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The study is designed to assess whether the transcutaneous approach is non-inferior to the intraoral standard, thereby contributing to the optimization and standardization of PBMT protocols in head and neck cancer (HNC) supportive care. Methods: A randomized pilot study is being conducted with 54 patients (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200927 per group) undergoing radiotherapy (60\u201370\u00a0Gy) for HNC. Participants will be randomly assigned to receive either intraoral PBMT (660\u00a0nm, 100 mW, 1\u00a0J\/point, fluence\u2009=\u200910.20\u00a0J\/ cm\u00b2, 10\u00a0s, 44 points) or transcutaneous PBMT (808\u00a0nm, 100 mW, 1\u00a0J\/point, fluence\u2009=\u200934.5\u00a0J\/ cm\u00b2 (central) and 4.3\u00a0J\/ cm\u00b2 (lateral), 10\u00a0s, 32 points). Interventions occur three times weekly throughout treatment. The primary outcome is OM severity, graded by WHO scale. Secondary outcomes include OM severity (NCI-CTCAE), pain intensity (Numeric Rating Scale, NRS), ulcerated area extension, registered through digital images, treatment interruptions and unscheduled healthcare utilization. Expected outcomes: the primary hypothesis posits that transcutaneous infrared PBMT is as effective as intraoral red PBMT in mitigating OM severity. Additionally, the transcutaneous approach is expected to offer logistical advantages, including a reduction in application time (80\u00a0s vs. 440\u00a0s) and improved tolerability in patients with radiation-induced trismus or severe oral pain. Conclusion: This protocol is expected to provide robust evidence to support the most feasible and effective PBMT modality for OM prevention. By optimizing treatment delivery, the study may enhance adherence, preserve nutritional status, and improve the quality of life for patients undergoing oncological therapy.\n                  <\/jats:p>","DOI":"10.1007\/s10103-026-04977-3","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:36:58Z","timestamp":1785310618000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative efficacy of two photobiomodulation protocols transcutaneous versus intraoral in the prevention of oral mucositis in head and neck cancer: a randomized study protocol"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6301-8767","authenticated-orcid":false,"given":"Waleska Tychanowicz","family":"Kolodziejwski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna Leal Klein","family":"Renz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Busnello","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa Franceschi","family":"Coimbra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana Almeida","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurindo Moacir","family":"Sassi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa Rodrigues","family":"de Araujo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"4977_CR1","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s10555-005-5044-4","volume":"24","author":"L D\u00f6brossy","year":"2005","unstructured":"D\u00f6brossy L (2005) Epidemiology of head and neck cancer: magnitude of the problem. 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