New, updated guidelines will provide health care professionals with better tools to deliver care for cancer patients who suffer from oral mucositis.
Frequently manifested as painful sores and ulcers, oral mucositis is often reported by patients to be one of the worst side effects of cancer treatment. Pain from the condition can slow or delay cancer treatment, and in severe cases require parenteral feeding and hospitalization.
Among several updated guidelines, Dr. Sharon Elad and her team recommend photobiomodulation therapy, a form of low-dose light therapy, as one of the most effective interventions for preventing oral mucositis.
Sharon Elad, DMD MSc, professor at UR Medicine’s Eastman Institute for Oral Health, led the effort in developing new guidelines in her role as chair of the Mucositis Study Group within the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The group's goal is to improve outcomes of patients experiencing oral and gastrointestinal mucositis associated with cancer therapies. Working on multiple fronts, the Mucositis Study Group includes 245 members from 33 countries.
Light therapies have existed for decades, but improvements in the technology have made the treatment more evidence-based and affordable for wider use. Low-level laser therapy was proved to relieve pain or inflammation and promote healing. The treatment is considered a routine therapy for oral mucositis across Europe, Brazil, India, and several other nations. As the body of literature increases, PBM therapy will likely be identified as beneficial for additional oral conditions.
“But even with the best evidence-based interventions, we don’t yet have an ultimate guideline for mucositis in all clinical settings,” added Dr. Elad, who also serves as chair of Eastman Institute’s Oral Medicine Department. “We look forward to future research to help shape a more universal implementation of photobiomodulation therapy as well as identify additional effective and validated protocols.”
Future studies are needed to verify the effectiveness of light therapy in managing oral mucositis in pediatric cancer patients and in adult cancer patients receiving only chemotherapy.
The MASCC/ISOO clinical practice guidelines covered a series of interventions categorized as 1) anti-inflammatory agents, 2) antimicrobials, coating agents, anesthetics, analgesics 3) basic oral care 4) cryotherapy, 5) growth factors and cytokines, 6) laser and light therapy, also known as photobiomodulation (PBM) therapy, 7) natural therapies and miscellaneous, and 8) interventions for gastrointestinal mucositis. These clinical practice guidelines are evidence-based and developed through meticulous and strict methods. Additionally, the MSG conducted a systematic review about the pathogenesis of mucositis. The first set of guidelines were published in