Low-level laser therapy for preventing or treating oral mucositis caused by radiotherapy or chemotherapy

To inform the committee, NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 11 sources, which was discussed by the committee. The evidence included 3 systematic reviews and meta-analysis and 7 randomised controlled trials (1 of which also reported outcomes from a prospective case series) and 1 non-randomised comparative study. These are presented in table 2 of the interventional procedures overview. Other relevant literature is in the appendix of the overview.

The specialist advisers and the committee considered the key efficacy outcomes to be: improved quality of life, reduction in oral mucositis, reduction in pain and the need for analgesia, reduction in dysphagia and the need for feeding tubes, improved nutrition, and reduction in chemotherapy treatment breaks.

Four commentaries from patients who had experience of this procedure were received, which were discussed by the committee.

The procedure can be used in children, but most of the evidence reviewed by the committee was from adults.

Most of the evidence reviewed by the committee was for treatment delivered intra-orally, and related to prophylactic use of this procedure.

The greatest benefit from the procedure appears to be in patients having radiotherapy for head and neck cancers, or having chemotherapy for haematological malignancies.