Photobiomodulation in the management of radiotherapy and Chemotherapy induced oral mucositis: a case report highlighting the role of a multidisciplinary team

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Aims: To present a clinical case illustrating the diagnosis and multidisciplinary management of oral complications particularly oral mucositis resulting from head and neck radiotherapy and chemotherapy, and to highlight the role of photobiomodulation therapy as an effective supportive approach due to its anti-inflammatory, analgesic, and tissue-healing effects. Case Report: A 78-year-old retired Caucasian man was referred by his local health unit to the Oral Medicine Specialty Center. The patient was diagnosed with squamous cell carcinoma (SCC) on the ventral aspect of the tongue. He did not undergo surgical resection of the lesion due to atrial fibrillation. After starting RT treatment, the patient was referred to the Oral Medicine Specialty Center, as the medical team identified extensive severe OM lesions that prevented the patient from eating and drinking. Photobiomodulation therapy (PBMT) treatment was initiated to relieve pain and promote healing of the lesions, was performed using a dual-wavelength diode laser (810 + 980 nm, Gemini EVO®, Ultradent). Extra-oral application used a 25 mm tip (1 W, 4.91 cm², 1.2 J/cm², 20 J per point) at 12 points for 20 seconds each. Intra-oral PBM used a 7 mm tip (0.3 W, 0.38 cm², 15.78 J/cm², 1.2 J per point) applied at 9 points for 4 seconds each. After 5 sessions of PBMT, the patient showed improvement and was able to resume oral feeding. Results: This case report details the diagnosis, treatment, and follow-up of a patient with multiple adverse effects induced by CT-RT, highlighting the significant role of PBMT in the care of patients undergoing head and neck cancer treatment. Conclusions: PBMT contributes to tissue repair of induced lesions and pain relief, ultimately improving the patient's quality of life during cancer therapy.

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