Use of Low-Level Diode Laser Therapy in the Management of Radiation-Induced Oral Mucositis: A Prospective Clinical Study

Introduction
Radiation-induced oral mucositis (RIOM) is one of the most frequent complications of radiotherapy and chemoradiotherapy for head and neck cancer. It is characterized by erythema, epithelial atrophy, and ulceration of the oral mucosa, leading to pain, dysphagia, impaired oral intake, and reduced quality of life. The aim of this prospective study was to evaluate the clinical effectiveness of low-level laser therapy (LLLT) using a diode laser in the prevention and management of radiation-induced oral mucositis.

Materials and Methods
A prospective clinical study was conducted at the Department of Dentistry, University of Bari. Twelve patients undergoing radiotherapy or concurrent chemoradiotherapy for head and neck cancer were prospectively enrolled. All patients received supportive care combined with low-level laser therapy using a 660 nm diode laser (30 mW). Laser irradiation was performed twice weekly throughout the oncological treatment. Oral mucositis severity was assessed using the World Health Organization (WHO) grading system, while pain intensity was evaluated using the Visual Analog Scale (VAS).

Results
All patients completed the planned oncological treatment and follow-up. Low-level laser therapy was associated with reduced severity of oral mucositis, lower pain scores, and improved maintenance of oral feeding during treatment. Most patients developed only mild to moderate mucosal lesions, and no interruptions of oncological therapy due to oral mucositis were required. No adverse effects related to laser therapy were observed.

Conclusions
Within the limitations of this prospective study, low-level laser therapy using a diode laser appears to be a safe and effective supportive treatment for radiation-induced oral mucositis. The protocol reduced the severity of mucosal lesions, improved pain control, and facilitated continuation of oncological therapy. Larger randomized controlled clinical trials are required to confirm the long-term clinical benefits of this therapeutic approach.