Effects Of Low Level Laser Therapy On Oral Mucositis In Patients Undergoing HSCT:a Meta-Analysis

BackgroudsOral mucositis which affect the quality of treatment and survival seriously is a common complication after radiotherapy, chemotherapy and hematopoietic stem cell transplantation (HSCT). Due to a larger dose conditioning regimen and graft-versus-host disease (GVHD), the incidence of oral mucositis in patients who achieved Hematopoietic stem cell transplantation is higher and more serious. The previous studies show that low level laser therapy (LLLT) can prevent the development of chemotherapy-induced oral mucositis (OM). The incidence and severity of the oral mucosa was significantly lower than the untreated group. But the effect of laser therapy on the patients with hematopoietic stem cell transplantation still do not have final conclusion. The main purpose of this study is a retrospective analysis of LLLT on prevention and treatment of oral mucositis in patients undergoing hematopoietic stem cell transplantation.PurposeIn this systematic review, we compared the oral mucositis of transplant patients with and without low level laser therapy in aspects of disease incidence and severity. We try to make reasonable analysis on the clinical application of low-dose laser on prevention of oral mucositis after hematopoietic stem cell transplantation. MethodsWe searched Medline, Embase, Cochrane Controlled Trials central database, Wanfang, CNKI using the following terms:"low level laser therapy" and "randomized controlled trial". Only randomized controlled trials comparing LLLT with placebo in HSCT patients were included. According to predefined strategies, we progressed literature screening, quality assessment and data extraction, analysis of heterogeneity and bias evaluation, and then draw conclusions.ResultsWe included8randomised placebo-controlled trials including456patients. The methodological quality of these papers were acceptable at4.10(SD±0.74) on the Jadad scale (5points in total). The relative risk for developing OM was significantly reduced after LLLT compared with placebo group (OR=5.20,95%CI (2.43,11.15)) The relative risk for developing Severe OM was also significantly reduced after LLLT compared with placebo group.(OR=0.27,95%Cl (0.14,0.52)) The patients of LLLT group fell less pain from the placebo group.(OR=0.43,95%Cl (0.30,0.62)) Butforthe paitients who was suffering the OM, the pain score is not significantly reduced.(OR=-2.01,95%CI (-4.12,-0.10)) All studies registered possible side-effects, but they were not significantly different from placebo LLLT.ConclusionThere is consistent evidence from small high-quality studies that LLLT can partly prevent development of OM in patients undergoing hematopoietic stem cell transplantation. LLLT also significantly reduced severity and duration of symptoms.But it can not reduce pain scores of the oral mucostis which had happened already.