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Photobiomodulation in oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis followed by a cost-effectiveness analysis

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Abstract

Background

Oral mucositis (OM) is an oral toxicity caused by cancer treatment, found often in patients with head and neck cancer. Low-intensity laser therapy for OM has anti-inflammatory, analgesic, and tissue reparative properties.

Objective

The objective of this work is to perform a systematic review and meta-analysis of the randomized clinical trials of OM laser therapy in patients undergoing treatment for head and neck cancers, followed by a cost-effectiveness analysis of the therapy.

Method

The search terms, mucositis and phototherapy, laser therapy and mucositis, photobiomodulation and mucositis, and low-level laser therapy and mucositis, were used to search the databases of PubMed, Web of Science, and MEDLINE. Randomized clinical trials were divided into two groups: one treated with laser therapy and the other given a placebo. Only 13 studies were included in the systematic review, and 6 studies in the meta-analysis.

Results

The results of the systematic review and meta-analysis show that the laser therapy presented good results in clinical improvement and pain reduction, decreasing the patients’ likelihood of developing OM, with degrees of debilitating lesions, to 64% (RR = 0.36 [95% CI = 0.29–0.44]). The cost-effectiveness analysis revealed an incremental cost of R$ 3687.53 for the laser group, with an incremental effectiveness of 132.2. The incremental cost-effectiveness ratio (ICER) was 27.89, for the severe OM cases that were avoided.

Conclusion

It was concluded, therefore, that photobiomodulation for OM in patients receiving head and neck cancer treatment was clinically effective and cost-effective.

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Authors and Affiliations

  1. Biophotonics Applied to Health Sciences Postgraduate Program, Nove de Julho University (UNINOVE), Rua Vergueiro 235/249, Liberdade, CEP, São Paulo, 01504-001, Brazil

    Thalita Molinos Campos, Carolina Antunes do Prado Tavares Silva, Ana Paula Taboada Sobral, Sergio Sousa Sobral, Maria Fernanda Setúbal Destro Rodrigues, Sandra Kalil Bussadori, Kristianne Porta Santos Fernandes, Raquel Angnelli Mesquita-Ferrari, Anna Carolina Ratto Tempestini Horliana & Lara Jansiski Motta

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  1. Thalita Molinos Campos
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Correspondence to Lara Jansiski Motta.

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Campos, T.M., do Prado Tavares Silva, C.A., Sobral, A.P.T. et al. Photobiomodulation in oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis followed by a cost-effectiveness analysis. Support Care Cancer 28, 5649–5659 (2020). https://doi.org/10.1007/s00520-020-05613-8

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