Springer_July-8-2019

Multinational Association for Supportive Care in Cancer (MASCC) guidelines recommend PBM treatment for the prevention of oral mucositis

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Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines.

Purpose:
To systematically review the literature and update the evidence-based clinical practice guidelines for the use of photobiomodulation (PBM), such as laser and other light therapies, for the prevention and/or treatment of oral mucositis (OM).

Springer Link

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National Institute of Health and Care Excellence (NICE-UK) guidance for the UK NHS recommends laser therapy for oral mucositis

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Low-level laser therapy for preventing or treating oral mucositis caused by radiotherapy or chemotherapy.

National Institute of Health and Care Excellence (NICE-UK)

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Low Level Laser improves survival of head and neck cancer patients.

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Long-term survival of a randomized phase III trial of head and neck cancer patients receiving concurrent chemoradiation therapy with or without low-level laser therapy (LLLT) to prevent oral mucositis

Abstract

Background: The impact of low-level laser therapy (LLLT) to prevent oral mucositis in patients treated with exclusive chemoradiation therapy remains unknown. This study evaluated the overall, disease-free and progression-free survival of these patients.

PubMed.gov

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30% reduction of the costs of hospitalization in PBM Oral Mucositis patients.

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Cost-effectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation

Abstract

Oral mucositis (OM) is one of the side effects of hematopoietic stem cell transplantation (HSCT), resulting in major morbidity. The aim of this study was to determine the cost-effectiveness of the introduction of a specialized oral care program including laser therapy in the care of patients receiving HSCT with regard to morbidity associated with OM. Clinical information was gathered on 167 patients undergoing HSCT and divided according to the presence (n = 91) or absence (n = 76) of laser therapy and oral care. Cost analysis included daily hospital fees, parenteral nutrition (PN) and prescription of opioids. It was observed that the group without laser therapy (group II) showed a higher frequency of severe degrees of OM (relative risk = 16.8, 95% confidence interval -5.8 to 48.9, p < 0.001), with a significant association between this severity and the use of PN (p = 0.001), prescription of opioids (p < 0.001), pain in the oral cavity (p = 0.003) and fever > 37.8°C (p = 0.005). Hospitalization costs in this group were up to 30% higher. The introduction of oral care by a multidisciplinary staff including laser therapy helps reduce morbidity resulting from OM and, consequently, helps minimize hospitalization costs associated with HSCT, even considering therapy costs.

PubMed.gov

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white paper

Cost-effectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation

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Oral mucositis (OM) is one of the side effects of hematopoietic stem cell transplantation (HSCT), resulting in major morbidity. The aim of this study was to determine the cost-effectiveness of the introduction of a specialized oral care program including laser therapy in the care of patients receiving HSCT with regard to morbidity associated with OM.

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white paper

Evaluating the Supportive Care Costs of Severe Radiochemotherapy-Induced Mucositis and Pharyngitis

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BACKGROUND
Few studies have examined the costs of supportive care for radiochemotherapy-induced mucosits/pharyngitis among patients with head and neck cancer (HNC) or lung cancers despite the documented negative clinical impact of these complications.

METHODS
The authors identified a retrospective cohort of patients with HNC or nonsmall lung cancer (NSCLC) who had received radiochemotherapy at 1 of 3 Chicago hospitals (a Veterans Administration hospital, a county hospital, or a tertiary care hospital). Charts were reviewed for the presence/absence of severe mucositis/pharyngitis and the medical resources that were used. Resource estimates were converted into cost units obtained from standard sources (hospital bills, Medicare physician fee schedule, Red Book). Estimates of resources used and direct medical costs were compared for patients who did and patients who did not develop severe mucositis/pharyngitis.

RESULTS
Severe mucositis/pharyngitis occurred in 70.1% of 99 patients with HNC and in 37.5% of 40 patients with NSCLC during radiochemotherapy. The total median medical costs per patient were $39,313 for patients with mucositis/ pharyngitis and $20,798 for patients without mucositis/pharyngitis (P 5 .007). Extended inpatient hospitalization accounted for $12,600 of the increased medical costs (median 14 days [$19,600] with severe mucositis/pharyngitis vs 5 days [$7000] without; P 5 .017). For patients who had HNC with mucositis/pharyngitis, incremental inpatient hospitalization costs were $14,000, and total medical costs were $17,244. For patients who had NSCLC with mucositis/pharyngitis, these costs were $11,200 and $25,000, respectively.

CONCLUSIONS
In the current study, the medical costs among the patients with HNC and NSCLC who received radiochemotherapy were greater for those who developed severe mucositis/pharyngitis than for those who did not.

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