1. Amelioration of Oral Mucositis Pain by NASA Near Infra Red Light Emitting Diodes in Bone Marrow Transplant Patients
Brian Hodgson, DDS
Assistant Professor, Pediatric Dentistry
Marquette University School of Dentistry
MASCC/ISOO Symposium, Vancouver, BC

2. Specific Aims
Document a 25% reduction in patient reported pain associated with oral mucositis by applying near-infra-red light (670nm) to the oral mucosa from an extra-oral source.
Randomized, double-blind, placebo controlled study.

3. Methods and Materials
85 consecutively recruited adult and pediatric cancer patients receiving a matched unrelated hematopoietic stem cell transplant as part of their cancer therapy. Five patients withdrawn from the study (4 due to admittance into an ICU (not related to the light therapy), 1 for personal reasons).
Recruited between Mar 07-Arp 09.

4. Methods and Materials

5. Methods and Materials
Control group (40) – placebo light treatment starting on Day 0 of their transplant and continuing through DAY +14.
Experimental group (40) – “real” light treatment as above.
670 (+/- 10) nm with a power density of ~50 mW/cm2 for eighty (80) seconds, resulting in a energy delivery of 4 J/cm2 to the extra-oral cheek and throat tissues.
All treatments, placebo and experimental, provided by blinded nurses.

6. Methods and Materials
Blinded evaluator examined each patient 3x/wk for 2 weeks reulting in 7 evaluations per pt. (baseline on Day 0 plus 6 more examinations)
Scored as per WHO, NCI, and OMAS criteria; also patient reported pain on VAS and patient reported ability to handle oral nutrition/secretions.

7. Results

8. Results

9. Results
Reduction in pain in the experimental regular risk group vs. the placebo regular risk group. (p = ) (Mantel-Haenszel Chi-square test)
All other measurements showed no significant differences, but majority of measures, experimental patients had better values than placebo patients.

10. Discussion
Results consistent with previous literature in respect to the reduction of pain in cancer therapy related oral mucositis.
Mechanism of action is still unknown.
Research supports reductions in ROS, proinflammatory cytokine reduction, healing gene upregulation.
Most likely a combination of all of the above actions.
Limitations:
Large differences in patient ages between low risk and regular risk treatment groups.

11. Conclusions
Extra-orally applied phototherapy appears to improve patient reported pain in cancer therapy related oral mucositis.
More studies needed to assess optimum timing, dose, frequency, and duration of phototherapy.

12. Support
This work was supported by the National Aeronautics and Space Administration Grant # NNM05AB48C; the Bleser Foundation Endowed Professorship, and the Chad Baumann Neurology Research Endowment at the Medical College of Wisconsin, Milwaukee Wisconsin.

13. Questions?