LED-based low-level light therapy for oral mucositis in cancer patients: a systematic review and GRADE analysis.

OBJECTIVE: This systematic review aimed to evaluate the efficacy of light-emitting diode (LED) therapy in reducing oral mucositis (OM) severity, pain, and healing time in cancer patients and compare it to standard care or sham light. MATERIALS AND METHODS: A comprehensive search of major databases was conducted using relevant MeSH terms and keywords. Two authors independently screened studies meeting the eligibility criteria. The Cochrane Risk-of-Bias tool for randomized controlled trials (RoB-2) and the Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-I) were used to assess the methodological quality of included studies. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: The review included five studies (256 participants). Four studies reported significant improvements in OM severity and pain with LED therapy while only one study suggested improved healing time. The risk of bias was moderate among the included studies. Due to heterogeneous data, a meta-analysis could not be performed. The GRADE assessment indicated low certainty of evidence, highlighting the need for further clinical research. CONCLUSION: LED therapy may effectively manage cancer therapy-induced OM by reducing patient-reported pain and OM duration. However, the low certainty of evidence warrants more well-designed, longitudinal studies with larger sample sizes to confirm these findings and establish optimal treatment protocols.