and Maxillofacial Surgery, Academic Medical Center, The Netherlands; Department of Medical Dental Interaction, ACTA, University of Amsterdam, Amsterdam, The Netherlands.
authors: Judith E
authors: JE
authors: Raber-Durlacher
mesh_terms: D059248:Chemoradiotherapy / Q000009:adverse effects; D006258:Head and Neck Neoplasms / Q000150:complications / Q000628:therapy; D006801:Humans; D028022:Low-Level Light Therapy; D011832:Radiation Injuries / Q000532:radiotherapy*; D015398:Signal Transduction / Q000528:radiation effects; D013280:Stomatitis / Q000378:metabolism* / Q000532:radiotherapy*; D016896:Treatment Outcome
keywords: Head and neck cancer; Low level laser therapy; Oral mucositis; Photobiomodulation; Radioprotection; Tumor behavior