Efficacy of extraoral photobiomodulation therapy in the management of oral mucositis in pediatric oncology patients: a preliminary study

Abstract

Objective

To compare the efficacy of intraoral (IOPBM) and extraoral photobiomodulation (EOPBM) protocols in the management of oral mucositis (OM) in pediatric patients.

Methods

This is a randomized, blinded clinical trial. Ten pediatric oncology patients were included and randomized into 2 groups: the IOPBM group (n = 5) received intraoral PBM using low-level laser, and the EOPBM group (n = 5) received extraoral PBM using defocused high-power laser. PBM therapy was administered to all patients, with a mean follow-up period of 8.8 days. Patients were evaluated daily, and OM was classified according to the World Health Organization and National Cancer Institute (NCI) scales. Additionally, oral pain, functional scores (chewing, dysphagia, fluid intake, and dysgeusia), and comfort with the procedure were assessed.

Results

Eight boys and 2 girls were included, with an average age of 8.4 years. Diagnoses included 50% acute lymphoblastic leukemia, 30% lymphomas, and 20% osteosarcoma. OM was classified by World Health Organization as grade 0 (10%), 1 (30%), 2 (50%), and 3 (10%). No patient experienced grade 4 OM. The mean duration of grade 2 OM was 2.2 days, and grade 3 was 1 day. No differences were observed between groups regarding OM grades, duration of OM, functional score, and comfort. Pain scores were similar between groups on days 3, 10, and 14. On Day 7, EOPBM exhibited a pain score of 2.2, which was higher than IOPBM (P = .018).

Conclusion

EOPBM could be considered as effective as IOPBM in the prevention and treatment of OM in pediatric oncology patients.