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Photobiomodulation (low-level laser) therapy for immediate pain relief of persistent oral ulcers in chronic graft-versus-host disease

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Abstract

Purpose

To determine the immediate pain-relieving effect of photobiomodulation therapy (PBMt) in patients with oral ulcers of chronic graft-versus-host disease (cGVHD) refractory to first line therapy with topical corticosteroids.

Methods

This retrospective study included all patients who underwent PBMt for pain relief of refractory oral cGVHD lesions. PBMt was applied using an intraoral approach to all sites with mucosal lesions, using a 940 nm InGaAsP diode laser device, with the following parameters: pulsed modulation (duty cycle of 50%), power 0.7 W, illuminated spot size 7.1 cm2, irradiance 98.6 mW/cm2, and irradiation time 90 s per point. Pain was self-assessed using a 0-to-10 scale immediately before and after PBMt.

Results

Data from eleven patients with a total of 56 PBMt sessions were analyzed. In 48 (85.7%) sessions, the patients reported less pain immediately after treatment, with a reduction of ≥ 50% of the initial pain level in 43 (76.8%) sessions. Mean pre- and post-treatment pain levels were 5.20 ±2.7 and 1.38 ±2.1, respectively (p < 0.001), i.e., a post-treatment reduction of 73.4% of the initial pain level. The benefits of the treatment remained for a mean of 6.50 ±5.4 days (range of 2 to 14 days). No adverse effects were reported.

Conclusions

PBMt seems to be a promising treatment modality for refractory oral cGVHD lesions as a rapid pain reliever with relatively long-lasting effects.

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Data availability

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Authors and Affiliations

  1. Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University–Hadassah School of Dental Medicine, Jerusalem, Israel

    Ori Finfter, Yaron Haviv, Chen Nadler & Yehuda Zadik

  2. Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah Medical Center, Jerusalem, Israel

    Batia Avni & Sigal Grisariu

  3. Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    Batia Avni, Sigal Grisariu & Yehuda Zadik

  4. Dental Branch, Medical Corps, Israel Defense Forces, Tel Hashomer, Israel

    Ori Rimon

  5. Department of Military Medicine, Hebrew University-Hadassah School of Medicine, P.O.Box 12000, 91120, Jerusalem, Israel

    Yehuda Zadik

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  1. Ori Finfter
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  2. Batia Avni
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Contributions

Conceptualization, Y.Z., O.F., B.A., S.G., and O.R.; methodology, Y.Z., O.F., B.A., S.G., and O.R.; data acquisition, O.F.; data analysis, Y.Z.; data interpretation, Y.Z., O.F., B.A., S.G., Y.H., C.N., and O.R.; writing—original draft preparation, Y.Z.; writing—review and editing, O.F., B.A., S.G., Y.H., C.N., and O.R.; supervision, Y.Z.; project administration, Y.Z.; all authors have read and agreed to the final version of the article.

Corresponding author

Correspondence to Yehuda Zadik.

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The authors declare that they have no conflict of interest.

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The study protocol was approved by the Institutional Review Board (HMO-20-0330).

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The Institutional Review Board determined of exemption from informed consent (because of the retrospective design of the study).

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N/A (there are no personal data and/or images in the article).

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Finfter, O., Avni, B., Grisariu, S. et al. Photobiomodulation (low-level laser) therapy for immediate pain relief of persistent oral ulcers in chronic graft-versus-host disease. Support Care Cancer 29, 4529–4534 (2021). https://doi.org/10.1007/s00520-021-05997-1

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  • DOI: https://doi.org/10.1007/s00520-021-05997-1

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