Low level laser therapy against radiation induced oral mucositis in elderly head and neck cancer patients-a randomized placebo controlled trial

Ajay Prashad Gautam, Donald J. Fernandes, Mamidipudi S. Vidyasagar, Arun G. Maiya, Vausudev Guddattu

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Abstract

Objectives Radiotherapy (RT) is treatment of choice for Elderly Head and Neck Cancer (HNC) patients. Oral mucositis (OM) during RT affects patient's routine oral activities and overall health. Low Level Laser Therapy (LLLT) provided some promising results against cancer therapy induced OM in children and adults. No study specifically evaluated effects of LLLT against RT induced OM in elderly HNC patients until date, hence we did this study. Material and methods This double blinded study randomized 46 elderly HNC patients scheduled for RT [Dosage = 66 Gray (2 Gy/fraction), 5 fractions/week, total 33 fractions for 6.5 weeks], into laser (22) and placebo (24) groups. Laser group patients received LLLT [Helium-Neon, λ = 632.8 nm, power density = 0.024 W/cm2, dosage = 3.0 J/point at six anatomical sites bilaterally i.e. 12 locations, total dose/session = 36 J, beam aperture diameter = 0.6 mm, beam spot size = 1 cm2, irradiated area diameter = 1 cm2, irradiation time/point = 125 s, 5 sessions/week, non-contact method-distance between probe and irradiated tissues <1 cm, whereas placebo group did not receive laser. OM grades (RTOG/EORTC Scale), oral pain, weight loss, need for morphine analgesics and tube feeding, and RT break were recorded by a blinded assessor. Descriptive statistics and repeated measures ANOVA were used for analysis keeping p < 0.05. Results Significant reduction in the incidence and duration of severe OM (p = 0.016) and severe pain (p = 0.023) and weight loss (p = 0.004) was observed in laser than placebo group. No difference was found for enteral feeding use (p = 0.667) between two groups. Conclusions LLLT decreased the severity of OM and oral pain in elderly HNC patients. Also, lesser weight loss, morphine analgesic use and radiation break happened in laser group.

Original languageEnglish
Pages (from-to)51-56
Number of pages6
JournalJournal of Photochemistry and Photobiology B: Biology
Volume144
DOIs
Publication statusPublished - 2015

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Stomatitis
Head and Neck Neoplasms
radiation therapy
Randomized Controlled Trials
cancer
Placebos
Radiation
Lasers
Radiotherapy
therapy
lasers
Weight Loss
pain
Enteral Nutrition
morphine
Pain
Morphine
Analgesics
Radiotherapy Dosage
Neon

All Science Journal Classification (ASJC) codes

  • Radiation
  • Radiological and Ultrasound Technology
  • Biophysics
  • Radiology Nuclear Medicine and imaging

Cite this

@article{ae1b8c15351243c9ade005fee5e3223e,
title = "Low level laser therapy against radiation induced oral mucositis in elderly head and neck cancer patients-a randomized placebo controlled trial",
abstract = "Objectives Radiotherapy (RT) is treatment of choice for Elderly Head and Neck Cancer (HNC) patients. Oral mucositis (OM) during RT affects patient's routine oral activities and overall health. Low Level Laser Therapy (LLLT) provided some promising results against cancer therapy induced OM in children and adults. No study specifically evaluated effects of LLLT against RT induced OM in elderly HNC patients until date, hence we did this study. Material and methods This double blinded study randomized 46 elderly HNC patients scheduled for RT [Dosage = 66 Gray (2 Gy/fraction), 5 fractions/week, total 33 fractions for 6.5 weeks], into laser (22) and placebo (24) groups. Laser group patients received LLLT [Helium-Neon, λ = 632.8 nm, power density = 0.024 W/cm2, dosage = 3.0 J/point at six anatomical sites bilaterally i.e. 12 locations, total dose/session = 36 J, beam aperture diameter = 0.6 mm, beam spot size = 1 cm2, irradiated area diameter = 1 cm2, irradiation time/point = 125 s, 5 sessions/week, non-contact method-distance between probe and irradiated tissues <1 cm, whereas placebo group did not receive laser. OM grades (RTOG/EORTC Scale), oral pain, weight loss, need for morphine analgesics and tube feeding, and RT break were recorded by a blinded assessor. Descriptive statistics and repeated measures ANOVA were used for analysis keeping p < 0.05. Results Significant reduction in the incidence and duration of severe OM (p = 0.016) and severe pain (p = 0.023) and weight loss (p = 0.004) was observed in laser than placebo group. No difference was found for enteral feeding use (p = 0.667) between two groups. Conclusions LLLT decreased the severity of OM and oral pain in elderly HNC patients. Also, lesser weight loss, morphine analgesic use and radiation break happened in laser group.",
author = "Gautam, {Ajay Prashad} and Fernandes, {Donald J.} and Vidyasagar, {Mamidipudi S.} and Maiya, {Arun G.} and Vausudev Guddattu",
year = "2015",
doi = "10.1016/j.jphotobiol.2015.01.011",
language = "English",
volume = "144",
pages = "51--56",
journal = "Journal of Photochemistry and Photobiology B: Biology",
issn = "1011-1344",
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T1 - Low level laser therapy against radiation induced oral mucositis in elderly head and neck cancer patients-a randomized placebo controlled trial

AU - Gautam, Ajay Prashad

AU - Fernandes, Donald J.

AU - Vidyasagar, Mamidipudi S.

AU - Maiya, Arun G.

AU - Guddattu, Vausudev

PY - 2015

Y1 - 2015

N2 - Objectives Radiotherapy (RT) is treatment of choice for Elderly Head and Neck Cancer (HNC) patients. Oral mucositis (OM) during RT affects patient's routine oral activities and overall health. Low Level Laser Therapy (LLLT) provided some promising results against cancer therapy induced OM in children and adults. No study specifically evaluated effects of LLLT against RT induced OM in elderly HNC patients until date, hence we did this study. Material and methods This double blinded study randomized 46 elderly HNC patients scheduled for RT [Dosage = 66 Gray (2 Gy/fraction), 5 fractions/week, total 33 fractions for 6.5 weeks], into laser (22) and placebo (24) groups. Laser group patients received LLLT [Helium-Neon, λ = 632.8 nm, power density = 0.024 W/cm2, dosage = 3.0 J/point at six anatomical sites bilaterally i.e. 12 locations, total dose/session = 36 J, beam aperture diameter = 0.6 mm, beam spot size = 1 cm2, irradiated area diameter = 1 cm2, irradiation time/point = 125 s, 5 sessions/week, non-contact method-distance between probe and irradiated tissues <1 cm, whereas placebo group did not receive laser. OM grades (RTOG/EORTC Scale), oral pain, weight loss, need for morphine analgesics and tube feeding, and RT break were recorded by a blinded assessor. Descriptive statistics and repeated measures ANOVA were used for analysis keeping p < 0.05. Results Significant reduction in the incidence and duration of severe OM (p = 0.016) and severe pain (p = 0.023) and weight loss (p = 0.004) was observed in laser than placebo group. No difference was found for enteral feeding use (p = 0.667) between two groups. Conclusions LLLT decreased the severity of OM and oral pain in elderly HNC patients. Also, lesser weight loss, morphine analgesic use and radiation break happened in laser group.

AB - Objectives Radiotherapy (RT) is treatment of choice for Elderly Head and Neck Cancer (HNC) patients. Oral mucositis (OM) during RT affects patient's routine oral activities and overall health. Low Level Laser Therapy (LLLT) provided some promising results against cancer therapy induced OM in children and adults. No study specifically evaluated effects of LLLT against RT induced OM in elderly HNC patients until date, hence we did this study. Material and methods This double blinded study randomized 46 elderly HNC patients scheduled for RT [Dosage = 66 Gray (2 Gy/fraction), 5 fractions/week, total 33 fractions for 6.5 weeks], into laser (22) and placebo (24) groups. Laser group patients received LLLT [Helium-Neon, λ = 632.8 nm, power density = 0.024 W/cm2, dosage = 3.0 J/point at six anatomical sites bilaterally i.e. 12 locations, total dose/session = 36 J, beam aperture diameter = 0.6 mm, beam spot size = 1 cm2, irradiated area diameter = 1 cm2, irradiation time/point = 125 s, 5 sessions/week, non-contact method-distance between probe and irradiated tissues <1 cm, whereas placebo group did not receive laser. OM grades (RTOG/EORTC Scale), oral pain, weight loss, need for morphine analgesics and tube feeding, and RT break were recorded by a blinded assessor. Descriptive statistics and repeated measures ANOVA were used for analysis keeping p < 0.05. Results Significant reduction in the incidence and duration of severe OM (p = 0.016) and severe pain (p = 0.023) and weight loss (p = 0.004) was observed in laser than placebo group. No difference was found for enteral feeding use (p = 0.667) between two groups. Conclusions LLLT decreased the severity of OM and oral pain in elderly HNC patients. Also, lesser weight loss, morphine analgesic use and radiation break happened in laser group.

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