Effectiveness of intraoral and combined intraoral-extraoral photobiomodulation therapy on patient-reported oral mucositis symptoms: A randomized controlled trial

Background: This study was conducted to compare the effects of two clinical protocols-intraoral red laser versus a combination of extraoral infrared laser and intraoral red laser-on the Patient-Reported Oral Mucositis Symptoms (PROMS) scale in patients undergoing chemotherapy. Methods: In this prospective randomized double-blind clinical trial, 45 patients were assigned to three groups, matched by age, sex, chemotherapy type, and baseline oral health status. Group 1 received standard oral care alone, Group 2 received standard oral care plus intraoral photobiomodulation (PBM) using a 635 nm diode laser, and Group 3 received standard oral care combined with both intraoral 635 nm and extraoral 980 nm laser therapy. The PROMS scale was assessed 1 week and 2 weeks after the start of chemotherapy. Results: Significant differences were observed between groups on the PROMS scale at both time points (p = .000). Pairwise comparisons showed improvements in both PBM groups compared to the control group, though no significant difference was found between the two PBM protocols. Conclusion: Photobiomodulation therapy, whether with intraoral laser alone or with intraoral and extraoral lasers, has a significant role in improving the quality of life of gastrointestinal cancer patients undergoing chemotherapy.