Cruz A.R. et al. - Photobiomodulation in the Treatment of Oral Mucositis: A Systematic Review and Meta-Analysis

This systematic review with meta-analysis included 6 studies and 299 patients to evaluate photobiomodulation in the management of oral mucositis occurring during antineoplastic therapy. A reduction in the severity of mucositis was more common in the photobiomodulation group than in the control group; however, the duration of the lesions and pain could not be statistically combined. Photobiomodulation is used here as supportive care, never as a treatment for cancer.

What this study measured

The study examined the effectiveness of photobiomodulation in treating oral mucositis, a painful inflammation of the oral mucosa that commonly occurs during chemotherapy or radiation therapy. The authors searched the LILACS, MEDLINE, EMBASE, COCHRANE, SCOPUS, Web of Science, and CINAHL databases, as well as the clinicaltrials.gov registry. Randomized, non-randomized, and observational studies were eligible. Three outcome measures were considered: the severity of mucositis, the duration of lesions, and pain. Patients were assigned to either a group receiving photobiomodulation—alone or in combination with other treatments—or a control group. Analyses were conducted using Review Manager 5.4 software. No PROSPERO number is mentioned in the abstract.

Key Findings

The selection process and results can be summarized as follows.

• 316 studies identified: 297 in electronic databases, 19 on clinicaltrials.gov
• 260 studies reviewed by title and abstract after removing duplicates; 223 excluded
• 37 studies reviewed in full text; 6 were ultimately included
• A total of 299 patients in the included studies
• Severity of oral mucositis: more likely to be reduced in the photobiomodulation group than in the control group
• Duration of lesions and pain reduction: meta-analysis not possible due to high heterogeneity among studies

The summary provides neither odds ratios, confidence intervals, nor p-values. No numerical data are available for pain or the duration of the injuries.

How photobiomodulation works for this indication

The proposed mechanism remains hypothetical and has not been tested here. Red and near-infrared light is thought to be absorbed by mitochondrial cytochrome c oxidase. This absorption could alter ATP production and the balance of oxidative stress in oral mucosal cells. This is expected to modulate the inflammatory response and potentially support mucosal healing—two key stages in the progression of mucositis. These hypotheses would explain the value of this approach as supportive care, that is, as a complement to cancer treatments rather than a substitute for them.

Limits You Should Know

Only six studies, involving 299 patients: the sample size remains small. Two of the three criteria—duration of lesions and pain—could not be included in a meta-analysis due to high heterogeneity. This is a negative result in its own right, which severely limits the scope of the review. Not all of the included studies were randomized, and the intervention could have been combined with other treatments, making it difficult to isolate the specific effect of light therapy. The summary does not specify the wavelengths, doses, or frequency of sessions.

What This Means in Practice

This review points to a focus on the severity of oral mucositis, without quantifying the benefit or reaching a definitive conclusion regarding pain and the duration of the lesions. Oral mucositis is managed in the hospital as part of the cancer care pathway. Any use of photobiomodulation must be decided upon and supervised by the healthcare team as part of supportive care. It is not a substitute for any prescribed anticancer treatment.

Frequently Asked Questions

Does photobiomodulation help treat oral mucositis caused by chemotherapy?

In this review of 6 studies involving 299 patients, a reduction in severity was more common in the photobiomodulation group. However, the abstract does not provide any specific figures. This is a supportive care measure, determined by the healthcare team.

Does photobiomodulation reduce the pain of oral mucositis?

This issue could not be resolved. Pain and the duration of lesions were among the criteria considered, but the heterogeneity among the studies was too great to allow for a meta-analysis. Therefore, no data are available on these two points.

Does photobiomodulation affect the cancer itself?

No. In this context, photobiomodulation is studied solely as a supportive treatment—that is, to mitigate an adverse effect of other treatments. It does not treat the cancer itself and is not a substitute for chemotherapy, radiation therapy, or surgery.

Reference

Cruz AR, Minicucci EM, Betini M, Almeida-Lopes L, Tieghi Neto V, Cataneo AJM. Efficacy of photobiomodulation in the treatment of oral mucositis in patients undergoing antineoplastic therapy: systematic review and meta-analysis. Supportive Care in Cancer, 2023. PMID 37853254. 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.