Comparable efficacy of extraoral and intraoral photobiomodulation in preventing oral mucositis during high-dose methotrexate therapy in pediatric oncology: A single-blind randomized controlled trial.
Isabela de Oliveira Plugge Freitas, Isabela Schuartz, Giovanna Leal Klein Renz et al.
✦ AI-curated · Sources linked
In 30 seconds
This single-blind randomized controlled trial compared intraoral (IO) with extraoral (EO) photobiomodulation (PBM) to prevent oral mucositis in 155 children and adolescents receiving high-dose methotrexate for leukemia, lymphoma, or osteosarcoma. Overall, mucositis occurred in 35.5% of participants, with no statistically significant difference between IO and EO PBM (41.1% vs 30.5%; p = 0.168). The groups also showed no significant differences in mucositis severity, pain, salivary pH, or plaque index. EO PBM required 30 s/session, compared with approximately 6 min for IO PBM.
Key findings
- Oral mucositis occurred in 41.1% with IO PBM and 30.5% with EO PBM (p = 0.168).
- No significant between-group differences were found in mucositis severity, pain, salivary pH, or plaque index.
- Median pain scores were 0 at every assessment point in both groups.
- Increasing age (OR = 1.14; 95% CI: 1.04-1.25; p = 0.004) and higher HDMTX dose (OR = 1.24; 95% CI: 1.03-1.49; p = 0.021) were associated with greater mucositis severity.
Why it matters
Preventive PBM is used in a setting where oral mucositis can be a treatment-related concern. In this trial, EO and IO approaches had similar measured outcomes, while EO application took substantially less time. This comparison may help inform evaluation of PBM delivery options, although the findings apply to the studied pediatric population receiving high-dose methotrexate.
What to keep in mind
The trial compared two PBM modalities and does not establish their effectiveness against no PBM; follow-up assessments were limited to days 0, 3, 5, and 10 after infusion.