Eficacia de la terapia con láser de baja potencia en la prevención y tratamiento de la mucositis oral en pacientes oncológicos pediátricos: una meta-revisión

Contenido principal del artículo

Jaime Enrique Plazas-Román
Mauricio Javier Guerrero-Román
María Camila Niebles-Ramírez
Jose Ignacio Llamas-García
Francisco Miguel Soto-Pacheco
Gennys Gutiérrez-Ramírez
Antonio José Díaz-Caballero

Resumen

This meta-review analyzed four major studies (published between 2021 and 2023) that evaluated photobiomodulation therapy for oral mucositis in pediatric oncology patients. The analysis included 3,314 patients across 154 studies, examining wavelengths (620-970 nm) and power settings (0.005-3.2 W). Results showed significant mucositis severity reduction (RR = 0.35, 95%CI 0.25-0.45), high treatment adherence (91%, 95%CI 88.30-93.70), and notable pain reduction [SMD = -0.85, 95%CI -1.20-(-)0.50]. Using WHO classification systems, positive outcomes were demonstrated across chemotherapy, radiotherapy, and HSCT treatments, supporting PBM's effectiveness in pediatric oncology settings.

Descargas

Los datos de descargas todavía no están disponibles.

Detalles del artículo

Cómo citar
Plazas-Román, J. E., Guerrero-Román, M. J., Niebles-Ramírez , M. C., Llamas-García, J. I., Soto-Pacheco, F. M., Gutiérrez-Ramírez, G., & Díaz-Caballero, A. J. (2025). Eficacia de la terapia con láser de baja potencia en la prevención y tratamiento de la mucositis oral en pacientes oncológicos pediátricos: una meta-revisión. Duazary, 22, e6408. https://doi.org/10.21676/2389783X.6408
Sección
Artículo de revisión
Biografía del autor/a

Jaime Enrique Plazas-Román, Universidad del Sinú Elías Bechara Zainúm, Universidad de Cartagena

Universidad del Sinú Elías Bechara Zainúm, Cartagena, Universidad de Cartagena, Correo: jaime.plazas@unisinu.edu.co - https://orcid.org/0000-0002-5040-6899

Mauricio Javier Guerrero-Román, Universidad del Sinú Elías Bechara Zainúm

Universidad del Sinú Elías Bechara Zainúm, Cartagena, Colombia. Correo: mauricioguerrero73@hotmail.com - https://orcid.org/0009-0006-4850-2941

María Camila Niebles-Ramírez , Universidad del Sinú Elías Bechara Zainúm

Universidad del Sinú Elías Bechara Zainúm, Cartagena, Colombia. Correo: camilaniebles@hotmail.com - https://orcid.org/0009-0007-6944-5859

Jose Ignacio Llamas-García, Universidad de Cartagena, Corporación Universitaria Rafael Núñez

Universidad de Cartagena, Corporación Universitaria Rafael Núñez.Colombia. Correo: jllamasg@unicartagena.edu.co - https://orcid.org/0000-0003-3514-9107

Francisco Miguel Soto-Pacheco, Universidad del Sinú Elías Bechara Zainúm

Universidad del Sinú Elías Bechara Zainúm, Cartagena, Colombia. Correo: francisco.soto@unisinu.edu.co -  https://orcid.org/0000-0003-4192-6144

Gennys Gutiérrez-Ramírez, Universidad del Sinú Elías Bechara Zainúm

Universidad del Sinú Elías Bechara Zainúm, Cartagena, Colombia. Correo: gennysgutierrez@unisinucartagena.edu.co - https://orcid.org/0000-0001-8571-6750

Antonio José Díaz-Caballero, Universidad de Cartagena

Universidad de Cartagena, Cartagena, Colombia. Correo: adiazc1@unicartagena.edu.co - http://orcid.org/0000-0001-9693-2969

Citas

Bell A, Kasi A. Oral Mucositis. StatPearls. 2024;1:1-8.

Al-Rudayni AHM, Gopinath D, Maharajan MK, Menon RK. Impact of oral mucositis on quality of life in patients undergoing oncological treatment: A systematic review. Transl Cancer Res. 2020;94:1-10. https://doi.org/10.21037/tcr.2020.02.77

Abdalla-Aslan R, Keegan R, Zadik Y, Yarom N, Elad S. Recent advances in cancer therapy-associated oral mucositis. Oral Dis. 2024;1:1-8. https://doi.org/10.1111/odi.14999

Razmara F, Khayamzadeh M. An Investigation into the prevalence and treatment of oral mucositis after cancer treatment. Int J Cancer Manag. 2019;1211:1-8. https://doi.org/10.5812/ijcm.88405

Singh V, Singh AK. Oral mucositis. Natl J Maxillofac Surg. 2020;112:159-68. https://doi.org/10.4103/njms.NJMS_10_20

Pulito C, Cristaudo A, Porta CL, Zapperi S, Blandino G, Morrone A, et al. Oral mucositis: The hidden side of cancer therapy. J Exp Clin Cancer Res. 2020;391:210. https://doi.org/10.1186/s13046-020-01715-7

Hong B-Y, Sobue T, Choquette L, Thompson A, Burleson JA, Dupuy AK, et al. Chemotherapy-induced oral mucositis is associated with detrimental bacterial dysbiosis. Microbiome. 2019;71:66. https://doi.org/10.1186/s40168-019-0679-5

Sonis ST. A hypothesis for the pathogenesis of radiation-induced oral mucositis: When biological challenges exceed physiologic protective mechanisms. Support Care Cancer. 2021;299:4939-47. https://doi.org/10.1007/s00520-021-06108-w

Blijlevens NMA, de Mooij CEM. Mucositis and Infection in Hematology Patients. Int J Mol Sci. 2023;2411:9592. https://doi.org/10.3390/ijms24119592

Soares JB, Gabriel AF, Kirschnick LB, Carrard VC, Curra M, Martins MAT, et al. Oral mucositis assessment scale in pediatric and adolescent oncological patients: A systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2024;1376:294. https://doi.org/10.1016/j.oooo.2023.12.685

Elad S, Cheng KKF, Lalla RV, Yarom N, Hong C, Logan RM, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2020;12619:4423-31. https://doi.org/10.1002/cncr.33100

Filetici P, Gallottini SG, Corvaglia A, Amendolea M, Sangiovanni R, Nicoletti F, et al. The role of oral microbiota in the development of oral mucositis in pediatric oncology patients treated with antineoplastic drugs: A systematic review. BMC Oral Health. 2024;241:183. https://doi.org/10.1186/s12903-024-03938-y

de Farias Gabriel A, Silveira FM, Curra M, Schuch LF, Wagner VP, Martins MAT, et al. Risk factors associated with the development of oral mucositis in pediatric oncology patients: Systematic review and meta-analysis. Oral Dis. 2022;284:1068-84. https://doi.org/10.1111/odi.13863

Qutob AF, Allen G, Gue S, Revesz T, Logan RM, Keefe D. Implementation of a hospital oral care protocol and recording of oral mucositis in children receiving cancer treatment. Support Care Cancer. 2013;214:1113-20. https://doi.org/10.1007/s00520-012-1633-2

Zhang L, Luo Y, Long J, Yin Y, Fu Q, Wang L, et al. Enhancing standardized practices for oral mucositis prevention in pediatric hematopoietic stem cell transplantation: A best practice implementation project. Risk Manag Health Policy. 2024;17:1909-20. https://doi.org/10.2147/RMHP.S471877

Santos FG, Bezerra PMM, Limão NP, Santana YN, Ribeiro IL, Bonan PR, et al. Oral mucositis in children with leukemia undergoing chemotherapy: A case series. Pesqui Bras Odontopediatr Clin Integr. 2023;23:220140. https://doi.org/10.1590/pboci.2023.067

Alhussain A, Alkhayal Z, Ayas M, Abed H. Prevalence and risk factors of oral mucositis in paediatric patients undergoing haematopoietic stem cell transplantation. Oral Dis. 2022;283:657-69. https://doi.org/10.1111/odi.13777

Donohoe C, Bosi J, Sykes A, Lu Z, Mandrell B. Clinical characteristics of children and adolescents undergoing hematopoietic cell transplant who develop oral mucositis. Oncol Nurs Forum. 2018;454:457-62. https://doi.org/10.1188/18.ONF.457-462

Mazur CE, Furquim CP, Nabhan SK, Soares GMS, Amenábar JM, Torres-Pereira CC. Evaluación longitudinal de la mucositis oral en el trasplante de células madre hematopoyéticas: un estudio piloto. Odontol Vital. 2019;30:31-8.

Stawarz-Janeczek M, Szczeklik K, Pytko-Polończyk J. Oral mucositis OM – a common problem for oncologists and dentists. Nowotw J Oncol. 2020;706:253-9. https://doi.org/10.5603/NJO.2020.0049

Sangavi R, Pandiyan I. Unveiling the multifaceted management of oral mucositis in cancer patients: A narrative review. Cureus. 2024;162:55213. https://doi.org/10.7759/cureus.55213

Lorini L, Perri F, Vecchio S, Belgioia L, Vinches M, Brana I, et al. Confounding factors in the assessment of oral mucositis in head and neck cancer. Support Care Cancer. 2022;3010:8455-63. https://doi.org/10.1007/s00520-022-07128-w

Chen X, Yao L, Shan Q, Qian X, Lu X, Tang X, et al. Risk factors for oral mucositis in patients with malignant tumors: a prospective cohort study. Ann Palliat Med. 2021;107:8180189-88. https://doi.org/10.21037/apm-21-1675

Allana A, Shamsi U, Rashid Y, Khan FR, Rozi S, Doroszko A, et al. Oral mucositis & oral health related quality of life in women undergoing chemotherapy for breast cancer in Karachi, Pakistan: A multicenter hospital based cross-sectional study. PLoS One. 2024;194:295456. https://doi.org/10.1371/journal.pone.0295456

Chaudhry S, Ehtesham Z. Treatment options for cancer patients suffering from oral mucositis. Asian Pac J Cancer Care. 2023;81:181-4. https://doi.org/10.31557/apjcc.2023.8.1.181-184

Karlsson C, Bohm N, Andersson JS, Finizia C, Almståhl A. Prospective study on health-related quality of life, oral mucositis and oral health during treatment of head and neck cancer. BMC Oral Health. 2024;241:697. https://doi.org/10.1186/s12903-024-04466-5

Colella G, Boschetti CE, Vitagliano R, Colella C, Jiao L, King-Smith N, et al. Interventions for the prevention of oral mucositis in patients receiving cancer treatment: Evidence from randomised controlled trials. Curr Oncol. 2023;301:967-80. https://doi.org/10.3390/curroncol30010074

Ferreira AS, Macedo C, Silva AM, Delerue-Matos C, Costa P, Rodrigues F. Natural products for the prevention and treatment of oral mucositis—A review. Int J Mol Sci. 2022;238:4385. https://doi.org/10.3390/ijms23084385

Daugėlaitė G, Užkuraitytė K, Jagelavičienė E, Filipauskas A. Prevention and treatment of chemotherapy and radiotherapy induced oral mucositis. Medicina. 2019;552:25. https://doi.org/10.3390/medicina55020025

Kashiwazaki H, Matsushita T, Sugita J, Shigematsu A, Kasashi K, Yamazaki Y, et al. Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation. Support Care Cancer. 2012;202:367-73. https://doi.org/10.1007/s00520-011-1116-x

Bahrami R, Pourhajibagher M, Gharibpour F, Hosseini S, Bahador A. The impact of low-level laser therapy photobiomodulation on the complications associated with conventional dental treatments and oral disorders: A literature review. J Dent Sci. 2024. https://doi.org/10.1016/j.jds.2024.08.023

Zecha JAEM, Raber-Durlacher JE, Nair RG, Epstein JB, Elad S, Hamblin MR, et al. Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: Part 2: Proposed applications and treatment protocols. Support Care Cancer. 2016;246:2793-805. https://doi.org/10.1007/s00520-016-3153-y

Wangsa CW, Gunardi I, Amtha R, Djamil MS, Sari EF. Photobiomodulation therapy for oral lesions: A bibliometric analysis. Laser Ther. 2024;312. https://doi.org/10.4081/ltj.2024.400

Hanna R, Dalvi S, Benedicenti S, Amaroli A, Sălăgean T, Pop ID, et al. Photobiomodulation therapy in oral mucositis and potentially malignant oral lesions: A therapy towards the future. Cancers. 2020;127:1949. https://doi.org/10.3390/cancers12071949

Mansouri V, Arjmand B, Rezaei Tavirani M, Razzaghi M, Rostami-Nejad M, Hamdieh M. Evaluation of efficacy of low-level laser therapy. J Lasers Med Sci. 2020;114:369-80. https://doi.org/10.34172/jlms.2020.60

Tam SY, Tam VCW, Ramkumar S, Khaw ML, Law HKW, Lee SWY. Review on the cellular mechanisms of low-level laser therapy use in oncology. Front Oncol. 2020;10:1255. https://doi.org/10.3389/fonc.2020.01255

Yang T-S, Nguyen L-T-H, Hsiao Y-C, Pan L-C, Chang C-J. Biophotonic Effects of low-level laser therapy at different wavelengths for potential wound healing. Photonics. 2022;98:591. https://doi.org/10.3390/photonics9080591

Courtois E, Bouleftour W, Guy J-B, Louati S, Bensadoun R-J, Rodriguez-Lafrasse C, et al. Mechanisms of PhotoBioModulation PBM focused on oral mucositis prevention and treatment: A scoping review. BMC Oral Health. 2021;211:220. https://doi.org/10.1186/s12903-021-01574-4

Rola P, Włodarczak S, Lesiak M, Doroszko A, Włodarczak A. Changes in Cell Biology under the Influence of Low-Level Laser Therapy. Photonics. 2022;97:502. https://doi.org/10.3390/photonics9070502

de Freitas LF, Hamblin MR. Proposed mechanisms of photobiomodulation or low-level light therapy. IEEE J Sel Top Quantum Electron. 2016;223:7000417. https://doi.org/10.1109/JSTQE.2016.2561201

Farivar S, Malekshahabi T, Shiari R. Biological effects of low level laser therapy. J Lasers Med Sci. 2014;52:58-62.

Cronshaw M, Parker S, Anagnostaki E, Mylona V, Lynch E, Grootveld M. Photobiomodulation and oral mucositis: A systematic review. Dent J. 2020;83:87. https://doi.org/10.3390/dj8030087

Sánchez-Martos R, Lamdaoui W, Arias-Herrera S. Therapeutic outcomes of photobiomodulation in cancer treatment-induced oral mucositis: A systematic review. J Clin Exp Dent. 2023;159:749-59. https://doi.org/10.4317/jced.60710

Legouté F, Bensadoun R-J, Seegers V, Pointreau Y, Caron D, Lang P, et al. Low-level laser therapy in treatment of chemoradiotherapy-induced mucositis in head and neck cancer: Results of a randomised, triple blind, multicentre phase III trial. Radiat Oncol. 2019;14:83. https://doi.org/10.1186/s13014-019-1292-2

Gautam AP, Fernandes DJ, Vidyasagar MS, Maiya AG, Guddattu V. Low level laser therapy against radiation induced oral mucositis in elderly head and neck cancer patients-a randomized placebo controlled trial. J Photochem Photobiol B. 2015;144:51-6. https://doi.org/10.1016/j.jphotobiol.2015.01.011

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://doi.org/10.1136/bmj.n71

Santos CM, Pimenta CA, Nobre MR. The PICO strategy for the research question construction and evidence search. Rev Lat Am Enfermagem. 2007;15:508-11. https://doi.org/10.1590/S0104-11692007000300023

Munn Z, Barker TH, Moola S, Tufanaru C, Stern C, McArthur A, et al. Methodological quality of case series studies: An introduction to the JBI critical appraisal tool. JBI Evid Synth. 2020;1810:2127-33. https://doi.org/10.11124/JBISRIR-D-19-00099

Resolución 8430 de 1993 -Colombia. Bogotá:Ministerio de Salud; 1993.

Patel P, Robinson PD, Baggott C, Gibson P, Ljungman G, Massey N, et al. Clinical practice guideline for the prevention of oral and oropharyngeal mucositis in pediatric cancer and hematopoietic stem cell transplant patients: 2021 update. Eur J Cancer. 2021;154:92-101. https://doi.org/10.1016/j.ejca.2021.05.013

Lai C-C, Chen S-Y, Tu Y-K, Ding Y-W, Lin J-J. Effectiveness of low level laser therapy versus cryotherapy in cancer patients with oral mucositis: Systematic review and network meta-analysis. Crit Rev Oncol Hematol. 2021;160:103276. https://doi.org/10.1016/j.critrevonc.2021.103276

Hafner D, Hrast P, Tomaževič T, Jazbec J, Kavčič M. Photobiomodulation for Chemotherapy-Induced Oral Mucositis in Pediatric Patients. Biomolecules. 2023;133:418. https://doi.org/10.3390/biom13030418

Cruz AR, Minicucci EM, Betini M, Almeida-Lopes L, Tieghi Neto V, Cataneo AJM, et al. Efficacy of photobiomodulation in the treatment of oral mucositis in patients undergoing antineoplastic therapy: systematic review and meta-analysis. Support Care Cancer. 2023;3112:645. https://doi.org/10.1007/s00520-023-08105-7

Moskvin S, Pritiko D, Sergeenko E, Lukash E, Gusev L. A brief literature review and own clinical experience in prophylaxis of oral mucositis in children using low level laser therapy. BioMedicine. 2019;91:1. https://doi.org/10.1051/bmdcn/2019090101

Fiwek P, Emerich K, Irga-Jaworska N, Pomiecko D. Photobiomodulation treatment in chemotherapy-induced oral mucositis in young haematological patients—A pilot study. Medicina. 2022;588:1023. https://doi.org/10.3390/medicina58081023

Noirrit-Esclassan E, Valera MC, Vignes E, Munzer C, Bonal S, Daries M, et al. Photobiomodulation with a combination of two wavelengths in the treatment of oral mucositis in children: The PEDIALASE feasibility study. Arch Pediatr. 2019;265:268-74. https://doi.org/10.1016/j.arcped.2019.05.012

Artículos más leídos del mismo autor/a