High-power laser photobiomodulation therapy for immediate relief of mucositis-related odynophagia

Background: Mucositis-related odynophagia (pain on swallowing) presenting during or shortly after radiotherapy, chemotherapy, hematopoietic cell transplantation, or other oncologic treatments is a common and clinically significant complication that may adversely affect oral intake, nutrition, weight, and quality of life. However, effective treatment options remain limited, and management often relies on supportive care or enteral feeding. This study evaluated the effect of combined intraoral and extraoral high-power laser photobiomodulation therapy (PBMT) on mucositis-related odynophagia. Methods: Patients with mucositis-related odynophagia received ≥ 1 session of 940 nm pulsed diode laser PBMT (intraoral: 2–3 W, non-contact, rotatory motion, 1 cm2 spot size; extraoral: 0.3–0.5 W, contact over the cervical region). Pain intensity was assessed before and after each session using a 0–10 numerical rating scale (NRS). Results: Forty-six patients underwent 85 treatment sessions, of which 80 were evaluable. Pain scores decreased significantly following PBMT (mean ± SD: 7.4 ± 2.5 vs. 4.6 ± 2.7; p < 0.001), corresponding to a mean reduction of 2.8 ± 2.1 points (∼40 %). Clinically meaningful improvement (≥ 2 NRS points) was observed in 73 % of sessions. The analgesic effect persisted for a mean of 3.8 ± 3.8 days. Treatment response was consistent across subgroups, with greater reductions observed in patients with higher baseline pain (β = 0.239, p = 0.006). Conclusions: High-power PBMT was associated with rapid and clinically meaningful pain relief in oncotherapy-induced odynophagia. This effect may help delay or reduce the need for gastrostomy tube (G-tube) placement and support oral intake. Accordingly, high-power PBMT may represent an additional layer in supportive care strategies for mucositis and its related complications.