Prophylactic photobiomodulation to reduce oral mucositis in head and neck cancer: an observational study.

Abstract

Purpose: Oral mucositis (OM) is a common side effect of radiotherapy (RT) and chemoradiotherapy (CRT) in patients with head and neck cancer (HNC). This study investigates the impact of prophylactic photobiomodulation (PBM) on OM incidence in patients with HNC undergoing RT or CRT.

Methods: This single-arm, observational study was conducted across multiple cancer centers in Brazil. Baseline assessments included clinical and radiographic dental evaluations, nutritional risk assessment via the Patient-Generated Subjective Global Assessment (PG-SGA), and HPV status determination. All patients received daily prophylactic PBM during RT. OM incidence and severity were assessed daily by a stomatologist using the Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Descriptive statistics summarized patient characteristics, and logistic regression identified potential predictors of severe OM (grade 3+).

Results: A total of 118 patients with HNC were recruited. The cumulative incidence of OM of any grade was 65.2% (95% CI 60.0-70.4%), with severe OM (Grade 3/4) observed in 28.0% of patients. Risk factors significantly associated with OM included HPV-positive tumor status (OR = 1.65, P = 0.02), concurrent CRT (OR = 1.86, P = 0.002), and nutritional risk (OR = 2.36, P = 0.004). Tumor location also influenced OM risk, with laryngeal cancers showing a lower incidence (OR = 0.72, P = 0.02).

Conclusion: Prophylactic PBM appears effective in reducing the incidence and severity of OM among patients with HNC undergoing RT or CRT. These findings support its potential role as a preventive strategy in routine clinical care.