Photodynamic therapy for treatment of oral mucositis: Pilot study with pediatric patients undergoing chemotherapy

Oral mucositis has become a major dose-limiting toxicity of antineoplastic treatment.

The aim of this study was to evaluate the effect of photodynamic therapy (PDT) and low level laser therapy (LLLT) on the treatment of chemotherapy-induced mucositis in pediatric patients.

An open, controlled, and blind, randomized clinical trial was conducted with 29 patients, from 10 months to 18 years old, who were divided into two groups. Group A was submitted to photodynamic therapy (0.01% Methylene Blue and red laser, λ660 nm) with 3J energy per point; and Group B submitted to low level laser therapy (λ660 nm) with 1J energy per point. The results were evaluated by using the WHO and ChIMES mucositis scales. The Chi-square, Exact Fisher, Student's-t and Mann-Whitney tests, and the mixed linear regression model were used for comparison between the groups, with the maximum error admitted of 5%.

There was no difference between the groups as regards the number of sessions necessary for clinical cure of the oral lesions (p = 0.954) or reduction in pain reported by the patients (p = 0.258; p = 0.486). Within each group, however, there was significant reduction in pain (p = 0.032; p = 0.003). The number needed to treat (NNT) was 4.75.

PDT or LLLT could be used for treatment of oral mucositis in children/young patients. Each were well tolerated and presented satisfactory results in reducing pain associated with the lesion.