Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines
- Study type
- Clinical guideline
- Study name
- MASCC/ISOO PBM 2019
- Design
- Systematic review and evidence-based clinical guideline development by the MASCC/ISOO Mucositis Study Group (search of PubMed and Web of Science)
- Sample size
- Not stated in the abstract
- Source
- Support Care Cancer · 2019
In plain words
Mouth sores and inflammation are a troublesome side effect of radiotherapy to the head and neck and of stem cell transplantation. This review shows that treatment with low-power light (laser) can prevent these sores and the related pain in some patients. There is not yet enough evidence for treating sores that have already formed, or sores caused by chemotherapy alone. Decide on using this approach together with your care team.
Key points
Key guideline recommendations
- Recommendation (level of evidence not stated in the abstract)
A recommendation is made for preventing oral mucositis and the associated pain with PBM therapy in patients undergoing haematopoietic stem cell transplantation, head and neck radiotherapy (without chemotherapy) and head and neck radiotherapy with chemotherapy; 1 to 2 clinically effective protocols are recommended for each setting, and all parameters of the chosen protocol must be adhered to.
- No guideline possible
For treatment of established oral mucositis or management of chemotherapy-associated mucositis with PBM, no guideline is possible because of insufficient evidence.
Treatment arms and regimens
For each of the three treatment settings, 1 to 2 clinically effective protocols are recommended, and the clinician must adhere to all parameters of the chosen protocol. Dose details in the full text of the paper.
Source of the regimen details: Abstract of the paper
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
Cancer patients at risk of oral mucositis (OM), including patients undergoing haematopoietic stem cell transplantation, patients receiving head and neck radiotherapy (without chemotherapy) and patients receiving head and neck radiotherapy with chemotherapy.
Endpoints
Prevention of oral mucositis and the associated pain, and treatment of established mucositis, with PBM. The evidence for each intervention in each cancer treatment setting was assessed and the level of evidence (LoE) determined; on that basis one of three outcomes was adopted: "recommendation", "suggestion" or "no guideline possible".
Safety and side effects
Safety data are not reported in the abstract.
Clinical significance and place in guidelines
This guideline recommends PBM for the prevention of oral mucositis and the associated pain in three specific settings (haematopoietic stem cell transplantation, head and neck radiotherapy without chemotherapy, and head and neck radiotherapy with chemotherapy). The clinician must adhere to all parameters of the chosen protocol. For treatment of established OM and chemotherapy-associated OM, no guideline is possible. The status of this guideline in other clinical guidelines should be checked.
Limitations
The reported clinical settings were highly variable, which limited data integration. Evidence is insufficient for treatment of established OM and chemotherapy-associated OM. The guidelines should be updated continually on the basis of new data.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.