Use of extraoral photobiomodulation in the management of oral mucositis: systematic literature review

Autores/as

DOI:

https://doi.org/10.5327/2525-5711.447

Palabras clave:

Mucositis, Laser Therapy, Low-Level Light Therapy, Lasers, Semiconductor

Resumen

Oral mucositis (OM) is an adverse effect in oncology patients and photobiomodulation (PBM) improve the quality of life of these patients through OM management. The objective of this study was to evaluate the effects of extraoral PBM on the prevention and/or treatment of OM in oncology patients. This systematic review was registered in PROSPERO, following the PRISMA guidelines. PubMed, Scopus, Science Direct, LILACS, CAPES, BVS and Google Scholar were consulted, and keywords from DeCS/MeSH were used. The risk of bias was analyzed using RoB2. A total of 1246 studies were identified and two articles were selected. A total of 115 patients were included, and the extraoral PBM promotes preventive and therapeutic action in OM, reduces pain, and is well-tolerated. When comparing intraoral and extraoral PBM, both achieved similar results; moreover, extraoral PBM required a shorter application time. Extraoral PBM prevented/treated OM, and optimized the application time in oncology patients.

Citas

1. Oberoi S, Zamperlini-Netto G, Beyene J, Treister NS, Sung L. Effect of prophylactic low level laser therapy on oral mucositis: a systematic review and meta-analysis. PLoS One. 2014;9(9):107418. https://doi.org/10.1371/journal.pone.0107418

2. Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M. Perspectives on cancer therapy-Induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer Supp. 2004;100(9):1995-2025. https://doi.org/10.1002/cncr.20162

3. Ramos Pinto MB, Gusmão TPL, Schmidt-Filho J, Jaguar GC, Martins MD, Alves FA. Intraoral versus extraoral photobiomodulation therapy in the prevention of oral mucositis in HSCT patients: a randomized, single-blind, controlled clinical trial. Support Care Cancer. 2021;29(11):6495-503. https://doi.org/10.1007/s00520-021-06228-3

4. Elad S, Cheng KKF, Lalla RV, Yarom N, Hong C, Logan RM, et al.. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2020;126(19):4423-31. https://doi.org/10.1002/cncr.33100

5. Faria KM, Gomes-Silva W, Kauark-Fontes E, Bonfim-Alves CG, Kowalski LP, Prado-Ribeiro AC, et al. Impact of pandemic COVID-19 outbreak on oral mucositis preventive and treatment protocols: new perspectives for extraoral photobiomodulation therapy. Support Care Cancer. 2020;28(10):4545-8. https://doi.org/10.1007/s00520-020-05636-1

6. Sobral APT, Sobral SS, Campos TM, Horliana ACRT, Fernandes KPS, Bussadori SK, et al. Photobiomodulation and myofascial temporomandibular disorder: Systematic review and meta-analysis followed by cost-effectiveness analysis. J Clin Exp Dent 2021;13(7):e724-32. https://doi.org/10.4317/jced.58084

7. Aisaiti A, Zhou Y, Wen Y, Zhou W, Wang C, Zhao J, et al. Efect of photobiomodulation therapy on painful temporomandibular disorders. Sci Reports 2021;11(9049):1-12. https://doi.org/10.1038/s41598-021-87265-0

8. Fetai A, Debeljak V, Kovačević Pavičić D, Jokić NI, Vranić DN, Kovač Z, et al. Self-massage and low-level laser in treatment of masseter myalgia: short-term effect. Med Acad Most. 2021;9(1):63-70.

9. Ahmad SA, Hasan S, Saeed S, Khan A, Khan M. Low-level laser therapy in temporomandibular joint disorders: a systematic review. J Med Life 2021;14(2):148-64. https://doi.org/10.25122/jml-2020-0169

10. Kauark-Fontes E, Migliorati CA, Epstein JB, Carroll J, Ramalho LMP, Santos-Silva AR, et al. Twenty-year analysis of photobiomodulation clinical studies for oral mucositis: a scoping review. Oral Surg Oral Med Oral Pathol Oral Radiol 2023;135(5):626-41. https://doi.org/10.1016/j.oooo.2022.12.010

11. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372(71). https://doi.org/10.1136/bmj.n71

12. World Health Organization. WHO handbook for reporting results of cancer treatment. WHO Offset Publication No. 48. Geneva: World Health Organization; 1979.

13. National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Bethesda (MD): U.S. Department of Health and Human Services; 2017.

14. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [Internet]. 2011 [cited 2023 Oct 23]. Available from: http://www.cochrane-handbook. org/

15. Schulz KF, Altman DG, Moher D. CONSORT 2010 state- ment: Updated guidelines for reporting parallel group randomized trials. BMJ. 2010;340:c332. https://doi.org/10.1136/bmj.c332

16. Higgins JPT, Altman DG, SJ, Editors. Chapter 8: Assessing risk of bias in included studies. Cochrane Handb Syst Rev Interv Version 510; 2011.

17. Kauark-Fontes E, Migliorati CA, Joel BE, Treister NS, Alves CGB, Faria KM, et al. Extraoral photobiomodulation for prevention of oral and oropharyngeal mucositis in head and neck cancer patients: interim analysis of a randomized, double blind, clinical trial. Support Care Cancer. 2022;30:2225-36. https://doi.org/10.1007/s00520-021-06625-8

18. Santos CMC, Pimenta CAM, Nobre MRC. A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Rev Latino-Am Enferm. 2007;15(3):1-4. https://doi.org/10.1590/S0104-11692007000300023

19. Dantas JBL, Martins GB, Lima HR, Carrera M, Reis SRA, Medrado ARAP. Evaluation of preventive laser photobiomodulation in patients with head and neck cancer undergoing radiochemotherapy: Laser in patients with head and neck cancer. Spec Care Dentist. 2020;40(4):364-73. https://doi.org/10.1111/scd.12486

20. Martins AFL, Morais MO, Sousa-Neto SS, Jesus APG, Nogueira TE, Valadares MC, et al. Photobiomodulation reduces the impact of radiotherapy on oral health-related quality of life due to mucositis-related symptoms in head and neck cancer patients. Lasers Med Sci. 2021;36(4):903-12. https://doi.org/10.1007/s10103-020-03167-z

21. Adnan A, Yaroslavsky AN, Carroll JD, Selting W, Juliano AF, London WB, et al. The Path to an Evidence-Based Treatment Protocol for Extraoral Photobiomodulation Therapy for the Prevention of Oral Mucositis. Front Oral Health. 2021;16(2):689386. https://doi.org/10.3389/froh.2021.689386

22. Kuhn A, Porto FA, Miraglia P, Brunetto AL. Low-level infrared laser therapy in chemotherapy-induced oral mucositis: a randomized placebo-controlled trial in children. J Pediatr Hematol Oncol. 2009;31(1):33-7. https://doi.org/10.1097/MPH.0b013e318192cb8e

23. Ferrari R, Felizardo AC, Siqueira L, Abreu L, Araújo D, Araujo L, et al. Prophylactic photobiomodulation to reduce oral mucositis in head and neck cancer: an observational study. Support Care Cancer. 2025;33(944). https://doi.org/10.1007/s00520-025-10020-y

24. Robijns J, Nair RG, Lodewijckx J, Arany P, Barasch A, Bjordal JM, et al. Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022. Front Oncol. 2022;12:927685. https://doi.org/10.3389/fonc.2022.927685

25. Soto M, Lalla RV, Gouveia RV, Zecchin VG, Seber A, Lopes NNF. 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. Photomed Laser Surg. 2015;33(11):540-6. https://doi.org/10.1089/pho.2015.3954

26. Costa JDR, Dantas JBL, Martins GB, Carrera M, Reis SRA, Medrado ARAP. Adherence of head and neck cancer patients to laser photobiomodulation in a public health service: Pilot study. Complement Ther Med. 2021;58:102687. https://doi.org/10.1016/j.ctim.2021.102687

Publicado

2026-07-15

Cómo citar

1.
Julião TLD, Brito E de S, Ferreira J de F, Almeida LA da L de, Néri J dos SV, Souza DAS, et al. Use of extraoral photobiomodulation in the management of oral mucositis: systematic literature review. J Oral Diagn [Internet]. 15 de julio de 2026 [citado 9 de octubre de 2026];11. Disponible en: https://joraldiagnosis.com/revista/article/view/447

Número

Sección

Review Article