Comparable efficacy of extraoral and intraoral photobiomodulation in preventing oral mucositis during high-dose methotrexate therapy in pediatric oncology: A single-blind randomized controlled trial

Published October 19, 2026. Extraoral and intraoral red-light protocols produced similar oral-mucositis, pain and oral-health outcomes during high-dose methotrexate treatment. Extraoral delivery was much faster. Because both groups received active PBM, the trial compares delivery methods rather than proving effectiveness against no PBM.

Freitas IDOP, Schuartz I, Renz GLK, Mobile RZ, França MLS, Pianovski MAD, Sassi LM, de Araujo MR.
Supportive Care in Cancer · Publication date: 2026-10-19
Added to site: 2026-10-21
DOI: 10.1007/s00520-026-11372-9

Published online October 19, 2026. Added to Neurofeedback.com October 21, 2026.

Modalities

Photobiomodulation, Red light

Clinical focus

Pediatric oncology, Oral mucositis, Treatment delivery

Population

Patients aged 1 to 18 receiving high-dose methotrexate for leukemia, lymphoma or osteosarcoma

Sample

155 randomized: 73 intraoral and 82 extraoral PBM

Intervention / method

Daily 660 nm red-light PBM at 100 mW and 1 J per point from admission through discharge; extraoral sessions took 30 seconds and intraoral sessions approximately six minutes excluding handling

Comparator

Extraoral active PBM versus intraoral active PBM; no sham or no-PBM group

Clinician summary

Oral mucositis occurred in 35.5% overall, with no significant difference between intraoral and extraoral delivery (41.1% versus 30.5%, p=.168). Severity, pain, salivary pH and plaque index also did not differ. Age and methotrexate dose, not PBM modality, were associated with severity. Median pain was zero at all assessments.

How to interpret the findings

There was no sham or no-treatment control, so similar outcomes cannot establish absolute preventive efficacy. The study was single-blind, and the accessible abstract does not provide adverse-event detail or durability beyond the treatment window.

Equipment and disclosures

The abstract reports 660 nm, 100 mW and 1 J per point but does not identify a manufacturer. No BrainMaster attribution is made.

The indexed record states that the authors declared no competing interests. Funding was not identified in the checked abstract. No correction, retraction or concern relation appeared in the retained Crossref record; this is a bounded check. AI-assisted review.

Related evidence

Compare findings from the same clinical area, including mixed results.