Low-Level Laser Therapy for Radiotherapy

Introduction: Radiation therapy, also called radiotherapy, is a type of cancer treatment. This treatment uses beams of intense energy to kill cancer cells. Radiation therapy most often uses X-rays.

Background: There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photo biomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved and diametric parameters may lead to the management of a broader range of complications associated with HNC treatment. This could enhance patient adherence to cancer therapy, and improve quality of life and treatment outcomes.

Method: Narrative review and presentation of PBM parameters are based on current evidence and expert opinion.

Results: PBM may have potential applications in the management of a broad range of side effects of (chemo)radiation therapy (CRT) in patients being treated for HNC. For OM management, optimal PBM parameters  identified were  as follows: wavelength,  typically  between 633  and  685  nm or 780-830  nm; energy density, laser or light-emitting diode (LED) output between 10 and 150 dose, 2-3 J (J/cm(2)), and no more than 6 J/cm(2) on the tissue surface treated; treatment schedule, two to three times a week up to daily; emission type, pulsed (< 100 Hz); and route of delivery, intraorally and/or transcutaneous . To facilitate further studies, we propose potentially effective PBM parameters for prophylactic and therapeutic use in supportive care for dermatitis, dysphagia, dry mouth, dysgeusia, trismus, necrosis, lymphedema, and voice/speech alterations.

Conclusions: : PBM may have a role in supportive care for a broad range of complications associated with the treatment of HNC with CRT. The suggested PBM irradiation and diametric parameters, which are potentially effective for these complications, are intended to provide guidance.