Supportive Care in Cancer

, Volume 19, Issue 8, pp 1069–1077

A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis


    • Centre for Evidence-Based PracticeBergen University College-HiB
  • Rene-Jean Bensadoun
    • Service d’Oncologie Radiothérapique
  • Jan Tunèr
    • Grängesberg Dental Clinic
  • Lucio Frigo
    • University of Cruzeiro do Sul
  • Kjersti Gjerde
    • Department of Clinical OdontologyUniversity of Bergen
  • Rodrigo AB Lopes-Martins
    • Institute of Biomedical SciencesUniversity of São Paulo (USP)
    • Centro de Pesquisa Clínica em Biofotônica Aplicada às Ciências da SaúdeUniversidade Nove de Julho
Review Article

DOI: 10.1007/s00520-011-1202-0

Cite this article as:
Bjordal, J.M., Bensadoun, R., Tunèr, J. et al. Support Care Cancer (2011) 19: 1069. doi:10.1007/s00520-011-1202-0



The purpose of this study is to review the effects of low-level laser therapy (LLLT) in the prevention and treatment of cancer therapy-induced oral mucositis (OM).


A systematic review and meta-analysis of randomised placebo-controlled trials of LLLT performed during chemotherapy or radiation therapy in head and neck cancer patients.


We found 11 randomised placebo-controlled trials with a total of 415 patients; methodological quality was acceptable at 4.10 (SD ± 0.74) on the 5-point Jadad scale. The relative risk (RR) for developing OM was significantly (p = 0.02) reduced after LLLT compared with placebo LLLT (RR = 2.03 (95% CI, 1.11 to 3.69)). This preventive effect of LLLT improved to RR = 2.72 (95% CI, 1.98 to 3.74) when only trials with adequate doses above 1 J were included. For treatment of OM ulcers, the number of days with OM grade 2 or worse was significantly reduced after LLLT to 4.38 (95% CI, 3.35 to 5.40) days less than placebo LLLT. Oral mucositis severity was also reduced after LLLT with a standardised mean difference of 1.33 (95% CI, 0.68 to 1.98) over placebo LLLT. All studies registered possible side-effects, but they were not significantly different from placebo LLLT.


There is consistent evidence from small high-quality studies that red and infrared LLLT can partly prevent development of cancer therapy-induced OM. LLLT also significantly reduced pain, severity and duration of symptoms in patients with cancer therapy-induced OM.


Low-level laser therapyOral mucositisCancerChemotherapyRadiation therapy

Copyright information

© Springer-Verlag 2011