ID #797 Photobiomodulation (PBMT) Strategies to Manage Chemotherapy-Induced Mucositis Risk

Background/Purpose

Photobiomodulation (PBMT) uses light therapy to promote tissue health and healing[1]. Published literature establishes feasibility and efficacy of PBMT in mucositis prevention and management in the inpatient setting[2, 3]. Mucositis risk however, extends beyond this setting, with a lack of demonstrated ambulatory PBMT options. The purpose of this multi-step project was to determine the feasibility of PBMT in the ambulatory setting.

Methods

In 2024, Children’s Minnesota completed a pilot study creating standard operating procedures (SOPs) and educational materials focused on ambulatory PBMT implementation. The pilot tracked mucositis risk, rate of mucositis documentation, the incidence and setting of PBMT administrations, and any impact to staffing.

This data guided a 2025 feasibility pilot to expand access to PBMT through handheld administration for patients in ambulatory or home settings. Patient demographic information and participation rates were measured. Study participants received a handheld PBMT device and educational materials upon enrollment. Participants diaries tracked oral cares, device use, and evidence of mucositis. Participant surveys reported symptom impact and study satisfaction.

Findings/Outcome

Initial implementation was complex but successful. Staff indicated improved knowledge and comfort with PBMT. Administration averaged 17.36 minutes (N = 138). Mucositis documentation rose from negligible to 76%. Despite the pilot’s ambulatory focus, 48% of administrations occurred inpatient. Financial and insurance constraints were the primary barriers to ambulatory administration.

Preliminary feasibility pilot data include patients screened (N = 316), 49% of patients eligible, and 39.6% enrollment of eligible patients. Reasons patients were not eligible or enrolled were reported. Participant demographic data aligned with the overall institutional data. 73% of expected diary days were completed. 100% of baseline and 91.2% of post-cycle 1 surveys were completed. 100% of participants reported adequate education, 96% reported it easy to use, 90% found it helpful, and 92% would use handheld PBMT again. Final data analysis is pending.

1. Amadori, F., Bardellini, E., Conti, G., Pedrini, N., Schumacher, R. F., & Majorana, A. (2016). Low-level laser therapy for treatment of chemotherapy-induced oral mucositis in childhood: A randomized double-blind controlled study. Lasers in Medical Science, 31(6), 1231–1236. https://doi.org/10.1007/s10103-016-1975-y

2. Miranda-Silva, W., Gomes-Silva, W., Zadik, Y., Yarom, N., Abdul, &, Al-Azri, R., Hong, C. H. L., Ariyawardana, A., Saunders, D. P., Correa, & M. E., Arany, P. R., Bowen, J., Kin, K., Cheng, F., Wim, &, & Tissing, J. E. (2021). MASCC/ISOO clinical practice guidelines for the management of mucositis: Sub-analysis of current interventions for the management of oral mucositis in pediatric cancer patients. Supportive Care in Cancer, 29, 3539–3562. https://doi.org/10.1007/s00520-020-05803-4/Published

3. Patel, P., Robinson, P. D., Baggott, C., Gibson, P., Ljungman, G., Massey, N., Ottaviani, G., Phillips, R., Revon-Rivière, G., Treister, N., White, M., Cabral, S., Dupuis, L., & Sung, L. (2021). Clinical practice guideline for the prevention of oral and oropharyngeal mucositis in pediatric cancer and hematopoietic stem cell transplant patients: 2021 update. In European Journal of Cancer, 154, 92–101. https://doi.org/10.1016/j.ejca.2021.05.013