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Clinical use of photobiomodulation for the prevention and treatment of oral mucositis: the real-life experience of MASCC/ISOO members

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Abstract

Aim

To assess clinical use and patient outcome of photobiomodulation (PBM) for oral mucositis (OM) prevention and treatment among specialized practitioners.

Methods

A poll was emailed to the members of the Mucositis Study Group of MASCC/ISOO. The PBM parameters used by the respondents were analyzed using exploratory statistical methods to identify combinations of PBM parameters (patterns) that characterize the variance in the protocols (principal component analysis).

Results

Responses were received from 101 MSG members, with 78 providing analyzable data. Most of the responders were dental practitioners or oral medicine specialists. PBM was used by 59% of the responders for OM or targeted therapy stomatitis. Technical parameters varied widely. Most responders used wavelengths ∼650 nm intra-orally. The spot-size and distance from the tissue were the main factors driving the variation. All PBM users noted that PBM relieved pain, either immediately or a delayed effect. High likelihood of pain relief (measured as responder’s report of pain relief in 67–100% of patients) was reported by 22% and 19% of PBM users for immediate pain relief and delayed pain relief, respectively. The most common reported barriers to using PBM were financial considerations, time constraints, lack of training or experience and concern about the potential for malignant transformation or increased risk of cancer recurrence.

Conclusions

The use of PBM for OM prevention or treatment is in early phases of adoption in practices, facing some obstacles to implement it. A wide variation in technical parameters was found. Nonetheless, responses indicate that PBM provided pain relief.

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Acknowledgements

The authors are grateful Praveen Arany, DDS, PhD, Eduardo Fregnani, DDS, PhD and Alessandra Majorana, DMD, MS, PhD for their helpful advice. This endeavor would not have been possible without MASCC/ISOO and its Mucositis Study Group, who continually strive to improve the supportive care of people with cancer. The authors thank MASCC/ISOO executive teams for their continuous support, and to the MASCC administrators for distributing the survey. Likewise, the authors thank for the members of the Mucositis Study Group of MASCC/ISOO for participating in this survey.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel

    Ragda Abdalla-Aslan

  2. Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel

    Ragda Abdalla-Aslan & Yehuda Zadik

  3. Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    Yehuda Zadik

  4. Department of Public Health Sciences, University of Rochester, Rochester, NY, USA

    Orna Intrator

  5. Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, School of Dentistry, University of Brescia, Brescia, Italy

    Elena Bardellini

  6. Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyō, Japan

    Karis Kin Fong Cheng

  7. Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST-Spedali Civili, Brescia, Italy

    Paolo Bossi

  8. Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Israel

    Noam Yarom

  9. School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel

    Noam Yarom

  10. Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA

    Sharon Elad

Authors
  1. Ragda Abdalla-Aslan
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  2. Yehuda Zadik
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  3. Orna Intrator
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  4. Elena Bardellini
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  5. Karis Kin Fong Cheng
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  6. Paolo Bossi
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  7. Noam Yarom
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  8. Sharon Elad
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Contributions

Ragda Abdalla-Aslan, Yehuda Zadik and Sharon Elad created the concept and composed the content of the poll, with feedback from all the coauthors. Sharon Elad coordinated the distribution of the survey. Noam Yarom managed the logistics of the electronic survey platform. Yehuda Zadik managed the IRB application. Orna Intrator conducted the statistical analysis. Sharon Elad and Ragda Abdalla-Aslan wrote the main manuscript. Elena Bardellini initiated and drafted the manuscript’s part about the pediatric patient population. All the coauthors reviewed and approved the manuscript.

Corresponding author

Correspondence to Sharon Elad.

Ethics declarations

Ethics approval

This study was approved by the Institute Review Board of the Faculty of Medicine, at the Hebrew University, Jerusalem, Israel (#25052021). ). This study was carried out in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Consent to participate

Informed consent was obtained from all individuals participating in the study by agreeing to fill in the survey.

Consent for publication

There is no personal data published in this study. However, all participants were informed that their deidentified data may be published for scientific purposes.

Conflict of interest

Yehuda Zadik reports personal fees for lectures, and equipment receipt, from Erika Carmel Ltd, outside the submitted work. Paolo Bossi reports consultation fees from Angelini. The remaining authors have no relevant financial or non-financial interests to disclose.

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Abdalla-Aslan, R., Zadik, Y., Intrator, O. et al. Clinical use of photobiomodulation for the prevention and treatment of oral mucositis: the real-life experience of MASCC/ISOO members. Support Care Cancer 31, 481 (2023). https://doi.org/10.1007/s00520-023-07919-9

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