@article {Bourbonnebmjspcare-2019-001851, author = {Vincent Bourbonne and Joelle Otz and Ren{\'e}-Jean Bensadoun and Gurvan Dissaux and Francois Lucia and Jean-Christophe Leclere and Olivier Pradier and Ulrike Schick}, title = {Radiotherapy mucositis in head and neck cancer: prevention by low-energy surface laser}, elocation-id = {bmjspcare-2019-001851}, year = {2019}, doi = {10.1136/bmjspcare-2019-001851}, publisher = {British Medical Journal Publishing Group}, abstract = {Background Modern radiotherapy (RT) planning techniques and the use of oral supportive care have reduced the occurrence of acute radiation-induced toxicities. Oral mucositis remains a major concern in patients with head and neck cancer as it can compromise treatment compliance and outcome.Objective To report the rate of mucositis with the preventive use of surface low-level laser therapy in patients with head and neck cancer.Methods Forty patients treated with definitive (n=27) or adjuvant (n=13) RT using volumetric arc therapy between August 2014 and October 2015 for squamous cell carcinoma of the head and neck were included. All patients were treated using photobiomodulation using surface low-level laser therapy (Heltschl kind FL 3500, 350 mW), 3 times a week during the whole treatment course. The grade of mucositis was obtained from week 1 to week 7 and at 1 month.Results The median RT dose was 70 Gy (64{\textendash}70). Concomitant chemotherapy was administered in 29 patients. According to the Common Terminology Criteria for Adverse Events (CTCAE) v. 3, grade 0, 1, 2 and 3 mucositis was observed in 9 (22.5\%), 9 (22.5\%), 16 (40\%) and 6 (15\%) patients at week 7, and 32 (80\%), 2 (5\%), 3 (7.5\%) and 3 (7.5\%) patients at 1 month following treatment. No grade 4 occurred. Median average and maximum dose to the oral mucosa was 42 Gy (12.9{\textendash}66.3) and 66.6 Gy (39{\textendash}76), respectively.Conclusion Despite a substantial dose to the oral mucosa, the rate of acute radiation-induced mucositis of grade >=3 remains low in patients receiving extraoral low-energy laser during RT.}, issn = {2045-435X}, URL = {https://spcare.bmj.com/content/early/2019/09/16/bmjspcare-2019-001851}, eprint = {https://spcare.bmj.com/content/early/2019/09/16/bmjspcare-2019-001851.full.pdf}, journal = {BMJ Supportive \& Palliative Care} }