Marques M.T. et al. - Photobiomodulation for the prevention of oral mucositis in pediatric patients undergoing chemotherapy
This systematic review with meta-analysis included 5 randomized trials evaluating photobiomodulation for the prevention of oral mucositis in children and young adults undergoing chemotherapy for malignant hematologic diseases. The three trials, when statistically combined, show a significant benefit, with p = 0.04 and a 95% confidence interval ranging from 0.01 to 0.84. Photobiomodulation is used here as supportive care, never as a treatment for cancer.
What this study measured
Oral mucositis is one of the most common and debilitating complications in children being treated for malignant hematologic disorders. The research question, formulated using the PICOS framework, is: Does photobiomodulation reduce the incidence and severity of oral mucositis in these children and adolescents undergoing chemotherapy? The authors searched PubMed, Scopus, Web of Science, Embase, and the Cochrane databases, with the search conducted up through February 2025. Only randomized clinical trials were eligible, involving patients aged 0 to 22 years receiving photobiomodulation for preventive purposes. No PROSPERO number is mentioned in the abstract.
Key Findings
The reported data are as follows.
- 5 randomized clinical trials included
- Patients aged 4 months to 22 years
- 97 patients who underwent low-power laser treatment
- 80 patients who received a light-emitting diode
- 3 trials eligible for the meta-analysis
- Significant benefit of photobiomodulation: p = 0.04, 95% CI from 0.01 to 0.84
The included trials consistently report a preventive effect on the onset of oral mucositis and a reduction in its severity. The abstract does not specify either the exact nature of the outcome measure associated with this confidence interval or the radiation parameters for each trial.
How photobiomodulation works for this indication
The proposed mechanism remains hypothetical and is not measured here. Red and near-infrared light are thought to be absorbed by mitochondrial cytochrome c oxidase. This absorption could alter ATP production and oxidative stress in oral mucosal cells exposed to chemotherapy. This would be expected to modulate inflammation and potentially support mucosal healing, which would justify its use before lesions appear. This reasoning explains why this approach is considered supportive care, used to complement treatments rather than replace them.
Limits You Should Know
The number of trials is small: 5 in total, and only 3 could be statistically combined. Sample sizes remain modest, with 97 patients treated with low-power laser and 80 with light-emitting diodes. The reported confidence interval, ranging from 0.01 to 0.84, is wide, indicating limited precision in the estimate. Two light technologies coexist in the included trials, which complicates interpretation. The authors call for larger-scale trials to establish standardized protocols. Finally, the study population is specific, and the results cannot be generalized to other situations.
What This Means in Practice
This study reinforces the value of a preventive strategy in pediatric oncology, specifically in supportive care. The authors present it as a noninvasive intervention that can improve patient comfort and treatment adherence. The lack of a standardized protocol remains the main obstacle to widespread adoption. Implementation is at the discretion of the hospital team caring for the child and does not replace any prescribed cancer treatment.
Frequently Asked Questions
Can photobiomodulation prevent oral mucositis in children undergoing chemotherapy?
This review of five randomized trials supports this conclusion, showing a significant benefit when the three trials were combined in a meta-analysis (p = 0.04). Sample sizes remain limited, and the authors call for larger trials. The decision rests with the hospital team, as part of supportive care.
At what age did research into this approach begin?
The included trials involved patients aged 4 months to 22 years with malignant hematologic diseases who were being treated with chemotherapy. The eligibility criteria covered the age range of 0 to 22 years. No data in the abstract allow for a breakdown of the results by age group.
Laser or light-emitting diode: What's the difference in these tests?
Both technologies were included in the study: 97 patients received low-power laser treatment and 80 received light-emitting diode (LED) therapy. The abstract does not provide a direct comparison between the two, nor does it include detailed irradiation parameters. Therefore, no conclusion can be drawn in favor of one over the other.
Reference
Marques MT, Arêde LT, Rodrigues JVS, Takeshita WM, Garcia VG, de Molon RS, Theodoro LH. Photobiomodulation as a preventive strategy for oral mucositis in pediatric oncology: a systematic review and meta-analysis. Journal of Dentistry, 2025. PMID 40889543. View the study on PubMed
This summary is provided for informational purposes only and does not constitute medical advice. Photobiomodulation is not a substitute for prescribed treatment. Consult a healthcare professional.