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Amelioration of oral mucositis pain by NASA near-infrared light-emitting diodes in bone marrow transplant patients

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Abstract

Purpose

This study seeks to investigate the use of extra-orally applied near-infrared phototherapy for the reduction of oral pain secondary to chemotherapy- and radiation therapy-induced mucositis in adult and pediatric hematopoietic stem cell transplant (HSCT) patients.

Methods

Eighty HSCT patients were divided into regular (R) and low (L) risk groups, then to experimental (E) and placebo (P) groups, resulting in four groups (ER, EL, PR, PL). Experimental subjects received 670 (±10) nm gallium-aluminum-arsinide light-emitting diode device for 80 s at ∼50 mW/cm2 energy density and power exposure of 4 J/cm2. Placebo patients received the same procedures, but with a placebo phototherapy (identical device but <5 mW/cm2 energy density). Patients received their respective light therapy once per day starting on the day of the HSCT (day 0) and continued through day +14. Blinded evaluators examined the patients three times per week and scored their oral tissues and patient-reported pain assessments at each evaluation utilizing the WHO, NCI-CTCAE, and OMAS scales.

Results

Analysis of the mean scores at each observation demonstrate that the extra-oral application of phototherapy resulted in a significant reduction in patient-reported pain between the ER and PR patients (p < 0.05) at day +14 when graded via the WHO criteria. The ER and EL patients were improved in almost all other categories and assessment scales, but the differences were not statistically significant.

Conclusion

Phototherapy demonstrated a significant reduction in patient-reported pain as measured by the WHO criteria in this patient population included in this study. Improvement trends were noted in most other assessment measurements.

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Acknowledgments

This work was supported by the National Aeronautics and Space Administration Grant # NNM05AB48C, the Bleser Foundation Endowed Professorship and Chad Baumann Neurology Research Endowment at the Medical College of Wisconsin, and the Marquette University School of Dentistry Pediatric Faculty Fund. Additionally, we would like to extend our warmest and sincerest appreciation to the nurses at the respective institutions who were instrumental in the completion of this study.

Conflict of interest

There are no conflicts of interest to report.

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Authors and Affiliations

  1. Pediatric Dentistry, Marquette University School of Dentistry, 1801 W. Wisconsin Ave., Rm. 326, Milwaukee, WI, 53233, USA

    Brian D. Hodgson

  2. Clinical Translational Science Institute, Medical College of Wisconsin, Wauwatosa, WI, USA

    Brian D. Hodgson

  3. Pediatric Oncology, Medical College of Wisconsin, 8701 Watertown Plank Road, Wauwatosa, WI, 53226, USA

    David M. Margolis

  4. Blood and Marrow Transplant, Children’s Hospital of Wisconsin, Wauwatosa, WI, USA

    David M. Margolis

  5. Education and Clinical Services BMT Program, University of Alabama at Birmingham, 2000 6th Avenue South, Birmingham, AL, 35233, USA

    Donna E. Salzman

  6. Division of Biostatistics, Medical College of Wisconsin, 8701 Watertown Plank Road, Wauwatosa, WI, 53226, USA

    Dan Eastwood & Sergey Tarima

  7. Bone Marrow Transplantation and Cell Therapy Program, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL, 35249, USA

    Lisa D. Williams

  8. Center for Cancer and Blood Disorders, Division of Blood and Marrow Transplant, Children’s National Medical Center, 111 Michigan Avenue NW, Washington, DC, 20010, USA

    Jane E. Sande

  9. BMT Program, University of Alabama at Birmingham, 2000 6th Avenue South, Birmingham, AL, 35233, USA

    William P. Vaughan

  10. Neurology, Medical College of Wisconsin, 8701 Watertown Plank Road, Wauwatosa, WI, 53226, USA

    Harry T. Whelan

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  1. Brian D. Hodgson
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Correspondence to Brian D. Hodgson.

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Hodgson, B.D., Margolis, D.M., Salzman, D.E. et al. Amelioration of oral mucositis pain by NASA near-infrared light-emitting diodes in bone marrow transplant patients. Support Care Cancer 20, 1405–1415 (2012). https://doi.org/10.1007/s00520-011-1223-8

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