Objective: The aim of this study was to evaluate the influence of low-level laser therapy (LLLT) on the prevention and treatment of oral mucositis (OM) in pediatric cancer patients taking methotrexate. Background data: OM is a very common, potentially severe side effect, caused by treatment with radiotherapy and chemotherapy for cancer. Methods: Forty patients with acute lymphoblastic leukemia, who received high doses of methotrexate, were distributed into two groups. Group A (Preventive Group) was composed of patients who received preventive laser (red-subgroup A1 or infrared-subgroup A2) for 5 days, beginning on the 1st day of infusion. Group B (Treatment Group) was composed of patients who received laser treatment only if they developed post-chemotherapy mucositis (red-subgroup B1 or infrared-subgroup B2). Laser was used at wavelengths of 660 or 830 nm with output 100 mW, power density 3.57 W/cm2, spot size 0.028 cm2, energy of 1 J, resulting in an energy density of 35 J/cm2 for 10 sec in the prophylactic group, and energy of 2 J, resulting in energy density of 70 J/cm2 for 20 sec in the therapeutic group. Results: The percentage of patients who did not develop OM was higher in Group A (60% vs. 25%). In Group B, 3/20 patients developed grade IV OM (15%), and a significant difference was found between the two subgroups at the end of treatment (p=0.019). Conclusions: Prophylactic laser produced a better outcome than when patients did not receive any preventive intervention, and red laser (660 nm) was better than infrared (830 nm) in the prevention and treatment of OM.
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