What This Review Looked At
For patients undergoing chemoradiotherapy for head and neck cancer, oral mucositis — painful inflammation and ulceration of the mouth and throat lining — is one of the most common and disruptive side effects of treatment. It interferes with eating, drinking, speaking, and sometimes with treatment itself: severe cases can force radiation or chemotherapy doses to be reduced. A 2024 systematic review and meta-analysis published in Head & Neck, led by Shen and Zhou, brought together the available randomised evidence on whether photobiomodulation — red and near-infrared light therapy — can meaningfully reduce this burden.
The researchers screened the literature and included 14 randomised controlled trials covering a total of 869 patients with head and neck cancer undergoing chemoradiotherapy. Across the trials, photobiomodulation was compared to control or placebo treatment in patients receiving standard cancer therapy. The meta-analysis pooled outcomes including incidence and severity of oral mucositis at multiple time points during treatment.
What They Found
The pooled analysis showed that photobiomodulation significantly reduced the incidence of oral mucositis compared with control treatment from the second week of cancer therapy onward. The relative risk reduction was meaningful (RR = 0.49, 95% CI 0.25–0.97) — meaning that across the pooled trials, fewer patients in the photobiomodulation group developed clinically significant mucositis as treatment progressed.
Severity outcomes followed the same direction. Photobiomodulation was associated with lower mucositis severity scores, fewer treatment interruptions due to oral side effects, and improved patient-reported pain and comfort during the course of cancer therapy.
What This Means in Context
This is one of the strongest pieces of evidence in the supportive-care space for any non-pharmacological intervention. Fourteen randomised controlled trials and nearly 900 patients is a meaningful evidence base, and the meta-analytic pooling shows a consistent direction of effect rather than a single anomalous positive study. The intervention is also already recommended in international supportive-care guidelines (MASCC/ISOO) for the prevention of oral mucositis in defined patient groups — this review adds confirmatory weight to that position.
Heterogeneity across trials was notable (I² = 71%), which is typical for a field where treatment protocols, wavelengths, and dose parameters vary between centres. The pooled effect held up despite that variability — and the practical implication is that the optimal protocol for any individual patient is still a clinical judgement made in dialogue with the oncology and oral medicine teams.
What It Means for You
If you or someone you love is preparing for chemoradiotherapy treatment for head and neck cancer, photobiomodulation is now an evidence-supported supportive option that has been shown to reduce the burden of one of the most disruptive treatment-related complications. This is a clinical intervention typically delivered by the oncology or dental oncology team during cancer therapy — not a self-administered approach in this context. Ask your treating team whether photobiomodulation is offered at your treatment centre, and whether it is appropriate for your specific protocol.
Citation: Shen, Y., & Zhou, P. (2024). Efficacy of photobiomodulation therapy in the management of oral mucositis in patients with head and neck cancer: A systematic review and meta-analysis of randomized controlled trials. Head & Neck, 46(5), 1264–1276. DOI: 10.1002/hed.27655
