A Case Series on the Combined Use of Zinc L-Carnosine and Nd:YAG Photobiomodulation for Radiation-Induced Oral Mucositis: Pain Reduction and Lesion Improvement.

Radiation-induced oral mucositis (RIOM) is a severe complication in patients with head and neck cancer (HNC) undergoing radiotherapy (RT). Despite several proposed strategies for prevention and treatment, the results remain inconsistent and unpredictable. A combined approach with zinc L-carnosine (ZnC) mouthwash and Nd:YAG laser photobiomodulation (PBM) was evaluated in three patients affected by RIOM, treated at the Unit of Oral Medicine, Pathology and Laser-assisted Surgery of the University of Parma, Italy. One patient had oropharyngeal cancer, one had tongue cancer, and one had soft palate cancer. Two patients presented with World Health Organization (WHO) grade III mucositis, and one with WHO grade II mucositis. The percentage reduction in oral lesions was calculated using Fiji software. All patients reported clinical improvement and a reduction in algic symptoms. A significant decrease in pain was observed after only 2 days, while complete mucosal healing was achieved within 3 weeks. These preliminary results suggest that the combined use of ZnC and Nd:YAG laser PBM may be a promising therapeutic option for patients affected by RIOM, warranting further investigation in larger clinical studies.