Extraoral Versus Intraoral Photobiomodulation for the Prevention of Oral Mucositis in Pediatric Patients Undergoing High-Dose Methotrexate Chemotherapy.
4 affiliations
- 1Department of Stomatology, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil.
- 2Pediatric Oncology Department, Hospital Erastinho, Curitiba, Paraná, Brazil.
- 3Institute of Biomedical Sciences, Federal University of Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil.
- 4Oncology Department, Hospital Erasto Gaertner, Curitiba, Paraná, Brazil.
Abstract
Aims
To compare intraoral (IO) and extraoral (EO) photobiomodulation therapy (PBMT) for preventing oral mucositis (OM) in pediatric patients receiving high-dose methotrexate (HD-MTX).Methods and results
This prospective, open-label, randomized clinical trial included 75 HD-MTX treatment episodes from 31 pediatric patients aged 1-18 years. Each episode was randomized to IO-PBMT or EO-PBMT with red light at 660 nm. Preventive PBMT was initiated before HD-MTX infusion and administered daily until discharge. OM was assessed at baseline and on days 3, 5, and 10 using the World Health Organization scale. Pain, salivary pH, and salivary biochemical profiles were secondary or exploratory outcomes. Cumulative OM occurred in 22/37 IO-PBMT episodes (59.5%) and 12/38 EO-PBMT episodes (31.6%). After accounting for repeated episodes within patients, OM risk was higher with IO-PBMT (risk ratio, 1.84; 95% CI, 1.07-3.19; p = 0.029). Pain scores, salivary pH, and biochemical profiles did not differ significantly between groups. EO-PBMT required substantially less application time, and no adverse effects were reported.Conclusion
EO-PBMT was associated with lower cumulative OM occurrence, shorter application time, and good tolerability, supporting its use as a promising, less burdensome preventive strategy in pediatric oncology.
Related
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BibTeX
@article{sassi2026extraoral,
title = {{Extraoral Versus Intraoral Photobiomodulation for the Prevention of Oral Mucositis in Pediatric Patients Undergoing High-Dose Methotrexate Chemotherapy.}},
author = {Mariana Lena Sassi and Nicoly Ghilardi Cardoso and Rafael Zancan Mobile and Bruna da Fonseca Wastner and Mara Albonei Dudeque Pianovski and Robinson Sabino-Silva and Marco Guevara-Vega and Douglas Carvalho Caixeta and Laurindo Moacir Sassi and Melissa Rodrigues de Araujo},
journal = {Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry},
year = {2026},
month = nov,
doi = {10.1111/scd.70279},
url = {https://europepmc.org/article/MED/42969421},
note = {CC BY},
}
RIS
TY - JOUR
TI - Extraoral Versus Intraoral Photobiomodulation for the Prevention of Oral Mucositis in Pediatric Patients Undergoing High-Dose Methotrexate Chemotherapy.
AU - Mariana Lena Sassi
AU - Nicoly Ghilardi Cardoso
AU - Rafael Zancan Mobile
AU - Bruna da Fonseca Wastner
AU - Mara Albonei Dudeque Pianovski
AU - Robinson Sabino-Silva
AU - Marco Guevara-Vega
AU - Douglas Carvalho Caixeta
AU - Laurindo Moacir Sassi
AU - Melissa Rodrigues de Araujo
PY - 2026
DA - 2026/11/01
JO - Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry
DO - 10.1111/scd.70279
UR - https://europepmc.org/article/MED/42969421
AB - Aims To compare intraoral (IO) and extraoral (EO) photobiomodulation therapy (PBMT) for preventing oral mucositis (OM) in pediatric patients receiving high-dose methotrexate (HD-MTX).Methods and results This prospective, open-label, randomized clinical trial included 75 HD-MTX treatment episodes from 31 pediatric patients aged 1-18 years. Each episode was randomized to IO-PBMT or EO-PBMT with red light at 660 nm. Preventive PBMT was initiated before HD-MTX infusion and administered daily until discharge. OM was assessed at baseline and on days 3, 5, and 10 using the World Health Organization scale. Pain, salivary pH, and salivary biochemical profiles were secondary or exploratory outcomes. Cumulative OM occurred in 22/37 IO-PBMT episodes (59.5%) and 12/38 EO-PBMT episodes (31.6%). After accounting for repeated episodes within patients, OM risk was higher with IO-PBMT (risk ratio, 1.84; 95% CI, 1.07-3.19; p = 0.029). Pain scores, salivary pH, and biochemical profiles did not differ significantly between groups. EO-PBMT required substantially less application time, and no adverse effects were reported.Conclusion EO-PBMT was associated with lower cumulative OM occurrence, shorter application time, and good tolerability, supporting its use as a promising, less burdensome preventive strategy in pediatric oncology.
SN - 0275-1879
SN - 1754-4505
ER -