Evaluation of high power laser therapy (HPLT) as treatment of chemotherapy-induced oral mucositis in paediatric patients with oncohematological diseases

Background: Oral mucositis (OM) is one of the most debilitating side effects of chemotherapy. Among the current methods used in OM management there is high power laser therapy (HPLT), the efficacy of which has been recently tested. Aim: This study was conducted to evaluate the efficacy of HPLT applied to the treatment of OM in paediatric patients. Design: Fourteen onco-hematological paediatric patients treated with chemotherapy and/or hematopoietic stem cell transplantation and affected by OM at different grades were enrolled in this study. All patients were treated with a class IV laser device in four sessions for four consecutive days; the OM evaluation was carried out with the WHO-OTS scale, while the perception of pain was assessed by visual analogue scale. Photographs and information about the lesions and patient questionnaires were collected. Descriptive analyses and the Wilcoxon signed rank test test (non-parametric test) were used, with a statistical significance of α = 0.05 RESULTS: After a week from the beginning of the treatment, 57% of patients were completely healed, while the whole cohort experienced a drastic decrease in pain, falling from an average value of 5.8 to 1.1 (p = 0.0016). The average number of injuries per patient decreased from 7.4 to 3.1 (p = 0.008). Conclusion: HPLT appears to be a safe and innovative method for the management of OM. It reduces pain and severity of oral cavity injuries. Further studies are needed to determine the optimal parameters useful in OM treatment and to evaluate which methodology, between HPLT and the well-known LLLT protocol, is the most effective.