Photobiomodulation During Chemoradiation for Head and Neck Cancer: Effect on Mucositis, Weight Loss, and Feeding Tube Dependence

Abstract

Purpose: The standard therapeutic approach in head and neck cancer (HNC) involves multimodality therapy, including surgery, radiation therapy (RT), or chemoradiation therapy (CRT). Treatment complications (mucositis, weight loss, and feeding tube dependence [FTD]) can result in treatment delays, incomplete treatment, and decreased quality of life. Studies on photobiomodulation (PBM) have shown promising reductions in mucositis severity but with little quantitative supporting data. We compared complications for patients with HNC receiving PBM with those in patients who did not, hypothesizing that PBM improves mucositis severity, weight loss, and FTD. Methods and Materials: Medical records of 44 patients with HNC treated with CRT or RT from 2015 to 2021 were reviewed (22 PBM, 22 controls; median age, 63.5 years; range, 45-83 years). Between-group outcomes of interest included maximum mucositis grade, weight loss, and FTD 100 days after initiation of treatment. Results: Median RT doses were 60 Gy (PBM) and 66 Gy (control). Eleven patients treated with PBM received CRT; 11 received RT alone (median of 22 PBM sessions [range, 6-32]). Sixteen control group patients received CRT; 6 received RT alone. Median maximal mucositis grades were 1 in the PBM group and 3 in the control group (P < .0001). The adjusted odds of higher mucositis grade were only 0.024% (P < .0001; 95% confidence interval, 0.004-0.135) in PBM compared with the control group. Conclusions: PBM may have a role in decreasing complications related to RT and CRT for HNC, mainly mucositis severity.