Photobiomodulation Therapy Mitigates Radiation-Induced Oral Mucositis in Head and Neck Cancer - A Prospective Randomized Study

Abstract

Author(s): K C Jyothish*, I Yuvalakshmi, TN Vijayasree and R Giridharan

Background: Oral mucositis is a frequent dose-limiting toxicity during curative head and neck radiotherapy. Photobiomodulation therapy is increasingly used as supportive care; but comparative data against standard topical therapy remain limited. Objectives: To compare 980 nm photobiomodulation therapy with 0.15% benzydamine mouthwash for the prevention and mitigation of radiation-induced oral mucositis in patients with head and neck cancer. Methods: In this prospective randomized open-label phase II study; 40 patients were assigned in a 1:1 ratio to photobiomodulation therapy or benzydamine mouthwash during curative radiotherapy or chemoradiotherapy (60–66 Gy). Oral mucositis was graded serially using the Radiation Therapy Oncology Group scale. Because the supplied workbook did not contain a harmonized numeric pain field; de novo reanalysis focused on mucositis outcomes. Results: The photobiomodulation arm showed a lower mucositis burden during treatment. At the fifth on-treatment assessment; median mucositis grade was 1 [interquartile range (IQR); 0.75–2] versus 2 [IQR; 1–2] in the benzydamine arm (p=0.037). Peak mucositis grade was also lower with photobiomodulation (median 1 [IQR; 1–2] versus 2 [IQR; 1.75–3]; p=0.025). Peak grade 2 or higher occurred in 8/20 versus 15/20 patients; and grade 3 mucositis occurred in 3/20 versus 6/20 patients. Follow-up entries were incomplete; so post-treatment recovery was summarized descriptively. Conclusions: 980 nm photobiomodulation was associated with less severe on- treatment oral mucositis than benzydamine mouthwash in this small randomized cohort. Larger trials with standardized patient-reported outcomes are needed before routine adoption.

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