Mucositis, an acute but unpleasant oral sequelae of chemotherapy and radiation therapy to the head and neck, is extremely common. There are several proposed treatment modalities for mucositis, but most of the treatments deal with palliative care of the sores. What about treatments to help potentially prevent mucositis? For several years, in Europe and South America, low level LASER therapy (LLLT) has been administered to prophylactically prevent mucositis.
How does it work?
Interestingly, the concept behind low level LASER therapy was actually first postulated by Albert Einstein. Nonetheless, hungarian surgeon Endre Mester in 1967 was the first healthcare professional to use LASER therapy to treat wounds. The idea behind low level LASER therapy is that it works through biostimulation to prevent mucositis at the cellular level. Basically, the LASER directly affects the cell's energy powerhouses known as the mitochondria. The energy transmitted to the mitochondria is then transformed altering the production of ATP and inflammatory mediators.
How is it administered?
After radiation therapy, patients receive low level LASER therapy for a total session of five to ten minutes.
Often called 'cold laser therapy,' low level LASER therapy does not generate heat during the administration.
What does it do?
Low level LASER therapy is associated with reducing the development of oral mucositis along with the pain and duration of mucositis. Additionally, there are some limited studies that suggest that low level laser therapy may be implicated in treating osteonecrosis of the jaw.
This sounds amazing...is there a catch?
Although low level LASER therapy is recommended by MASCC/ISOO, it does not work for every patient. Nonetheless, low level LASER therapy may be a treatment consideration to prophylactically prevent oral mucositis in patients undergoing head and neck radiation therapy as well as those who are about to undergo a stem cell transplant.
Lalla, Rajesh, Joanne Bowen, Andrei Barasch, Linda Elting, Joel Epstein, Dorothy Keefe, Deborah McGuire, Cesar Migliorati, Ourania Nicolatou-Galitis, Douglas Peterson, Judith Raber-Durlacher, Stephen Sonis, and Sharon Elad. "MASCC/ISOO Clinical Practice Guidelines for the Management of Mucositis Secondary to Cancer Therapy." SpringerReference (2011): n. pag. Web. <http://www.mascc.org/assets/Guidelines-Tools/mascc%20isoo%20mucositis%20guidelines%20paper%206jun2014.pdf>.