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A global coalition of researchers and clinicians agreed that light therapy is one of the most effective interventions for the prevention of oral mucositis, painful mouth ulcers resulting from cancer treatment.
New guidelines from the Multinational Cancer Support Association (MASCC) and the International Society of Oral Oncology (ISOO), published July 8 in the journal Supportive care in cancer, presents a significant update of care recommendations for adult cancer patients around the world.
The guidelines recommend photobiomodulation therapy, a form of low-dose light therapy, for the prevention of oral mucositis caused by radiotherapy for head and neck cancer or stem cell transplantation.
"Many cancer patients can now benefit from this treatment," said Praveen Arany, DDS, PhD, co-authored journal correspondent and badistant professor of oral biology at the University of Buffalo School of Dental Medicine.
"The extent of clinical applications for photobiomodulation therapy has been both a boon and a scourge in the field.Anecdotal clinical reports have been tainted with inconsistent results and questionable reasons, often relegating this treatment to pseudoscience. . "
Dr. Arany also said that recent advances have allowed rigorous validation of clinical protocols.
"This is a major milestone for the industry and we are confident that it will pave the way for several interesting clinical applications for photobiomodulation therapy, ranging from concussions and wound healing to new work." exciting on regenerative medicine and stem cells, "said Arany, president of the World Association for Photobiomodulation Therapy (WALT).
Several studies have shown that patients report oral mucositis as the worst side effect of their treatment for cancer. The pain of the disease can slow down or delay cancer treatment and, in severe cases, require hospitalization.
Light therapy has been around for decades, but technological improvements have made treatment more affordable for wider use. At high power, the light, often in the form of a laser, is used in medicine to cut or destroy tissue. But at low power, it has the ability to relieve pain or inflammation and promote healing.
Treatment is increasingly used in Europe, Brazil, India, Canada and several other countries. The results provide an upgrade from previous guidelines published in 2013, which noted the efficacy of light therapy and recommended, based on relatively limited evidence at the time, the intervention as a whole. than optional therapy in specific cancer patient populations and environments.
The journal was led by Zadik Yehuda, DMD, senior lecturer at the Hebrew University-Hadbadah School of Dental Medicine in Jerusalem, Israel; and Sharon Elad, DMD, Chair of the MASCC / ISOO Mucositis Study Group. With 14 other world experts, they examined hundreds of published research papers on the photobiomodulation treatment of oral mucositis.
"These updated guidelines will provide healthcare professionals with better tools for providing care to cancer patients," said Elad, also a professor at the Eastman Institute for Oral Health at the Medical Center of the United States. University of Rochester.
"But even with the best evidence-based interventions, we do not yet have an ultimate guideline for mucositis in all clinical settings, and we look forward to future research to help design a more universal implementation of the disease." photobiomodulation treatment and to identify other effective methods and validated protocols. "
Among the other findings, the researchers identified five new protocols, recommending light therapy for the prevention of oral mucositis in stem cell transplant patients and patients with head and neck cancer receiving radiation therapy with or without chemotherapy. No major short-term side effects of light therapy have been reported.
The therapy could potentially serve as an alternative to opioids, often prescribed to relieve the symptoms of oral mucositis, said Arany.
Light therapy was also the subject of a recent hearing before the Committee on Science, Space and Technology in Washington, DC. The briefing, held in October 2018, invited a panel of international experts to discuss the potential of photobiomodulation to improve opioid addiction care.
Further studies are needed to verify the efficacy of light therapy in the management of oral mucositis in pediatric cancer patients and in adult cancer patients receiving only chemotherapy.
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