The potential effect of photobiomodulation on oral mucositis induced by head and neck radio-chemotherapy: A literature review

Oral mucositis (OM) is a common side effect of head and neck radio-chemotherapy. It manifests as painful, ulcerative lesions in the oral mucosa, significantly impairing essential functions such as eating, speaking, and maintaining oral hygiene. It finally has adverse effects on the patient's quality of life. Photobiomodulation therapy (PBMT) has emerged as a promising non-invasive modality for preventing and treating OM. Due to controversy among the results of studies, this literature review synthesizes findings from recent randomized controlled trials that evaluated the use of PBMT in adult and pediatric cancer patients. This review also highlights the mechanisms, clinical efficacy, and future challenges of integrating PBMT into routine supportive cancer care. The evidence shows that PBMT significantly reduces the severity and duration of OM, improved patient-reported outcomes, and minimized treatment-related morbidity. By utilizing low-intensity light sources—typically lasers or LEDs—PBMT enhances cellular metabolism, reduces inflammation, alleviates pain, and promotes mucosal healing. Despite its clinical potential, widespread implementation of PBMT is hindered by variability in treatment protocols and limited standardization; in brief, laser protocols — wavelengths (630–980 nm), energy densities (2–6 J/cm²), and application durations (10–125 s/point) are commonly used for preventing and treating OM induced by head and neck radio-chemotherapy. However, future studies with long-term follow-ups will be necessary to standardize PBMT protocols, as standardization is essential to integrate PBMT into routine cancer care.