Topic Status Complete

Photobiomodulation for the prevention and treatment of oral mucositis associated with cancer treatment

Outcome of the appraisal


Photobiomodulation for the prevention or treatment of oral mucositis in people receiving cancer treatment shows promise, but the evidence is insufficient to support routine adoption.
The use of low-level laser photobiomodulation reduces the incidence of oral mucositis compared to sham or standard care, but there is limited evidence on the clinical effectiveness of light-emitting diode (LED) photobiomodulation.
HTW economic analyses show that laser photobiomodulation is not cost effective compared to standard care. The main driver behind the relative cost effectiveness analysis is staffing costs. Therefore, routine adoption of laser photobiomodulation cannot be supported. Further research is recommended to establish the clinical effectiveness of LED photobiomodulation.

Why was this topic appraised?


Oral mucositis is a common side effect of cancer treatment, and can often have a severe impact on an individual’s quality of life. Symptoms can range from mild to severe and include minor discomfort, speech difficulties, ulceration, severe pain and inability to eat solid food. Current treatment options to manage oral mucositis included oral hygiene, good hydration, avoiding irritating food and drink, and painkillers. In cases of subsequent infection, antibiotics may also be used. Photobiomodulation is a non-invasive hand-held technology that aims to prevent or treat oral mucositis by stimulating healing, decreasing inflammation and increasing cellular metabolism. At the time of this guidance, there are two types of photobiomodulation: low-level laser photobiomodulation and light emitting diode (LED) photobiomodulation.

Plain language summary


Cancers are most commonly treated using radiotherapy or chemotherapy. Both treatments can have side effects. Oral mucositis is a common side effect of both radiotherapy and chemotherapy. Signs and symptoms can include:

  • Red, shiny, or swollen mouth and gums.
  • Blood in the mouth.
  • Sores in the mouth, including on the gums or tongue.
  • Soreness or pain in the mouth or throat.
  • Trouble with swallowing or talking.
  • Feeling of dryness, mild burning, or pain when eating food.

This can be uncomfortable and the sores may be painful. If severe, it may mean that the cancer treatment must be temporarily stopped, or doses reduced.

Photobiomodulation is a non-invasive procedure that promotes the healing of the skin. The hand-held device delivers an application of low-power, red or near-infrared light. The light can stimulate, heal, regenerate, and protect tissue. There are many different kinds of photobiomodulation devices that can be used both inside and outside of the mouth.

Health Technology Wales looked for evidence on the clinical and cost effectiveness of photobiomodulation to prevent or treat oral mucositis associated in people with cancer.

Topic Exploration Report

TER322 02.2022

Evidence Appraisal Review

EAR044 10.2022


GUI044 10.2022


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