A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis

被引:168
作者
Bjordal, Jan Magnus [1 ]
Bensadoun, Rene-Jean [2 ]
Tuner, Jan [3 ]
Frigo, Lucio [4 ]
Gjerde, Kjersti [5 ]
Lopes-Martins, Rodrigo A. B. [6 ]
机构
[1] Univ Bergen, Coll HiB, Ctr Evidence Based Practice, N-5009 Bergen, Norway
[2] CHU Poitiers, Serv Oncol Radiotherap, F-86021 Poitiers, France
[3] Grangesberg Dent Clin, Grangesberg, Sweden
[4] Univ Cruzeiro Sul, Sao Miguel Paulista, SP, Brazil
[5] Univ Bergen, Dept Clin Odontol, Bergen, Norway
[6] Univ Sao Paulo, Inst Biomed Sci, Sao Paulo, Brazil
关键词
Low-level laser therapy; Oral mucositis; Cancer; Chemotherapy; Radiation therapy; LOW-ENERGY LASER; RADIATION-INDUCED MUCOSITIS; HE-NE-LASER; CLINICAL-TRIALS; PREVENTION; RADIOTHERAPY; QUALITY; IMPACT; PAIN; TRANSPLANT;
D O I
10.1007/s00520-011-1202-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose The purpose of this study is to review the effects of low-level laser therapy (LLLT) in the prevention and treatment of cancer therapy-induced oral mucositis (OM). Methods A systematic review and meta-analysis of randomised placebo-controlled trials of LLLT performed during chemotherapy or radiation therapy in head and neck cancer patients. Results We found 11 randomised placebo-controlled trials with a total of 415 patients; methodological quality was acceptable at 4.10 (SD +/- 0.74) on the 5-point Jadad scale. The relative risk (RR) for developing OM was significantly (p= 0.02) reduced after LLLT compared with placebo LLLT (RR= 2.03 (95% CI, 1.11 to 3.69)). This preventive effect of LLLT improved to RR=2.72 (95% CI, 1.98 to 3.74) when only trials with adequate doses above 1 J were included. For treatment of OM ulcers, the number of days with OM grade 2 or worse was significantly reduced after LLLT to 4.38 (95% CI, 3.35 to 5.40) days less than placebo LLLT. Oral mucositis severity was also reduced after LLLT with a standardised mean difference of 1.33 (95% CI, 0.68 to 1.98) over placebo LLLT. All studies registered possible side-effects, but they were not significantly different from placebo LLLT. Conclusions There is consistent evidence from small high-quality studies that red and infrared LLLT can partly prevent development of cancer therapy-induced OM. LLLT also significantly reduced pain, severity and duration of symptoms in patients with cancer therapy-induced OM.
引用
收藏
页码:1069 / 1077
页数:9
相关论文
共 39 条
[1]   Anti-inflammatory effects of low-level laser therapy (LLLT) with two different red wavelengths (660 nm and 684 nm) in carrageenan-induced rat paw edema [J].
Albertini, R. ;
Villaverde, A. B. ;
Aimbire, F. ;
Salgado, M. A. C. ;
Bjordal, J. M. ;
Alves, L. P. ;
Munin, E. ;
Costa, M. S. .
JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY, 2007, 89 (01) :50-55
[2]  
Antunes HS, 2008, MED ORAL PATOL ORAL, V13, pE189
[3]   Low-energy He Ne laser in the prevention of radiation-induced mucositis - A multicenter phase III randomized study in patients with head and neck cancer [J].
Bensadoun, RJ ;
Franquin, JC ;
Ciais, G ;
Darcourt, V ;
Schubert, MM ;
Viot, M ;
Dejou, J ;
Tardieu, C ;
Benezery, K ;
Nguyen, TD ;
Laudoyer, Y ;
Dassonville, O ;
Poissonnet, G ;
Vallicioni, J ;
Thyss, A ;
Hamdi, M ;
Chauvel, P ;
Demard, F .
SUPPORTIVE CARE IN CANCER, 1999, 7 (04) :244-252
[4]   Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials [J].
Bjordal, Jan M. ;
Johnson, Mark I. ;
AB Lopes-Martins, Rodrigo ;
Bogen, Bard ;
Chow, Roberta ;
Ljunggren, Anne E. .
BMC MUSCULOSKELETAL DISORDERS, 2007, 8 (1)
[5]   A systematic review with procedural assessments and meta-analysis of Low Level Laser Therapy in lateral elbow tendinopathy (tennis elbow) [J].
Bjordal, Jan M. ;
Lopes-Martins, Rodrigo A. B. ;
Joensen, Jon ;
Couppe, Christian ;
Ljunggren, Anne E. ;
Stergioulas, Apostolos ;
Johnson, Mark I. .
BMC MUSCULOSKELETAL DISORDERS, 2008, 9 (1)
[6]   Photoradiation in acute pain: A systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials [J].
Bjordal, Jan Magnus ;
Johnson, Mark I. ;
Iversen, Vegard ;
Aimbire, Flavio ;
Lopes-Martins, Rodrigo Alvaro Brandao .
PHOTOMEDICINE AND LASER SURGERY, 2006, 24 (02) :158-168
[7]   Low level laser therapy (classes I, II and III) for treating rheumatoid arthritis [J].
Brosseau, L. ;
Robinson, V ;
Wells, G. ;
deBie, R. ;
Gam, A. ;
Harman, K. ;
Morin, M. ;
Shea, B. ;
Tugwell, P. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2005, (04)
[8]  
CHOR A, 2010, EUR J HAEMATOL, V4, P78
[9]   Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials [J].
Chow, Roberta T. ;
Johnson, Mark I. ;
Lopes-Martins, Rodrigo A. B. ;
Bjordal, Jan M. .
LANCET, 2009, 374 (9705) :1897-1908
[10]  
Clarkson JE, 2010, COCHRANE DB SYST REV, V8