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Background <p>Oral mucositis (OM) is a frequent and clinically significant toxicity of head and neck radiotherapy (RT) and chemoradiotherapy (CRT), contributing to pain, dysphagia, nutritional compromise, greater supportive care needs, and treatment interruptions.</p> Objective <p>To review and critically synthesize the current literature on the preventive use of PBMT for oral mucositis in patients undergoing head and neck RT/CRT, with emphasis on efficacy, protocol translation, delivery modalities, baseline oral risk factors, safety, guideline recommendations, and implementation issues.</p> Methods <p>A narrative literature review informed by a structured search of PubMed/MEDLINE, Scopus, and Web of Science was conducted to identify relevant literature published between January 2010 and January 2026. Priority was given to randomized controlled trials, prospective comparative studies, systematic reviews, meta-analyses, and relevant guidelines or consensus statements addressing prophylactic PBMT in adults undergoing head and neck RT/CRT.</p> Results <p>The available literature generally supports PBMT as an effective preventive intervention for reducing OM severity, including severe OM, and for improving related outcomes such as pain and symptom burden. Systematic reviews and meta-analyses broadly support these benefits, with recent RCT-focused evidence showing reduced severe OM and OM-related pain, although interpretation is limited by heterogeneity in wavelength, fluence, irradiance, treatment frequency, anatomical targets, and outcome assessment. Emerging comparative evidence suggests that extraoral PBMT may be a pragmatic alternative to intraoral delivery in selected settings, whereas transcutaneous delivery remains under investigation. Current guidelines support PBMT in selected cancer-treatment settings when validated parameters, trained personnel, and appropriate safety measures are used.</p> Conclusion <p>PBMT is among the better-supported preventive options for RT/CRT-associated oral mucositis in head and neck cancer, particularly when delivered intraorally according to validated protocols. However, persistent protocol heterogeneity, limited comparative route data, evolving delivery models, and the likely influence of baseline oral health status mean that PBMT is best implemented as an adjunctive, protocol-based component of multidisciplinary oral supportive care.</p>

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Photobiomodulation for Prevention of Oral Mucositis in Head and Neck Radiotherapy and Chemoradiotherapy: a Narrative Literature Review

  • 期刊论文

  • 发表日期：

    2026年7月29日

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  • Balqees Mohammed M. Rawashdeh,
  • Abdulrhman H.M. Muhaisen

摘要

Background

Oral mucositis (OM) is a frequent and clinically significant toxicity of head and neck radiotherapy (RT) and chemoradiotherapy (CRT), contributing to pain, dysphagia, nutritional compromise, greater supportive care needs, and treatment interruptions.

Objective

To review and critically synthesize the current literature on the preventive use of PBMT for oral mucositis in patients undergoing head and neck RT/CRT, with emphasis on efficacy, protocol translation, delivery modalities, baseline oral risk factors, safety, guideline recommendations, and implementation issues.

Methods

A narrative literature review informed by a structured search of PubMed/MEDLINE, Scopus, and Web of Science was conducted to identify relevant literature published between January 2010 and January 2026. Priority was given to randomized controlled trials, prospective comparative studies, systematic reviews, meta-analyses, and relevant guidelines or consensus statements addressing prophylactic PBMT in adults undergoing head and neck RT/CRT.

Results

The available literature generally supports PBMT as an effective preventive intervention for reducing OM severity, including severe OM, and for improving related outcomes such as pain and symptom burden. Systematic reviews and meta-analyses broadly support these benefits, with recent RCT-focused evidence showing reduced severe OM and OM-related pain, although interpretation is limited by heterogeneity in wavelength, fluence, irradiance, treatment frequency, anatomical targets, and outcome assessment. Emerging comparative evidence suggests that extraoral PBMT may be a pragmatic alternative to intraoral delivery in selected settings, whereas transcutaneous delivery remains under investigation. Current guidelines support PBMT in selected cancer-treatment settings when validated parameters, trained personnel, and appropriate safety measures are used.

Conclusion

PBMT is among the better-supported preventive options for RT/CRT-associated oral mucositis in head and neck cancer, particularly when delivered intraorally according to validated protocols. However, persistent protocol heterogeneity, limited comparative route data, evolving delivery models, and the likely influence of baseline oral health status mean that PBMT is best implemented as an adjunctive, protocol-based component of multidisciplinary oral supportive care.