Lavaee F. et al. - Photobiomodulation for the prevention and treatment of oral mucositis in children with hematologic cancers

Share this article:

In a clinical trial conducted among children being treated for hematologic cancer, photobiomodulation used as a preventive measure reduced the incidence of methotrexate-induced oral mucositis from 66.67% to 6.67%. Photobiomodulation is used in this study as supportive care for the adverse effects of chemotherapy—never as a treatment for cancer—and the section addressing existing lesions was based on a different protocol.

What this study measured

This is a two-arm clinical trial published in BMC Cancer in 2025, involving pediatric patients undergoing chemotherapy for hematologic cancer. Oral mucositis is a debilitating complication that affects the majority of children undergoing chemotherapy.

In the prevention arm, patients were first assigned to a control group without laser treatment and then reassigned to the photobiomodulation group in the following cycle. This design allows for an intra-patient comparison under similar chemotherapy regimens. In the treatment arm, patients diagnosed with mucositis were randomly assigned to either a control group receiving a sham laser or a photodynamic therapy group combining indocyanine green and a low-power laser. The outcome measures were the incidence of mucositis and the WHO, NCI, and WCCNR scores. The trial is registered under number IRCT20120101008585N16.

Key Findings

The authors report the following data, as published in the article's abstract.

Bras prévention : incidence de la mucite orale de 66,67 % sans photobiomodulation contre 6,67 % avec photobiomodulation (p < 0,05).
Bras traitement : baisse significative des scores OMS, NCI et WCCNR à 3 jours et à 5 jours après le début du traitement dans le groupe thérapie photodynamique par rapport au groupe contrôle (p < 0,05).
Baisse du score NCI entre le troisième et le cinquième jour plus marquée dans le groupe thérapie photodynamique que dans le groupe contrôle (p < 0,05).
No confidence intervals or adjusted effect sizes are reported in the published summary.

How photobiomodulation works for this indication

Photobiomodulation involves applying low-intensity light to tissues without causing a thermal effect. In this trial, it is used prophylactically—that is, before lesions appear—during cycles of methotrexate chemotherapy.

It is essential to make a distinction when reading this study: the prevention arm evaluates photobiomodulation alone, while the treatment arm evaluates photodynamic therapy, which involves the addition of a photosensitizing agent, indocyanine green. These are two distinct approaches, and the results from one cannot be applied to the other.

Limits You Should Know

The prevention arm is not randomized: the comparison is sequential and within-patient, which exposes it to an order effect between cycles. The abstract provides neither a confidence interval nor an adjusted analysis.

The section on established mucositis does not test photobiomodulation alone but rather photodynamic therapy; therefore, this study does not provide direct evidence in favor of photobiomodulation for established mucositis. Furthermore, the study focuses on a single agent, methotrexate. Existing international guidelines remain cautious regarding chemotherapy-induced mucositis.

What This Means in Practice

This study provides encouraging evidence for the preventive use of photobiomodulation in children with hematologic malignancies, although this finding requires confirmation through larger randomized trials. Photobiomodulation is considered a supportive care measure: it targets the adverse effects of cancer treatment and is not a substitute for chemotherapy or oral health care. The parameters for its application are determined by medical decision-making within the oncology team.

Frequently Asked Questions

Does photobiomodulation treat cancer?

No. In this study, photobiomodulation is an adjunctive therapy: it targets an adverse effect of the treatment, oral mucositis. It has no documented effect on the tumor and does not replace any prescribed treatment.

Can photobiomodulation be used to treat mucositis in children?

This trial involved pediatric patients being treated for hematologic cancer and reports a preventive benefit in this setting. The abstract does not specify a minimum age. The decision is left to the pediatric oncology team, which determines the protocols for implementation.

Should treatment begin before or after oral lesions appear?

In this study, the most clear-cut result concerns preventive use, initiated before lesions appear. The part of the study focusing on existing lesions was based on photodynamic therapy, a different protocol.

Reference

Lavaee F, Rezazadeh F, Amanati A, Sookhakian A, Amiri MA, Dehghani N, Fereidouni K. Efficacy of photobiomodulation for the prevention and treatment of chemotherapy-induced oral mucositis in pediatric patients with hematologic cancers: a randomized clinical trial. BMC Cancer, 2025. PMID 40316940. https://pubmed.ncbi.nlm.nih.gov/40316940/

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.