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Shirazian S, Mohseni A, Pourshahidi S, Alaeddini M, Etemad-Moghadam S, Vatanpour M. The effect of different parameters of low-level laser used in the treatment of oral mucositis, on the viability and apoptosis of oral squamous cell carcinoma cells: In vitro study. Photochem Photobiol 2024. [PMID: 39032055 DOI: 10.1111/php.13997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 06/23/2024] [Accepted: 06/26/2024] [Indexed: 07/22/2024]
Abstract
Oral mucositis is a complication of chemo/radiotherapy. To assess the impact of various power levels of diode-laser on the survival and expression of apoptosis-related genes in oral cancer cells, it is crucial to consider the potential existence of malignant cells within the treatment region and the reliance of laser effectiveness on its specific characteristics. Cal-27 cells were cultivated and exposed to a 660 nm-diode-laser at power levels of 20, 40, and 80 mW, alongside non-irradiated control cells. Viability and expression of Bax and Bcl-2 mRNA were assessed with Methyl Thiazolyl Tetrazolium (MTT) and Real-time Polymerase Chain Reaction (RT-PCR), respectively. The results were analyzed using one-way ANOVA and Tukey post-hoc test (p < 0.05). A significant reduction in viability was found only in the 20 mW group compared to controls (p = 0.001). Cell survival was significantly lower in cells receiving 20 mW laser than those treated with 40 and 80 mW (p < 0.05). None of the laser groups showed significant changes in BcL-2, but Bax was significantly lower in cells receiving 40 and 80 mW (p < 0.05), compared to controls. Laser irradiation at 660 nm (2 J/cm2, 30 s) significantly reduced the viability of oral cancer cells when using 20 mW power. These specifications align with the recommendation that the lowest possible laser dose should be applied for treating cancer patients. The exact mechanism of cell death following laser therapy with these specifications requires further investigation.
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Affiliation(s)
- Shiva Shirazian
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Atieh Mohseni
- Student of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Pourshahidi
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Alaeddini
- Oral and Maxillofacial Pathology, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahroo Etemad-Moghadam
- Oral and Maxillofacial Pathology, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Vatanpour
- Department of Endodontics, Tehran Dental Branch, Islamic Azad University, Tehran, Iran
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Soh WK, Cheah KF, Veettil SK, Pandiar D, Nimbalkar S, Gopinath D. Photobiomodulation Therapy in the Management of Oral Lichen Planus: A Systematic Review and Meta-Analysis. Eur J Dent 2024. [PMID: 38744337 DOI: 10.1055/s-0044-1782213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
Photobiomodulation therapy (PBMT) is a non-invasive and the latest form of therapy used in the treatment of non oncological diseases as well as cancers of various types and locations. The aim of this study was to systematically review and assess the efficacy of PBMT in managing oral lichen planus (OLP) compared to the interventions. A systematic review and meta-analysis were implemented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search using PubMed, Scopus, and Cochrane was conducted to retrieve relevant studies published until June 2023. The outcomes evaluated included the reduction in pain score and clinical severity scores (Prospero No CRD42023428626). A total of eight studies were identified for qualitative synthesis. The pooled analysis incorporating six studies revealed that there are no significant differences for both mean pain score (mean difference [MD] = 0.21, 95% confidence interval [CI] = -0.51, 0.93) as well as clinical score (MD = -0.08, 95% CI = -0.4, 0.25) between PBMT and comparison groups. Subgroup analysis based on corticosteroids as controls showed that there was no significant difference in mean reduction in pain score between PBMT and topical steroids (MD = 0.38, 95% CI = -0.54, 1.31). PBMT is as effective as other interventions in the treatment of OLP, though not superior, and can be a promising alternative treatment for cases resistant to steroids or when steroids are contraindicated. Further studies are recommended to standardize the optimal settings for the treatment of OLP.
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Affiliation(s)
- Wei Kang Soh
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Kwok Fu Cheah
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Sajesh K Veettil
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Deepak Pandiar
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Smita Nimbalkar
- Clinical Oral Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Divya Gopinath
- Basic Medical and Dental Sciences Dept, College of Dentistry, Ajman University, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
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Khalil M, Hamadah O, Saifo M, Khalil H, Adi M, Alabeedi F, Kujan O. Effect of Photobiomodulation on Salivary Cytokines in Head and Neck Cancer Patients with Oral Mucositis: A Systematic Review. J Clin Med 2024; 13:2822. [PMID: 38792366 PMCID: PMC11122140 DOI: 10.3390/jcm13102822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/11/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Oral mucositis is a common and distressing side effect of head and neck oncology treatment. Photobiomodulation therapy can be utilized to prevent and treat oral mucositis. Its impact on salivary cytokines has yet to be thoroughly investigated. This is the first systematic review aiming to evaluate the effect of photobiomodulation on salivary cytokines in patients undergoing anticancer treatment. Methods: Numerous data resources, from the Web of Science, Embase, ScienceDirect, PubMed, Cochrane Library, and Scopus were sought. Articles published up until February 2024 were included if they met the following inclusion criteria: clinical trials reporting the effect on salivary cytokines in patients undergoing anticancer therapy. The methodological quality was assessed using several appraisal tools. Results: Four studies were deemed eligible for inclusion. All the studies were conducted in Brazil and used an InGaAlP diode laser with a wavelength of 660 nm. The included studies had a relatively low risk of bias. The head and neck cancer patients' salivary cytokines that were assessed by the studies, along with photobiomodulation therapy, included IL-12p70, TNF-α, IL-6, IL-8, IL-10, CXCL8, and IL-1β. The results varied among the studies. Conclusions: Our results show that photobiomodulation demonstrated positive results for reducing the severity of OM in all the included studies. Among the examined salivary cytokines, IL-6 is the most relevant cytokine for oral mucositis development and severity. A variation in the cytokine levels between the studies was noted due to differences in the type of anticancer treatment and saliva sampling.
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Affiliation(s)
- Marwa Khalil
- Department of Oral Medicine, Faculty of Dental Medicine, Damascus University, Damascus P.O. Box 30621, Syria; (M.K.); (O.H.)
| | - Omar Hamadah
- Department of Oral Medicine, Faculty of Dental Medicine, Damascus University, Damascus P.O. Box 30621, Syria; (M.K.); (O.H.)
- The Higher Institute for Laser Research and Applications, Damascus University, Damascus P.O. Box 30621, Syria
| | - Maher Saifo
- Faculty of Medicine, Medical Oncology, Damascus University, Damascus P.O. Box 30621, Syria;
- Albairouni University Hospital, Damascus University, Damascus P.O. Box 30621, Syria
| | - Hasan Khalil
- Department of Microbiology and Biochemistry, Tishreen University, Lattakia P.O. Box 2230, Syria;
| | - Mowaffak Adi
- Shining Horizons Dental Center, Inaya Medical Colleges, Riyadh 13541, Saudi Arabia;
| | - Faris Alabeedi
- UWA Dental School, The University of Western Australia, Nedlands, WA 6009, Australia;
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Nedlands, WA 6009, Australia;
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Schepanski N, Costa FS, Machado EFM, Pacheco MN, Amaral CDB, Machado RC, Nogueira ARA, Brancher JA, Sassi LM, de Araujo MR. Evaluation of photobiomodulation therapy (PBMT) on salivary flow and composition in head and neck cancer patients undergoing radiation therapy. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:253-263. [PMID: 38218654 DOI: 10.1016/j.oooo.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/13/2023] [Accepted: 11/04/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVE Assess the impact of photobiomodulation therapy (PBMT) on xerostomia, salivary flow rate (SFR) and composition in patients undergoing radiotherapy (RT) for head and neck cancer (HNC). STUDY DESIGN Thirty patients undergoing RT (65 Gy) for HNC were enrolled. Saliva and xerostomia evaluations collected pre- and post-PBMT-RT. PBMT involved irradiation of extra and intraoral points, 15-20 sessions, 2-3 times/week. SFR, trace elements, total protein, alkaline phosphatase, xerostomia, and pH were analyzed. RESULTS The average age was 60.7 years. After treatment, there was not a significant reduction in SFR and there was no difference on xerostomia. Significant reductions in Al, Cd, Fe, Ni, P, and Sb concentrations were observed, along with a significant increase in Mg concentration. Sample data were organized into 3 groups based on a self-organizing map. Low concentrations of Al, As, Co, Cr, Cu, Fe, Mn, Mo, S, Sr, and Zn were the primary discriminatory factors for group A, while group B consisted of post-PBMT-RT samples with high concentrations of Ca, K, Mg, Na, and S. CONCLUSIONS PBMT prevented a significant reduction in SFR and xerostomia induced by radiation therapy. These findings suggest that PBMT prevents salivary gland damage minimizing the decline in salivary flow.
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Affiliation(s)
- Natalia Schepanski
- Department of Stomatology, Federal University of Paraná, Curitiba, PR, Brazil
| | | | | | | | - Clarice D B Amaral
- Department of Chemistry, Federal University of Paraná, Curitiba, PR, Brazil
| | | | | | - João Armando Brancher
- Pontifícia Universidade Católica do Paraná, Escola de Ciências da Vida, Curitiba, PR, Brazil
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Polat B, Okur DT, Çolak A, Okur S, Özkaraca M, Yilmaz K. Comparison of three different dosages of low-level laser therapy on expression of cell proliferation and inflammatory markers following ovariohysterectomy in rats. Cutan Ocul Toxicol 2023; 42:273-282. [PMID: 37624142 DOI: 10.1080/15569527.2023.2252075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
The objective of the current study was to evaluate Low-level laser therapy (LLLT) on the healing of incisional wounds following ovariohysterectomy in rats, by means of subjective histopathological and immunohistochemical analysis. A total of 72 female Wistar rats were categorised into four treatment groups (Group I; sacrification 4 hours following only one LLLT application, Group II; sacrification 7 days following only one LLLT application, Group III; sacrification 4 hours after two LLLT applications, and Group IV; sacrification 7 days after two LLLT applications). Each group was further divided into four different doses subgroups (Group Control [C, off mode LLLT application], L1 [1 J/cm2], L3 [3 J/cm2], and L6 [6 J/cm2]), with equal representation in each subgroup. Ovariohysterectomy was employed using two 2-cm-length midline abdominal incisions in the left and right sides of line alba. The Group C was assigned to the left side incision to each rat in the study. After irradiation, the tissue was subjected to histopathological analysis to determine the extent of mononuclear cell infiltration, edoema, and epithelialization. Additionally, immunohistochemical analysis was performed to evaluate the expression of proliferating cell nuclear antigen (pCNA) and inducible nitric oxide synthase (iNOS). Group L1 and L3 significantly decreased mononuclear cell infiltration compared with Group C in all treatment groups (p < 0.05). Group L3 significantly decreased edoema compared with Group C in all groups except for treatment Group I (p < 0.05). Group L2 and L3 significantly increased epithelization in treatment Group IV (p < 0.05). Moreover, Group L2 and L3 significantly increased pCNA in all groups, while L2 and L3 significantly decreased iNOS expression in treatment Group II, III, and IV (p < 0.05). However, no statistical difference was found between subgroups of treatment Group I in iNOS expiration (p > 0.05). The results of the current examination demonstrated that LLLT can modulate mononuclear cell infiltration and edoema, and improve epithelization, as well as increase pCNA expression, whereas decrease iNOS expression during the wound healing process, therefore enhancing wound healing following ovariohysterectomy in rats.
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Affiliation(s)
- Bülent Polat
- Department of Obstetrics and Gynecology, Atatürk University, Erzurum, Turkey
- Bil-Tek, Ata Teknokent, Erzurum, TR, Turkey
| | - Damla Tuğçe Okur
- Department of Obstetrics and Gynecology, Atatürk University, Erzurum, Turkey
| | - Armağan Çolak
- Department of Obstetrics and Gynecology, Atatürk University, Erzurum, Turkey
| | - Sıtkıcan Okur
- Department of Surgery, Atatürk University, Erzurum, Turkey
| | - Mustafa Özkaraca
- Department of Pathology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Kader Yilmaz
- Celal Oruç Animal Production School, Ağrı İbrahim Çeçen University, Ağrı, Turkey
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Agbele AT, Dehpour AR, Jafari RM, Mahdavi SRM, Elyassi A, Seydi M, Bagheri M, Ala M, Roudsari BA, Hejazi M. Development and Application of Prototype System Based on Light-Emitting Diode Arrays (660 nm) with a Top Hat Beam Profile in Order to Optimize Photobiomodulation Protocols for Treatment of Radiation-Induced Oral Mucositis in Rats. Photobiomodul Photomed Laser Surg 2023; 41:622-631. [PMID: 37890115 DOI: 10.1089/photob.2023.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023] Open
Abstract
Background: Oral mucositis (OM) is a common adverse effect of radiation to the head and neck. Recent research has shown that extra oral photobiomodulation (EO-PBM) reduces the severity of OM. However, appropriate EO-PBM therapy parameters for OM severity reduction have not been documented. Objective: This work aims to optimize EO-PBM radiation parameters for lowering the severity of radiation-induced OM in rats by establishing a photobiomodulation (PBM) treatment system based on light-emitting diode arrays with top-hat beam profile. Methods: The 36 rats are separated into 2 control groups and 4 groups receiving PBM treatment. The PBM groups are exposed to irradiance between 4 and 24 J/cm2 at 660 nm. The cheek pouch mucosa is removed after scarification for biochemical and histological examination. Student's t-test, and one-way analysis of variance (ANOVA) followed by Tukey's Multiple were applied to compare the statistical significance of differences between control groups and PBM treatment groups. Results: Statistical analysis reveals that PBM irradiation at 12 J/cm2 (200 sec) with a flatness of 0.8 and a diameter of 3 cm substantially decreased the level of inflammatory cytokines compared with the positive control group. Conclusions: Our results indicate that the designed treatment PBM system is capable of delivering the optical parameters necessary for therapeutic treatment.
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Affiliation(s)
- Alaba Tolulope Agbele
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Dehpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Razieh Mohammad Jafari
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Rabi Mehdi Mahdavi
- Department of Cell Biology and Anatomy, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Arash Elyassi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Seydi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmood Bagheri
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Ala
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Arji Roudsari
- Department of Cell Biology and Anatomy, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Marjaneh Hejazi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Cotomacio CC, Yshikawa BK, Calarga CC, Arana-Chavez VE, Simões A. Red, infrared, and simultaneous laser-wavelengths irradiation effects on 5-fluorouracil-induced oral mucositis in hamsters. JOURNAL OF BIOPHOTONICS 2023; 16:e202300156. [PMID: 37420314 DOI: 10.1002/jbio.202300156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/09/2023]
Abstract
The association of more than one wavelength for photobiomodulation therapy (PBMT) to treat oral mucositis (OM) is unusual in the literature. Thus, this study aims to compare the simultaneous irradiation effects with their isolated application to treat OM. In order of that, 48 male Syrian hamsters were divided into 4 groups: Chemotherapy (Ch), which received only a OM induction protocol (5-fluorouracil chemotherapy and superficial oral mucosa scratches); red laser (RL), which received the OM induction and a PBMT protocol at 660 nm; infrared laser (IRL), which received the OM induction, and a PBMT protocol at 808 nm; and the RL + IRL group, which received the simultaneous application, of 660 and 808 nm wavelengths. Clinical (OM grade classification), histological (light microscopy analysis with H&E and collagen staining), immunohistochemical (TNF-α expression), and biochemical (TNF-α and hydroxyproline concentration) analyzes were performed after 7 and 10 days. Mainly on the 10th day, the RL and IRL groups showed lower OM grades and faster microscopic repair process, with greater expression of collagen fibers and lower TNF-α levels, besides the higher hydroxyproline concentrations, mainly in comparison with the Ch group. In conclusion, in this study, the simultaneous protocol did not present superior results than the isolated irradiations.
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Affiliation(s)
- Claudia C Cotomacio
- School of Dentistry, Paulista University (UNIP), São Paulo, SP, Brazil
- Department of Dentistry, Pediatric Oncology Institute/Support Group for Children and Adolescents with Cancer (GRAACC), São Paulo, Brazil
| | - Bianca K Yshikawa
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (FOUSP), São Paulo, SP, Brazil
| | - Caio C Calarga
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (FOUSP), São Paulo, SP, Brazil
| | - Victor E Arana-Chavez
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (FOUSP), São Paulo, SP, Brazil
| | - Alyne Simões
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (FOUSP), São Paulo, SP, Brazil
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Ahmed SF, Saafan AM, Rasmy AH, Bakr MA. Histomorphometric Analysis of the Healing Capacity of Low-Level Laser on Thermally Induced Tongue Ulcers for Gamma-Irradiated Rats. Photobiomodul Photomed Laser Surg 2023; 41:467-474. [PMID: 37738367 DOI: 10.1089/photob.2023.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
Objective: This study aimed to assess the efficacy of low-level laser therapy (LLLT) for treating thermal tongue ulcers in gamma-irradiated rats. Background: Postradiotherapeutic trauma may cause cell death, tissue damage, organ dysfunction, and loss of hematological components. Materials and methods: Thermal ulcers were induced on the dorsal surfaces of tongues of gamma-irradiated rats (15 Gy). Rats were divided into three groups, group 1 received no treatment, group 2 was subjected to a single dose of diode laser 807 nm with energy density 4 J/cm2, and group 3 was subjected to the same dose of LLLT but fractionated into three sessions at days 1, 3, and 5 after ulcers induction. Ulcers were assessed clinically for their areas and healing percentage. Specimens were examined for the quality of ulcer closure and expression of IL-1β and TGF-β1. Results: Results revealed significant improvement of ulcer healing clinically and histologically in both treatment groups compared to control. Moreover, IL-1β and TGF-β1 expression in both treatment groups was high at the earlier stage of healing then declined by time to reach a normal level. However, untreated group showed higher expression of IL-1β and TGF-β1 compared to treatment groups. In addition, IL-1β expression decreased by time but still of high level and TGF-β1 expression increased then declined. Conclusions: We concluded that gamma radiation-impaired mucosal healing could be related to the over expression of IL-1β and TGF-β1. LLLT, whether one session or fractionated, could be an effective treatment for postradiotherapeutic ulcers. The healing power of LLLT might be due to modulation of IL-1β and TGF-β1. Clinical Trial Registration number is 25A122.
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Affiliation(s)
- Salwa Farid Ahmed
- Health Radiation Research Department, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt
| | - Ali Mohamed Saafan
- Medical Laser Applications Department, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - Amr H Rasmy
- Health Radiation Research Department, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt
| | - Mostafa A Bakr
- Health Radiation Research Department, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Cairo, Egypt
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Fiani B, Jarrah R, Nathani KR. Laser oromaxillofacial photobiomodulation therapy: molecular mechanisms, outcomes and considerations. Regen Med 2022; 17:611-615. [PMID: 35730260 DOI: 10.2217/rme-2022-0091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Tweetable abstract Photobiomodulation therapy is largely characterized as a safe therapeutic model that can modulate the activity of inflammatory and immune biomarkers while facilitating a metabolic response that can regenerate damaged tissue.
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Affiliation(s)
- Brian Fiani
- Department of Neurosurgery, Cornell Medical Center/New York Presbyterian, New York, NY 10065, USA
| | - Ryan Jarrah
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN 55905, USA
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Nabarrete JM, Pereira AZ, Garófolo A, Seber A, Venancio AM, Grecco CES, Bonfim CMS, Nakamura CH, Fernandes D, Campos DJ, Oliveira FLC, Cousseiro FK, Rossi FFP, Gurmini J, Viani KHC, Guterres LF, Mantovani LFAL, Darrigo LG, Albuquerque MIBPE, Brumatti M, Neves MA, Duran N, Villela NC, Zecchin VG, Fernandes JF. Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: children and adolescents. EINSTEIN-SAO PAULO 2021; 19:eAE5254. [PMID: 34909973 PMCID: PMC8664291 DOI: 10.31744/einstein_journal/2021ae5254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 12/10/2020] [Indexed: 11/28/2022] Open
Abstract
The Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Children and Adolescents was developed by dietitians, physicians, and pediatric hematologists from 10 Brazilian reference centers in hematopoietic stem cell transplantation. The aim was to emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to patient´s nutritional assessment. This consensus is intended to improve and standardize nutrition therapy during hematopoietic stem cell transplantation. The consensus was approved by the Brazilian Society of Bone Marrow Transplantation.
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Affiliation(s)
- Juliana Moura Nabarrete
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Andrea Z Pereira
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Adriana Garófolo
- Universidade Federal de São PauloInstituto de Oncologia PediátricaSão PauloSPBrazilInstituto de Oncologia Pediátrica, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Adriana Seber
- Universidade Federal de São PauloSão PauloSPBrazilUniversidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Angela Mandelli Venancio
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Carlos Eduardo Setanni Grecco
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoHospital das ClínicasRibeirão PretoSPBrazilHospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Carmem Maria Sales Bonfim
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Claudia Harumi Nakamura
- Universidade Federal de São PauloInstituto de Oncologia PediátricaSão PauloSPBrazilInstituto de Oncologia Pediátrica, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Daieni Fernandes
- Santa Casa de Misericórdia de Porto AlegrePorto AlegreRSBrazilSanta Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Denise Johnsson Campos
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Fernanda Luisa Ceragioli Oliveira
- Universidade Federal de São PauloEscola Paulista de MedicinaSão PauloSPBrazilEscola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Flávia Krüger Cousseiro
- Santa Casa de Misericórdia de Porto AlegrePorto AlegreRSBrazilSanta Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Flávia Feijó Panico Rossi
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Jocemara Gurmini
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Karina Helena Canton Viani
- Universidade de São PauloFaculdade de MedicinaHospital das ClínicasSão PauloSPBrazilInstituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Luciana Fernandes Guterres
- Santa Casa de Misericórdia de Porto AlegrePorto AlegreRSBrazilSanta Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | | | - Luiz Guilherme Darrigo
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoHospital das ClínicasRibeirão PretoSPBrazilHospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Maria Isabel Brandão Pires e Albuquerque
- Instituto Nacional de Câncer José Alencar Gomes da SilvaRio de JaneiroRJBrazilInstituto Nacional de Câncer José Alencar Gomes da Silva - INCA, Rio de Janeiro, RJ, Brazil.
| | - Melina Brumatti
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Mirella Aparecida Neves
- Universidade Federal do ParanáHospital de ClínicasCuritibaSPBrazilHospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Natália Duran
- Hospital de Câncer de BarretosBarretosSPBrazilHospital de Câncer de Barretos, Barretos, SP, Brazil.
| | - Neysimelia Costa Villela
- Hospital de Câncer de BarretosBarretosSPBrazilHospital de Câncer de Barretos, Barretos, SP, Brazil.
| | - Victor Gottardello Zecchin
- Universidade Federal de São PauloInstituto de Oncologia PediátricaSão PauloSPBrazilInstituto de Oncologia Pediátrica, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Juliana Folloni Fernandes
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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11
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Silva LAD, Pinheiro SL. Clinical Evaluation of Intravascular Blood Irradiation with Laser, Photobiomodulation, and Photodynamic Therapy in Cancer Patients with Mucositis. Photobiomodul Photomed Laser Surg 2021; 39:687-695. [DOI: 10.1089/photob.2021.0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Lucas Augusto da Silva
- Center for Life Sciences, Postgraduate Program in Health Sciences, Pontifícia Universidade Católica de Campinas (PUC Campinas), Campinas, Brazil
| | - Sérgio Luiz Pinheiro
- Center for Life Sciences, Postgraduate Program in Health Sciences, Pontifícia Universidade Católica de Campinas (PUC Campinas), Campinas, Brazil
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12
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Agbele AT, Hejazi SM, Dehpour AR, Mohammad Jafari R, Elyassi A, Bagheri M, Seydi M. Treatment Parameters of Photobiomodulation in the Prevention of Non-surgical Cancer Treatment-Induced Oral Mucositis: A Review of Preclinical Studies. J Lasers Med Sci 2021; 12:e54. [DOI: 10.34172/jlms.2021.54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 03/06/2021] [Indexed: 01/03/2023]
Abstract
Introduction: The most important side effect after non-surgery cancer treatment (NSCT) is oral mucositis (OM) which degrades the quality of life. Using photobiomodulation (PBM), formerly known as low-level laser therapy (LLLT), in the prevention of NSCT-induced OM was widely studied. Hence, this review evaluates the efficacy of optical treatment parameters behind the working process of PBM in preventing NSCT-induced OM in preclinical studies. Methods: Using the PubMed, Scopus and Embase databases, the present study systematically reviewed existing preclinical studies for optical treatment parameters of PBM in preventing NSCT-induced OM in experimental models without restriction on the year of publication. Results: In total, 51 articles were recognized during the search of the literature, and only 16 research papers were included in this review, taking into consideration the inclusion as well as exclusion benchmarks. The reviewed studies showed that a consensus has yet to be reached on the optimal PBM treatment parameters in preventing NSCT-induced OM. However, a wavelength of 660 nm, a power density of 40 mW as well as fluence which ranged between 2 and 6 J/cm2 were mostly utilized in the included studies. Furthermore, the severity of NSCT-induced OM was reduced following PBM application with no reported severe side effects. Conclusion: The efficacy of PBM with the associated optical parameters is a promising strategy in preventing NSCT-induced OM. However, the optimal parameters of PBM need to be investigated.
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Affiliation(s)
- Alaba Tolulope Agbele
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, 1417613151, Tehran, Iran
- Department of Basic Medical Sciences, College of Health Sciences and Technology, Ijero-Ekiti, Nigeria
- Department of Physics, School of Sciences, Federal University of Technology Akure, Nigeria
| | - Sedigheh Marjaneh Hejazi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, 1417613151, Tehran, Iran
- Bio Optical Imaging Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Dehpour
- Experimental Medicine Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Razieh Mohammad Jafari
- Experimental Medicine Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Elyassi
- Bio Optical Imaging Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Bagheri
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, 1417613151, Tehran, Iran
- Bio Optical Imaging Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Seydi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, 1417613151, Tehran, Iran
- Bio Optical Imaging Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
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13
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Cotomacio CC, Calarga CC, Yshikawa BK, Arana-Chavez VE, Simões A. Wound healing process with different photobiomodulation therapy protocols to treat 5-FU-induced oral mucositis in hamsters. Arch Oral Biol 2021; 131:105250. [PMID: 34482219 DOI: 10.1016/j.archoralbio.2021.105250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aim of this study was to analyze the effects of three different Photobiomodulation Therapy (PBMT) protocols in the treatment of 5-fluorouracil-induced oral mucositis in hamsters. DESIGN 60 hamsters were divided into five groups: group "C", which did not receive oral mucosa scratching, 5-fluorouracil (5-FU) or PBMT; group "Ch", which received anesthesia, superficial oral mucosa scratching and 5-FU (oral mucositis induction); and three groups that received oral mucositis induction and a PBMT protocol: groups ChLI, ChLII and ChLIII that received 0.24 J (one point), 1 J (one point) and 1.2 J (five points of 0.24 J) of energy, respectively. The laser equipment used had λ = 660 nm and 0.04 cm2 of spot area (0.226 cm diameter). The animals were euthanized on days 7 and 10 of the experiment, and their oral mucosas were removed for histological (light microscopy and collagen staining), immunohistochemical (NF-kB and TNF-α), and biochemical (TNF-α, NF-kB and hydroxyproline) analysis. RESULTS Group ChLI (less energy), showed the most accelerated repair rates and a lower concentration of inflammatory biomarkers than group Ch. Comparing the three PBMT protocols for treatment of 5-FU-induced oral mucositis in hamsters, the one with low energy (0.24 J) showed better results, regarding reduction of inflammatory biomarkers and tissue repair, than the ones with higher energy (1 and 1.2 J).
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Affiliation(s)
- Claudia C Cotomacio
- School of Dentistry, Paulista University (UNIP), Sao Paulo, SP, Brazil; Pediatric Oncology Institute/GRAACC (Support Group for Children and Adolescents with Cancer), Department of Dentistry, Sao Paulo, Brazil
| | - Caio C Calarga
- Department of Biomaterials and Oral Biology, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Bianca K Yshikawa
- Department of Biomaterials and Oral Biology, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Victor E Arana-Chavez
- Department of Biomaterials and Oral Biology, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Alyne Simões
- Department of Biomaterials and Oral Biology, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil.
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14
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Coutinho JOPA, Quintanilha MF, Campos MRA, Ferreira E, de Menezes GCA, Rosa LH, Rosa CA, Vital KD, Fernandes SOA, Cardoso VN, Nicoli JR, Tiago FCP, Martins FS. Antarctic Strain of Rhodotorula mucilaginosa UFMGCB 18,377 Attenuates Mucositis Induced by 5-Fluorouracil in Mice. Probiotics Antimicrob Proteins 2021; 14:486-500. [PMID: 34255281 DOI: 10.1007/s12602-021-09817-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2021] [Indexed: 12/17/2022]
Abstract
Mucositis is one of the most strenuous side effects caused by chemotherapy drugs, such as 5-fluorouracil (5-FU), during the treatment of several types of cancers. The disease is so prevalent and aggressive that many patients cannot resist such symptoms. However, despite its frequency and clinical significance, there is no effective treatment to prevent or treat mucositis. Thus, the use of probiotics as an adjuvant for the treatment has gained prominence. In the present study, we evaluated the effectiveness of oral administration of the Antarctic strain of Rhodotorula mucilaginosa UFMGCB 18,377 as an alternative to minimize side effects of 5-FU-induced mucositis in mice. Body weight, food consumption, stool consistency, and presence of blood in the feces were assessed daily in mice orally treated or not with the yeast and submitted or not to experimental mucositis. Blood, bones, and intestinal tissues and fluid were used to determine intestinal permeability and immunological, microbiological, and histopathological parameters. Treatment with R. mucilaginosa UFMGCB 18,377 was able to decrease clinical signs of the disease, such as reduction of food intake and body weight loss, and also decreased the number of intestinal enterobacteria and intestinal length shortening. Additionally, treatment was able to decrease the levels of MPO and EPO activities and inflammatory infiltrates, as well as the histopathological lesions characteristic of mucositis in the jejunum and ileum. Results of the present study showed that the oral administration of R. mucilaginosa UFMGCB 18,377 protected mice against mucositis induced by 5-FU.
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Affiliation(s)
- Joana O P A Coutinho
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mônica F Quintanilha
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marina R A Campos
- Departamento de Patologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Enio Ferreira
- Departamento de Patologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Graciéle C A de Menezes
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luiz H Rosa
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Carlos A Rosa
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Katia D Vital
- Departamento de Análises Clínicas E Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Simone O A Fernandes
- Departamento de Análises Clínicas E Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Valbert N Cardoso
- Departamento de Análises Clínicas E Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Jacques R Nicoli
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fabiana C P Tiago
- Centro Federal de Educação Tecnológica de Minas Gerais (CEFET-MG), Belo Horizonte, MG, Brazil
| | - Flaviano S Martins
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. .,Laboratório de Agentes Bioterapêuticos, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, MG, 30270-901, Brazil.
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15
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Photobiomodulation and Antiviral Photodynamic Therapy in COVID-19 Management. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:517-547. [PMID: 33973198 DOI: 10.1007/978-3-030-63761-3_30] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has shocked the world by its spread and contagiousness. There is no approved vaccine and no proven treatment for this infection. Some potential treatments that have already been associated with antiviral and anti-inflammatory effects are under investigation. Photobiomodulation therapy (PBMT) is a photon-based therapy that uses light to mediate a variety of metabolic, analgesic, anti-inflammatory, and immunomodulatory effects. Antiviral photodynamic therapy (aPDT) is a branch of photodynamic therapy based on the reaction between a photosensitizing agent and a light source in the presence of oxygen, which can produce oxidative and free radical agents to damage the viral structures such as proteins and nucleic acids. This chapter aims to discuss the potential therapeutic benefit of PBMT and aPDT in the context of the novel coronavirus. Studies indicate that PBMT and aPDT could be useful in many viral and bacterial pulmonary complications like influenza, SARS-CoV, and MERS, but we found no direct study on SARS-CoV-2. With a combination of PBMT and aPDT, we may be able to combat COVID-19 with minimal interference with pharmaceutical agents. It might improve the efficacy of PBMT and aPDT by using monoclonal antibodies and preparing new photosensitizers at the nanoscale that target the lung tissue specifically. More animal and human studies would need to take place to reach an effective protocol. This chapter would encourage other scientists to work on this new platform.
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16
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de Oliveira AB, Ferrisse TM, Basso FG, Fontana CR, Giro EMA, Brighenti FL. A systematic review and meta-analysis of the effect of photodynamic therapy for the treatment of oral mucositis. Photodiagnosis Photodyn Ther 2021; 34:102316. [PMID: 33940208 DOI: 10.1016/j.pdpdt.2021.102316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 02/09/2023]
Abstract
BACKGROUND Oral mucositis is a significant reaction to antineoplastic treatment characterized with pain, nutritional compromise, impact on the quality of life, interruption in cancer therapy and risk for infection. There is no effective standard protocol for the treatment of oral mucositis. This study aims to synthesize the scientific evidence available about the effects of photodynamic therapy on treatment of oral mucositis. METHODS PubMed, Scopus, Web of Science, Science Direct, Scielo, Embase and Cochrane libraries were searched. Two independent and calibrated researchers (kappa = 0.92) performed all systematic steps according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). To access the risk of bias, RoB 2 and Delphi list criteria for clinical trials were used. Meta-analysis was conducted using the R software with "META" package. RESULTS Clinical and randomized clinical trials were included with a total of five articles. Meta-analysis, level of evidence, and risk of bias assessment were performed showing that photodynamic therapy was effective in reducing healing time in association with low-power laser therapy when compared to low-power laser therapy alone (p = 0.0005). CONCLUSION Photodynamic therapy presents promising results for the treatment of oral mucositis. It may be an effective therapeutic option, contributing to the healing of injured tissues especially in the time needed for repair.
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Affiliation(s)
- Analú Barros de Oliveira
- São Paulo State University (UNESP), School of Dentistry - Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | - Túlio Morandin Ferrisse
- São Paulo State University (UNESP), School of Dentistry - Department of Dental Materials and Prosthesis, Araraquara, SP, Brazil
| | | | - Carla Raquel Fontana
- São Paulo State University (UNESP), School of Pharmaceutical Sciences - Department of Clinical Analysis, Araraquara, SP, Brazil
| | - Elisa Maria Aparecida Giro
- São Paulo State University (UNESP), School of Dentistry - Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | - Fernanda Lourenção Brighenti
- São Paulo State University (UNESP), School of Dentistry - Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil.
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17
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Shirazian S, Keykha E, Pourshahidi S, Ebrahimi H. Effects of 660 nm and 810 nm Low-Power Diode Laser on Proliferation and Invasion of Oral Cancer Cells in Cell Culture Media. Photochem Photobiol 2020; 97:618-626. [PMID: 33119134 DOI: 10.1111/php.13351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/08/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022]
Abstract
In the present study, the effects of 660 and 810 nm diode laser on the proliferation and invasion of cancer cells were investigated. Sixteen plates of oral cancer cells originated from tongue SCC were irradiated with diode laser at 660 nm (40 and 80 mW) and 810 nm (100 and 200 mW) with the energy density of 4 J cm-2 . One plate received no irradiation (the control). Irradiation was performed at four times (0, 24, 72 and 168 h). Cell proliferation was measured by MTT assay. The Ki67 and vascular endothelial growth factor (VEGF) markers were examined by real-time polymerase chain reaction (RT-PCR). Cyclin D1, E-cadherin, β-catenin and matrix metalloproteinase-9 (MMP-9; flow cytometry) were also evaluated. Proliferation was lower in the irradiated groups. This result was significant for all groups at 24 h. The percentages of cyclin D1 and MMP-9 were higher in 810 nm groups, β-catenin and E-cadherin were higher in 660 nm groups, VEGF marker was significantly lower in 810 nm/200 mW group, and Ki67 marker has no difference between the groups. According to the results of this study, laser irradiation at 0 and 24 h resulted in a significant inhibitory effect on cell proliferation especially in 660 nm/80 mW and 810 nm/200 mW. Further studies are needed in this respect.
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Affiliation(s)
- Shiva Shirazian
- Department of Oral and Maxillofacial Medicine, Dentistry School, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Keykha
- Department of Oral Medicine, Dentistry School, Qom University of Medical Science and Health Services, Qom, Iran
| | - Sara Pourshahidi
- Department of Oral and Maxillofacial Medicine, Dentistry School, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooman Ebrahimi
- Laser Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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18
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Pulito C, Cristaudo A, Porta CL, Zapperi S, Blandino G, Morrone A, Strano S. Oral mucositis: the hidden side of cancer therapy. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2020; 39:210. [PMID: 33028357 PMCID: PMC7542970 DOI: 10.1186/s13046-020-01715-7] [Citation(s) in RCA: 147] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023]
Abstract
Inflammation response of epithelial mucosa to chemo- radiotherapy cytotoxic effects leads to mucositis, a painful side effect of antineoplastic treatments. About 40% of the patients treated with chemotherapy develop mucositis; this percentage rises to about 90% for head and neck cancer patients (HNC) treated with both chemo- and radiotherapy. 19% of the latter will be hospitalized and will experience a delay in antineoplastic treatment for high-grade mucositis management, resulting in a reduction of the quality of life, a worse prognosis and an increase in patient management costs. Currently, several interventions and prevention guidelines are available, but their effectiveness is uncertain. This review comprehensively describes mucositis, debating the impact of standard chemo-radiotherapy and targeted therapy on mucositis development and pointing out the limits and the benefits of current mucositis treatment strategies and assessment guidelines. Moreover, the review critically examines the feasibility of the existing biomarkers to predict patient risk of developing oral mucositis and their role in early diagnosis. Despite the expression levels of some proteins involved in the inflammation response, such as TNF-α or IL-1β, partially correlate with mucositis process, their presence does not exclude others mucositis-independent inflammation events. This strongly suggests the need to discover biomarkers that specifically feature mucositis process development. Non-coding RNAs might hold this potential.
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Affiliation(s)
- Claudio Pulito
- Oncogenomic and Epigenetic Unit, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Antonio Cristaudo
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Caterina La Porta
- Center for Complexity and Biosystems, Department of Environmental Science and Policy, University of Milan, via Celoria 26, 20133, Milano, Italy.,CNR - Consiglio Nazionale delle Ricerche, Istituto di Biofisica, via Celoria 26, 20133, Milano, Italy
| | - Stefano Zapperi
- Center for Complexity and Biosystems, Department of Physics, University of Milan, Via Celoria 16, 20133, Milano, Italy.,CNR - Consiglio Nazionale delle Ricerche, Istituto di Chimica della Materia Condensata e di Tecnologie per l'Energia, Via R. Cozzi 53, 20125, Milano, Italy
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Director Office, San Gallicano Institute, Rome, Italy
| | - Sabrina Strano
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS, Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144, Rome, Italy.
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19
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Martins AFL, Morais MO, Sousa-Neto SS, Oton-Leite AF, Pereira CH, Valadares MC, Freitas NMA, Batista AC, Leles CR, Mendonça EF. The Effect of Photobiomodulation on Nitrite and Inflammatory Activity in Radiotherapy-Induced Oral Mucositis: A Randomized Clinical Trial. Lasers Surg Med 2020; 53:671-683. [PMID: 32997817 DOI: 10.1002/lsm.23328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/29/2020] [Accepted: 09/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES To investigate pro- and anti-inflammatory cytokines and nitrite salivary levels in patients with head and neck cancer receiving photobiomodulation therapy (PBMT) associated with a Preventive Oral Care Program (POCP), for prevention and control of oral mucositis (OM) during radiotherapy (RT) associated or not with chemotherapy protocol. STUDY DESIGN/MATERIALS AND METHODS In this randomized double-blinded clinical trial, 48 patients were randomly assigned to two groups: PBMT (n = 25) and Control (n = 23). In the PBMT group, patients were submitted to PBMT associated with the POCP. In the Control group, patients were submitted only to the POCP. Saliva samples were collected in the 1st (baseline), 7th, 14th, 21st, and 30th sessions of RT, and the levels of interleukin-6 (IL-6), IL-8, IL-10, IL-12p70, IL-1β, and tumoral necrosis factor-α (TNF-α) were measured using the cytometric bead array. Nitrite levels were measured by colorimetric method. OM was assessed using the World Health Organization and the National Cancer Institute scales. RESULTS Patients in the PBMT group presented less severe OM. PBMT tended to stabilize nitrite concentration levels during the RT regimen. The IL-1β concentration was associated with higher OM scores. PBMT promoted an increase in IL-12p70, TNF-α, and IL-10 concentration. CONCLUSION PBMT was effective in the prevention and control of severe OM, and its mechanism of action may be related to a better balance of inflammatory response that may favor injury control. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Allisson F L Martins
- Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Marília O Morais
- Setor de Odontologia do Hospital de Câncer Araújo Jorge. R. 239, 206-Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Sebastião S Sousa-Neto
- Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Angélica F Oton-Leite
- Setor de Odontologia do Hospital de Câncer Araújo Jorge. R. 239, 206-Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Carlos H Pereira
- Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Marize C Valadares
- Laboratório de Farmacologia e Toxicologia Celular da, Faculdade de Farmácia da, Universidade Federal de Goiás, 5ª Avenida Esquina com Rua 240, s/n. Setor Universitário, Goiânia, Goiás, 74605-170, Brazil.,Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil
| | - Nilceana M A Freitas
- Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil
| | - Aline C Batista
- Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Departamento de Prevenção e Reabilitação Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil
| | - Cláudio R Leles
- Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil
| | - Elismauro F Mendonça
- Departamento de Radioterapia do Hospital de Câncer Araújo Jorge. R. 239, 206, Setor Universitário, Goiânia, Goiás, 74175-120, Brazil.,Laboratório de Patologia Oral da, Faculdade de Odontologia da, Universidade Federal de Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, 74605-220, Brazil
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Cronshaw M, Parker S, Anagnostaki E, Mylona V, Lynch E, Grootveld M. Photobiomodulation and Oral Mucositis: A Systematic Review. Dent J (Basel) 2020; 8:dj8030087. [PMID: 32764305 PMCID: PMC7559189 DOI: 10.3390/dj8030087] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 12/31/2022] Open
Abstract
Oral mucositis (OM) is a debilitating complication of chemotherapy, and head and neck radiotherapy. In an effort to offer the best possible advice within the limitations of published research, a systematic review with an extended discussion and commentary on dosimetry and dose delivery is presented. Using keywords as listed, Pubmed, Google Scholar and Cochrane databases were searched during a period extending from 1995 to 2019. A total of 782 abstracts were identified. A total of 50 papers were analysed, and of these, 29 satisfied criteria required for systematic review in accordance with an optimized PRISMA statement. Clinical outcome as reported was subject to analysis with respect to time of intervention, incidence and severity of oral mucositis, and pain amelioration, and a comprehensive combined univariate and multivariate statistical analysis of the methods employed was performed. Recommendations are made with respect to the timing of the intervention. Moreover, there is an extended discussion available on the treatment care rationale of photobiomodulation (PBM), and its adjunctive association with OM. In conclusion, early prophylactic application offers clear advantages in clinical management. The many studies and associated variables and covariables assessed here revealed a choice of delivery techniques, associated wavelengths and many further indices to consider with regard to the accomplishment of optical parameters. It is therefore our recommendation that clinicians use PBM as a therapy with a full and proper understanding and training in order to optimise the clinical effects achievable.
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Affiliation(s)
- Mark Cronshaw
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham B5 7EG, UK
- Correspondence:
| | - Steven Parker
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
| | - Eugenia Anagnostaki
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
| | - Valina Mylona
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
| | - Edward Lynch
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
- School of Dental Medicine, University of Nevada, Las Vegas, NV 89106, USA
| | - Martin Grootveld
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
- School of Dental Medicine, University of Nevada, Las Vegas, NV 89106, USA
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21
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Hanna R, Dalvi S, Benedicenti S, Amaroli A, Sălăgean T, Pop ID, Todea D, Bordea IR. Photobiomodulation Therapy in Oral Mucositis and Potentially Malignant Oral Lesions: A Therapy Towards the Future. Cancers (Basel) 2020; 12:cancers12071949. [PMID: 32708390 PMCID: PMC7409159 DOI: 10.3390/cancers12071949] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/10/2020] [Accepted: 07/16/2020] [Indexed: 12/18/2022] Open
Abstract
Photobiomodulation therapy (PBMT) is an effective treatment modality, which has the significant advantage of enhancing a patient’s quality of life (QoL) by minimising the side effects of oral cancer treatments, as well as assisting in the management of potentially cancerous lesions. It is important to note that the major evidence-based documentation neither considers, nor tackles, the issues related to the impact of PBMT on tumour progression and on the downregulation of cellular proliferation improvement, by identifying the dose- and time-dependency. Moreover, little is known about the risk of this therapy and its safety when it is applied to the tumour, or the impact on the factor of QoL. The review aimed to address the benefits and limitations of PBMT in premalignant oral lesions, as well as the conflicting evidence concerning the relationship between tumour cell proliferation and the applied dose of photonic energy (fluence) in treating oral mucositis induced by head and neck cancer (H&N) treatments. The objective was to appraise the current concept of PBMT safety in the long-term, along with its latent impact on tumour reaction. This review highlighted the gap in the literature and broaden the knowledge of the current clinical evidence-based practice, and effectiveness, of PBMT in H&N oncology patients. As a result, the authors concluded that PBMT is a promising treatment modality. However, due to the heterogeneity of our data, it needs to undergo further testing in well-designed, long-term and randomised controlled trial studies, to evaluate it with diligent and impartial outcomes, and ensure laser irradiation’s safety at the tumour site.
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Affiliation(s)
- Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV,6, 16132 Genoa, Italy; (S.D.); (S.B.)
- Department of Oral Surgery, Dental Institute, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK
- Correspondence: ; Tel.: +93-010-353-7446
| | - Snehal Dalvi
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV,6, 16132 Genoa, Italy; (S.D.); (S.B.)
- Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur 441110, India
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV,6, 16132 Genoa, Italy; (S.D.); (S.B.)
| | - Andrea Amaroli
- Department of Orthopaedic Dentistry, First Moscow State Medical University (Sechenov University), Trubetzkaya Street, 8, Bldg. 2, 119146 Moscow, Russia;
| | - Tudor Sălăgean
- Department of Land Measurements and Exact Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania; (T.S.); (I.D.P.)
| | - Ioana Delia Pop
- Department of Land Measurements and Exact Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania; (T.S.); (I.D.P.)
| | - Doina Todea
- Department of Pulmonology, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400332 Cluj-Napoca, Romania;
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania;
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Martins MD, Silveira FM, Webber LP, Wagner VP, Martins MAT, Squarize CH, Castilho RM. The impact of photobiomodulation therapy on the biology and behavior of head and neck squamous cell carcinomas cell lines. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 209:111924. [PMID: 32570058 DOI: 10.1016/j.jphotobiol.2020.111924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 10/30/2019] [Accepted: 06/01/2020] [Indexed: 01/01/2023]
Abstract
Photobiomodulation therapy (PBMT) is an emerging therapeutic modality designed to prevent and treat chemotherapy-driven oral mucositis (OM). However, the response of tumor cells to the effects of PBMT remains poorly understood. Our study explores the effects of PBMT in head and neck squamous cell carcinoma (HNSCC) based on cellular proliferation, migration, and survival of tumor cells and its population of cancer stem cells (CSC). We explored the behavior of two HNSCC cell lines (HN6 and HN13) under two distinct conditions, a physiological growing condition (10% FBS), and under stress growing condition (2% FBS) prior to irradiation using diode laser (InGaAlP; MM Optics, São Carlos, SP, Brazil). Diode laser (660 nm) was applied with a power of 100 mW delivering a total energy per point of 0.24 J. MTT and wound healing test (scratch assay) were performed to evaluate, respectively, proliferation and migration of tumor cells. Clonogenic and spheres formation assays were also performed to evaluate the survival and percentage of CSC upon irradiation. Overall, we observed that PBMT does not exacerbate the behavior of HNSCC. We could only observe a decrease in cellular proliferation of one cell line (HN6) when cultured under nutritional stress conditions (p < .05). There were no significant differences between the control and the PBMT groups regarding cell migration, survival and the percentage of CSC. Collectively, our results suggest that in vitro administration of PBMT to HNSCC does not modify the behavior of tumor cells.
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Affiliation(s)
- Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil; Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA
| | - Felipe Martins Silveira
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Liana Preto Webber
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil; Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA
| | - Vivian Petersen Wagner
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil; Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA
| | - Marco Antonio Trevizani Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil; Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA
| | - Cristiane Helena Squarize
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA
| | - Rogerio Moraes Castilho
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA.
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Pires Marques EC, Piccolo Lopes F, Nascimento IC, Morelli J, Pereira MV, Machado Meiken VM, Pinheiro SL. Photobiomodulation and photodynamic therapy for the treatment of oral mucositis in patients with cancer. Photodiagnosis Photodyn Ther 2019; 29:101621. [PMID: 31841687 DOI: 10.1016/j.pdpdt.2019.101621] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/18/2019] [Accepted: 12/05/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Photobiomodulation therapy (PBM-T) can penetrate soft tissues and exert analgesic and healing effects, and is thus a promising alternative for prevention and treatment of oral mucositis (OM). The aim of this study was to evaluate the efficacy of PBM-T, alone or combined with photodynamic therapy (PDT), for treatment of OM in cancer patients. METHODS Fifty-six patients were recruited from the Oncology Department of a teaching hospital. Patients underwent grading of OM and were divided into two groups (n = 28 each): PBM-T and PBM-T + PDT. In the PBM-T group, low-level laser was applied to 61 points in the oral cavity, once weekly for 4 weeks (wavelength 660 nm, power 100 mW, energy density 142 J/cm², spot energy 4 J, irradiation time 40 s). In the PBM-T + PDT group, in addition to PBM-T as described above, patients rinsed with 20 ml of photosensitizing mouthwash (curcumin 1.5 g/L) and the oral cavity was irradiated with a blue (468 nm) LED for 5 min. RESULTS Significant reductions in OM grade were observed after application of PBM-T or PBM-T + PDT (p < 0.0001). PBM-T + PDT resulted in a shorter time to resolution of lesions compared to PBM-T alone (p = 0.0005). CONCLUSIONS PBM-T, alone or combined with PDT, can be used for the treatment of OM. PDT + PBM-T in particular accelerated the OM healing process, reducing time to lesion remission from 15 to 11 days.
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Affiliation(s)
- Erika Cristina Pires Marques
- Department of Restorative Dentistry, Pontifical Catholic University of Campinas (PUC-Campinas), Campus II, Av. John Boyd Dunlop, s/n, Jardim Ipaussurama, 13034-685, Campinas, SP, Brazil.
| | - Felipe Piccolo Lopes
- Department of Restorative Dentistry, Pontifical Catholic University of Campinas (PUC-Campinas), Campus II, Av. John Boyd Dunlop, s/n, Jardim Ipaussurama, 13034-685, Campinas, SP, Brazil.
| | - Ingrid Camargo Nascimento
- Department of Restorative Dentistry, Pontifical Catholic University of Campinas (PUC-Campinas), Campus II, Av. John Boyd Dunlop, s/n, Jardim Ipaussurama, 13034-685, Campinas, SP, Brazil.
| | - Juliana Morelli
- Department of Restorative Dentistry, Pontifical Catholic University of Campinas (PUC-Campinas), Campus II, Av. John Boyd Dunlop, s/n, Jardim Ipaussurama, 13034-685, Campinas, SP, Brazil.
| | - Milena Valini Pereira
- Department of Restorative Dentistry, Pontifical Catholic University of Campinas (PUC-Campinas), Campus II, Av. John Boyd Dunlop, s/n, Jardim Ipaussurama, 13034-685, Campinas, SP, Brazil.
| | - Vitória Moron Machado Meiken
- Department of Restorative Dentistry, Pontifical Catholic University of Campinas (PUC-Campinas), Campus II, Av. John Boyd Dunlop, s/n, Jardim Ipaussurama, 13034-685, Campinas, SP, Brazil.
| | - Sérgio Luiz Pinheiro
- Pontifical Catholic University of Campinas (PUC-Campinas), Center for Health Sciences, Postgraduate Program in Health Sciences, Campus II, Av. John Boyd Dunlop, s/n, Jardim Ipaussurama, 13034-685, Campinas, SP, Brazil.
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24
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Kalhori KA, Vahdatinia F, Jamalpour MR, Vescovi P, Fornaini C, Merigo E, Fekrazad R. Photobiomodulation in Oral Medicine. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:837-861. [DOI: 10.1089/photob.2019.4706] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Farshid Vahdatinia
- Dental Implants Research Center, Dental School of Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Jamalpour
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Paolo Vescovi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Carlo Fornaini
- Group of Applied ElectroMagnetics, Department of Engineering and Architecture, University of Parma, Parma, Italy
- Laboratoire MicOralIS (Microbiologie Orale, Immunothérapie et Santé) EA7354, UFR d'Odontologie, Université Nice Sophia Antipolis, Nice, France
| | - Elisabetta Merigo
- Laboratoire MicOralIS (Microbiologie Orale, Immunothérapie et Santé) EA7354, UFR d'Odontologie, Université Nice Sophia Antipolis, Nice, France
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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25
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Choi S, Shin S, Lee H, Sohn K, Yoon SY, Kim JW. 1‐Palmitoyl‐2‐linoleoyl‐3‐acetyl‐rac‐glycerol ameliorates chemoradiation‐induced oral mucositis. Oral Dis 2019; 26:111-121. [DOI: 10.1111/odi.13224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/18/2019] [Accepted: 10/29/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Solji Choi
- Division of Systems Biology and Bioengineering Cell Factory Research Center Korea Research Institute of Bioscience and Biotechnology Daejeon Korea
- Department of Functional Genomics University of Science and Technology Daejeon Korea
| | - Su‐Hyun Shin
- Division of Systems Biology and Bioengineering Cell Factory Research Center Korea Research Institute of Bioscience and Biotechnology Daejeon Korea
- Department of Functional Genomics University of Science and Technology Daejeon Korea
| | | | | | | | - Jae Wha Kim
- Division of Systems Biology and Bioengineering Cell Factory Research Center Korea Research Institute of Bioscience and Biotechnology Daejeon Korea
- Department of Functional Genomics University of Science and Technology Daejeon Korea
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26
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Blakaj A, Bonomi M, Gamez ME, Blakaj DM. Oral mucositis in head and neck cancer: Evidence-based management and review of clinical trial data. Oral Oncol 2019; 95:29-34. [PMID: 31345391 DOI: 10.1016/j.oraloncology.2019.05.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 12/15/2022]
Abstract
Oral Mucositis (OM) continues to be an oncologic challenge in the context of antineoplastic therapy for head and neck cancer (HNC) treatment. It is a dose-limiting toxicity of chemotherapy and radiation treatment and negatively impacts quality of life and cancer treatment efficacy. Significant effort in the field of OM has been made to help alleviate its symptoms and its subsequent clinical and economic impact. Despite these advances, the treatment of oral mucositis remains difficult and focuses on palliative measures. There are, however, many promising new biological targets currently undergoing investigation to ameliorate or help prevent the toxicity of OM in HNC. Some of these targets undergoing investigation in phase 2 and 3 clinical trials are further highlighted along with the pathobiology of OM, clinical course, prevention, and management measures.
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Affiliation(s)
- Adriana Blakaj
- Yale School of Medicine, Department of Therapeutic Radiology, 35 Park St., New Haven, CT 06519, USA
| | - Marcelo Bonomi
- The Ohio State University, Division of Medical Oncology, 320 West 10th Avenue, Columbus, OH 43210, USA
| | - Mauricio E Gamez
- The Ohio State University, Department of Radiation Oncology, 460 West 10th Avenue, Columbus, OH 43210, USA
| | - Dukagjin M Blakaj
- The Ohio State University, Department of Radiation Oncology, 460 West 10th Avenue, Columbus, OH 43210, USA.
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27
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Comparison of photobiomodulation using either an intraoral or an extraoral laser on oral mucositis induced by chemotherapy in rats. Support Care Cancer 2019; 28:867-876. [PMID: 31165336 DOI: 10.1007/s00520-019-04889-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of the present study was to compare the effect of intraoral (IO) and extraoral (EO) diode laser irradiation on oral mucositis (OM) induced by 5-fluorouracil (5-FU) in rats. METHODS Animals (n = 78) were divided into the following groups: negative control (NC), positive control (PC), IO 6 J/cm2, EO with 6 J/cm2 (EO 6 J/cm2), and 12 J/cm2 (EO 12 J/cm2). OM was induced with an intraperitoneal injection of 5-FU and scarification of the buccal mucosa. Over the following 14 days, animals received photobiomodulation (PBM) daily. Clinical and histological evaluation was done by scores at days 8, 10, and 14. The redox state was evaluated by reactive species levels, antioxidant network, and immunohistochemistry analysis. RESULTS Clinically, on day 8, PBM groups showed lower scores of OM with EO 6 J/cm2 presenting a significantly lower degree compared to PC (p < 0.05). On days 10 and 14, all PBM groups exhibited improvement of OM compared to PC (p < 0.01). On day 8, all PBM groups exhibited an accelerated healing process compared to PC (p < 0.01) and reduction of reactive species (p < 0.001). Also, all PBM groups demonstrated higher levels of antioxidant GPx compared to PC (p < 0.001). Analysis of nitrotyrosine revealed that on day 14, this protein damage marker was significantly reduced in the EO 6 J/cm2 group (p > 0.05). CONCLUSIONS An EO diode laser protocol promoted positive effects in the clinical, histopathological, and redox state in OM induced by 5-FU in rats. Among the EO protocols, EO 6 J/cm2 showed the most encouraging results.
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Martins AFL, Nogueira TE, Morais MO, Oton-Leite AF, Valadares MC, Batista AC, Freitas NMA, Leles CR, Mendonça EF. Effect of photobiomodulation on the severity of oral mucositis and molecular changes in head and neck cancer patients undergoing radiotherapy: a study protocol for a cost-effectiveness randomized clinical trial. Trials 2019; 20:97. [PMID: 30709370 PMCID: PMC6359861 DOI: 10.1186/s13063-019-3196-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/14/2019] [Indexed: 01/28/2023] Open
Abstract
Background Oral mucositis (OM) is the most frequent and debilitating acute side effect associated with head and neck cancer (HNC) treatment. When present, severe OM negatively impacts the quality of life of patients undergoing HNC treatment. Photobiomodulation is a well-consolidated and effective therapy for the treatment and prevention of severe OM, and is associated with a cost reduction of the cancer treatment. Although an increase in the quality of life and a reduction in the severity of OM are well described, there is no study on cost-effectiveness for this approach considering the quality of life as a primary outcome. In addition, little is known about the photobiomodulation effects on salivary inflammatory mediators. Thus, this study aimed to assess the cost-effectiveness of the photobiomodulation therapy for the prevention and control of severe OM and its influence on the salivary inflammatory mediators. Methods/design This randomized, double-blind clinical trial will include 50 HNC patients undergoing radiotherapy or chemoradiotherapy. The participants will be randomized into two groups: intervention group (photobiomodulation) and control group (preventive oral care protocol). OM (clinical assessment), saliva (assessment of collected samples) and quality of life (Oral Health Impact Profile-14 and Patient-Reported Oral Mucositis Symptoms questionnaires) will be assessed at the 1st, 7th, 14th, 21st and 30th radiotherapy sessions. Oxidative stress and inflammatory cytokine levels will be measured in the saliva samples of all participants. The costs are identified, measured and evaluated considering the radiotherapy time interval. The incremental cost-effectiveness ratio will be estimated. The study will be conducted according to the Brazilian public health system perspective. Discussion Photobiomodulation is an effective therapy that reduces the cost associated with OM treatment. However, little is known about its cost-effectiveness, mainly when quality of life is the effectiveness measure. Additionally, this therapy is not supported by the Brazilian public health system. Therefore, this study widens the knowledge about the safety of and strengthens evidence for the use of photobiomodulation therapy, providing information for public policy-makers and also for dental care professionals. This study is strongly encouraged due to its clinical relevance and the possibility of incorporating new technology into public health systems. Trial registration Brazilian Registry of Clinical Trials—ReBEC, RBR-5h4y4n. Registered on 13 June 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3196-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Allisson Filipe Lopes Martins
- Department of Oral Pathology, Dentistry Faculty, Federal University of Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, CEP 74605-220, Brazil
| | - Túlio Eduardo Nogueira
- Department of Prevention and Oral Rehabilitation, Dentistry Faculty, Federal University of Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, CEP 74605-220, Brazil
| | - Marília Oliveira Morais
- Department of Stomatology, Araujo Jorge Cancer Hospital , R. 239, 206-Setor Universitário, Goiânia, Goiás, CEP 74175-120, Brazil
| | - Angélica Ferreira Oton-Leite
- Department of Stomatology, Araujo Jorge Cancer Hospital , R. 239, 206-Setor Universitário, Goiânia, Goiás, CEP 74175-120, Brazil
| | - Marize Campos Valadares
- Department of Pharmacology and Cellular Toxicology, Pharmacy Faculty, Federal University of Goiás, 5ª Avenida Esquina com Rua 240, s/n. Setor Universitário, Goiânia, Goiás, CEP 74605-170, Brazil
| | - Aline Carvalho Batista
- Department of Oral Pathology, Dentistry Faculty, Federal University of Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, CEP 74605-220, Brazil
| | - Nilceana Maya Aires Freitas
- Department of Radiotherapy, Araujo Jorge Cancer Hospital, R. 239, 206-Setor Universitário, Goiânia, Goiás, CEP 74175-120, Brazil
| | - Cláudio Rodrigues Leles
- Department of Prevention and Oral Rehabilitation, Dentistry Faculty, Federal University of Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, CEP 74605-220, Brazil
| | - Elismauro Francisco Mendonça
- Department of Oral Pathology, Dentistry Faculty, Federal University of Goiás, Avenida Universitária Esquina com 1ª Avenida, s/n. Setor Universitário, Goiânia, Goiás, CEP 74605-220, Brazil.
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29
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Silveira FM, Paglioni MDP, Marques MM, Santos-Silva AR, Migliorati CA, Arany P, Martins MD. Examining tumor modulating effects of photobiomodulation therapy on head and neck squamous cell carcinomas. Photochem Photobiol Sci 2019; 18:1621-1637. [DOI: 10.1039/c9pp00120d] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of the present systematic review was to analyze studies that investigated the effects of photobiomodulation therapy on head and neck squamous cell carcinoma cells.
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Affiliation(s)
| | | | - Márcia Martins Marques
- Department of Restorative Dentistry
- School of Dentistry
- University of Sao Paulo
- Sao Paulo-SP
- Brazil
| | | | | | - Praveen Arany
- Departments of Oral Biology and Biomedical Engineering
- Schools of Dental Medicine
- Engineering and Applied Sciences
- State University of New York at Buffalo
- Buffalo
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30
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Sá OMDS, Lopes NNF, Alves MTS, Caran EMM. Effects of Glycine on Collagen, PDGF, and EGF Expression in Model of Oral Mucositis. Nutrients 2018; 10:nu10101485. [PMID: 30322002 PMCID: PMC6213743 DOI: 10.3390/nu10101485] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 12/28/2022] Open
Abstract
Oral mucositis is frequently a toxic effect of chemotherapeutic and/or radiotherapeutic treatment, resulting from complex multifaceted biological events involving DNA damage. The clinical manifestations have a negative impact on the life quality of cancer patients. Preventive measures and curative treatment of mucositis are still not well established. The glycine has anti-inflammatory, immunomodulatory, and cytoprotective actions, being a potential therapeutic in mucositis. The objective was to evaluate the effects of glycine on the expression of collagen and growth factors, platelet and epidermal in a hamster model oral mucositis. The mucositis was induced by the protocol of Sonis. There were 40 hamsters used, divided into two groups: Group I-control; Group II-supplemented with 5% intraperitoneal glycine, 2.0 mg/g diluted in hepes. Histopathological sections were used to perform the immune-histochemical method, the evaluation of collagen expression, and the growth factors: Epidermal growth factor (EGF) and platelet (PDGF). It was observed that the group supplemented with glycine experienced higher amounts of collagen expression and predominance type of collagen I. The glycine group presented lower immunoexpression of the growth factors, EGF and PDGF. The group supplemented with glycine showed a marked healing process of the oral mucosite, demonstrated by the predominance of collagen type I and reduction of growth factors, EGF and PDGF.
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Affiliation(s)
| | | | | | - Eliana Maria Monteiro Caran
- Department of Pediatrics, IOP/GRAACC Medical School of Federal University of São Paulo, São Paulo 04023-062, Brazil.
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Barbosa MM, de Araújo AA, de Araújo Júnior RF, Guerra GCB, de Castro Brito GA, Leitão RC, Ribeiro SB, de Aragão Tavares E, Vasconcelos RC, Garcia VB, de Medeiros CACX. Telmisartan Modulates the Oral Mucositis Induced by 5-Fluorouracil in Hamsters. Front Physiol 2018; 9:1204. [PMID: 30210365 PMCID: PMC6123383 DOI: 10.3389/fphys.2018.01204] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 08/10/2018] [Indexed: 01/20/2023] Open
Abstract
Oral mucositis (OM) is a common adverse effect resulting from cancer therapy. The OM it has implications that may compromise oncologic treatment and decrease the patient's quality of life. The therapeutic options to prevent or treat the symptoms of OM are scarce; there is no effective therapy that improves the symptoms. Based on the need for further research for the treatment of OM, the present study objective was to evaluate the effect of telmisartan (TELM) on the OM induced by 5-fluorouracil (5-FU), using as animal model Golden Syrian hamsters. 5-FU followed by mechanical trauma on day 4 was used to induce OM in hamsters. Euthanasia occurred on the day 10. The experiments were constituted by the groups saline, mechanical trauma, 5-FU, and TELM in three doses (1, 5, or 10 mg/kg). Macroscopic, histopathological, and immunohistochemical analyses as well as immunofluorescence experiments were performed on the oral mucosa of the animals. The samples also were used for analysis enzyme-linked immunosorbent assays and quantitative real-time polymerase chain reactions (qPCR). TELM (5 or 10 mg/kg) was able to reduce the inflammatory ulceration and infiltration in the oral mucosa of the animals, decreasing the levels of the cytokines TNF-α and IL-1β. These treatments was minimize the immunostaining for cyclooxygenase-2, matrix metalloproteinase-9, transforming growth factor-β, and smad 2/3. The nuclear transcription factor kappa B (NFκB) p65 and inducible nitric oxide synthase were reduced in the oral mucosa. Finally, TELM (10 mg/kg) increased the PPARγ gene expression and reduced STAT1 and NFκB p65 gene expression relative to the 5-FU group. Therefore, TELM prevents the OM produced by 5-FU on animal model.
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Affiliation(s)
- Maisie M Barbosa
- Post Graduation Program in Biological Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Aurigena A de Araújo
- Post Graduation Program Public Health/Post Graduation Program in Pharmaceutical Science, Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Raimundo F de Araújo Júnior
- Post Graduation Program in Functional and Structural Biology/Post Graduation Program Health Science, Department of Morphology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Gerlane C B Guerra
- Post Graduation Program in Biological Sciences/Post Graduation Program in Pharmaceutical Science, Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Gerly A de Castro Brito
- Post Graduation Program of Morphological Science, Department of Morphology, Universidade Federal do Ceará, Fortaleza, Brazil
| | - Renata C Leitão
- Post Graduation Program of Morphological Science, Department of Morphology, Universidade Federal do Ceará, Fortaleza, Brazil
| | - Susana B Ribeiro
- Post Graduation Program in Biotechnology RENORBIO, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Roseane C Vasconcelos
- Post Graduation Program Public Health, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Vinícius B Garcia
- Post Graduation in Program of Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Caroline A C X de Medeiros
- Post Graduation Program in Biological Sciences/Post Graduation Program in Biotechnology RENORBIO, Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
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Ribeiro da Silva VC, da Motta Silveira FM, Barbosa Monteiro MG, da Cruz MMD, Caldas Júnior ADF, Pina Godoy G. Photodynamic therapy for treatment of oral mucositis: Pilot study with pediatric patients undergoing chemotherapy. Photodiagnosis Photodyn Ther 2018; 21:115-120. [DOI: 10.1016/j.pdpdt.2017.11.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 12/26/2022]
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Sroussi HY, Epstein JB, Bensadoun R, Saunders DP, Lalla RV, Migliorati CA, Heaivilin N, Zumsteg ZS. Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Med 2017; 6:2918-2931. [PMID: 29071801 PMCID: PMC5727249 DOI: 10.1002/cam4.1221] [Citation(s) in RCA: 335] [Impact Index Per Article: 47.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 12/22/2022] Open
Abstract
Patients undergoing radiation therapy for the head and neck are susceptible to a significant and often abrupt deterioration in their oral health. The oral morbidities of radiation therapy include but are not limited to an increased susceptibility to dental caries and periodontal disease. They also include profound and often permanent functional and sensory changes involving the oral soft tissue. These changes range from oral mucositis experienced during and soon after treatment, mucosal opportunistic infections, neurosensory disorders, and tissue fibrosis. Many of the oral soft tissue changes following radiation therapy are difficult challenges to the patients and their caregivers and require life-long strategies to alleviate their deleterious effect on basic life functions and on the quality of life. We discuss the presentation, prognosis, and management strategies of the dental structure and oral soft tissue morbidities resulting from the administration of therapeutic radiation in head and neck patient. A case for a collaborative and integrated multidisciplinary approach to the management of these patients is made, with specific recommendation to include knowledgeable and experienced oral health care professionals in the treatment team.
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Affiliation(s)
- Herve Y Sroussi
- Division of Oral Medicine & Dentistry, Brigham and Women's Hospital BostonMA
| | - Joel B. Epstein
- Samuel Oschin Comprehensive Cancer InstititueCedars‐Sinai Medical CenterLos AngelesCA
- Division of Otolaryngology and Head and Neck SurgeryDuarteCalifornia
| | | | - Deborah P. Saunders
- Department of Dental OncologyHealth Sciences NorthNortheastern Cancer CentreSudburyOntarioCanada
- Northern Ontario School of MedicineRm 42036SudburyOntarioP3E 5J1Canada
| | - Rajesh V. Lalla
- Section of Oral MedicineUniversity of Connecticut HealthFarmingtonConnecticut
| | - Cesar A. Migliorati
- Department of Oral and Maxillofacial Diagnostic SciencesUniversity of FloridaGainesvilleFlorida
| | - Natalie Heaivilin
- Oral Maxillofacial Surgery DepartmentUniversity of CaliforniaSan FranciscoCalifornia
| | - Zachary S. Zumsteg
- Department of Radiation OncologyCedars‐Sinai Medical CenterLos AngelesCalifornia90048
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Theodoro LH, Longo M, Novaes VCN, Miessi DMJ, Ferro-Alves ML, Ervolino E, de Almeida JM, Garcia VG. Low-level laser and antimicrobial photodynamic therapy on experimental periodontitis in rats submitted to chemotherapy by 5-fluorouracil. Support Care Cancer 2017; 25:3261-3271. [PMID: 28488051 DOI: 10.1007/s00520-017-3738-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/24/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effects of low-level laser therapy (LLLT) and antimicrobial photodynamic therapy (aPDT) as adjuvant to mechanical treatment of experimental periodontitis (EP) in adult rats submitted to 5-fluorouracil (5-FU) chemotherapy. METHODS EP was induced through ligature around the left mandibular first molar for 7 days. The ligature was removed and the animals separated into groups: EP, no treatment; 5FU, systemic administration of 5-FU (80 and 40 mg/kg); 5FU/scaling and root planing (SRP), systemic application of 5-FU and SRP; 5FU/SRP/LLLT, systemic application of 5-FU, SRP, and LLLT (660 nm, 0.035 W; 29.4 J/cm2); and 5FU/SRP/aPDT, systemic application of 5-FU, SRP, and aPDT (methylene blue irrigation and LLLT). The animals were euthanized 7, 15, and 30 days after treatments. Histological sections from mandibles were processed for histomorphometric and immunohistochemical analysis (TRAP, RANKL, OPG, TNF-α, IL-6, IL-10). The alveolar bone loss (BL) area in the furcation region of the mandibular first molar was analyzed histometrically. RESULTS There was less bone loss in 5FU/SRP/aPDT compared with 5FU at 7 days (p < 0.05). The immunohistochemical analysis showed no significant difference for TRAP and osteoprotegerin, but lower RANKL immunolabeling was observed in the 5FU/SRP/LLLT and 5FU/SRP/aPDT groups compared with the 5FU group at 15 days. There was lower TNF-α and IL-6 immunolabeling in the 5FU/SRP/LLLT and 5FU/SRP/aPDT groups and higher IL-10 immunolabeling in 5FU/SRP/aPDT at 30 days. CONCLUSION LLLT and aPDT adjuvant to SRP minimized the effects of 5-FU on periodontal disease. Furthermore, aPDT promoted greater benefits in bone loss control and inflammatory response.
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Affiliation(s)
- Leticia Helena Theodoro
- Division of Periodontology, Department of Surgery and Integrated Clinic, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil.
| | - Mariéllen Longo
- Division of Periodontology, Department of Surgery and Integrated Clinic, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - Vivian Cristina Noronha Novaes
- Division of Periodontology, Department of Surgery and Integrated Clinic, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - Daniela Maria Janjacomo Miessi
- Division of Periodontology, Department of Surgery and Integrated Clinic, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - Marcio Luiz Ferro-Alves
- Division of Periodontology, Department of Surgery and Integrated Clinic, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - Edilson Ervolino
- Division of Histology and Embryology, Department of Basic Science, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - Juliano Milanezi de Almeida
- Division of Periodontology, Department of Surgery and Integrated Clinic, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - Valdir Gouveia Garcia
- Division of Periodontology, Department of Surgery and Integrated Clinic, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
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Campos L, Cruz ÉP, Pereira FS, Arana-Chavez VE, Simões A. Comparative study among three different phototherapy protocols to treat chemotherapy-induced oral mucositis in hamsters. JOURNAL OF BIOPHOTONICS 2016; 9:1236-1245. [PMID: 27105906 DOI: 10.1002/jbio.201600014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/02/2016] [Accepted: 04/03/2016] [Indexed: 06/05/2023]
Abstract
In this study, clinical, biochemical and histological analysis were used to compare different phototherapies, including LED, low and high-power laser (HPL) for the treatment of chemotherapy (CT)-induced oral mucositis (OM). One-hundred-fifty hamsters were divided into five groups: C: control; CH: CT/OM induction; L: CT/OM induction and treatment with LED (635 nm, 1.2 J), HL: CT/OM induction and treatment with HPL (808 nm, 10 J), LL: CT/OM induction and treatment with low-level laser therapy (LLLT) (660 nm, 1.2 J). OM was induced by scratches performed on check pouch mucosa after two injections of 5-Fluorouracil. The experiment lasted 10 days and OM was analyzed by specific clinical scales on days 5, 7 and 10. The animals were euthanized and the cheek pouch mucosa removed for biochemical (TNF-α concentration) and histological (light microscopy) analysis. After statistical analysis, the authors' results showed LED and LLLT therapies were efficient treatments for OM, decreasing TNF-α concentration on day 7 (p < 0.05) and completely healing the mucosa on day 10. HPL showed no interference in final healing of OM. According to the methodology used and the results obtained in the present study, LLLT and LED therapies were the best choices to decrease the severity of OM, accelerating tissue repair and decreasing the inflammatory process. Clinical evaluation of OM in Groups CH, LL, L and HL and their respective arrangement of phototherapy treatments at different time intervals (5, 7 and 10 days).
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Affiliation(s)
- Luana Campos
- Laboratory of Oral Biology, Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, 05508-000, Brazil
| | - Érika P Cruz
- Laboratory of Oral Biology, Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, 05508-000, Brazil
| | - Filipi S Pereira
- Laboratory of Oral Biology, Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, 05508-000, Brazil
| | - Victor E Arana-Chavez
- Laboratory of Oral Biology, Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, 05508-000, Brazil
| | - Alyne Simões
- Laboratory of Oral Biology, Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, 05508-000, Brazil
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36
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Effect of low-level laser therapy on angiogenesis and matrix metalloproteinase-2 immunoexpression in wound repair. Lasers Med Sci 2016; 32:35-43. [PMID: 27649960 DOI: 10.1007/s10103-016-2080-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 09/12/2016] [Indexed: 12/15/2022]
Abstract
Low-level laser therapy (LLLT) induces anti-inflammatory and angiogenic activities in wound healing. However, the mechanism of action and optimal parameters require further clarification. In this study, we investigated the effects of LLLT on wound healing matrix metalloproteinase (MMP)-2 immunoexpression and angiogenic processes. Twenty female Wistar rats were randomly divided into four groups (n = 5) according to the treatments as follows. CG7 and CG14 were control groups at days 7 and 14, respectively, which received physiological saline (0.9 % NaCl daily). LG7 and LG14 were laser therapy groups at days 7 and 14, respectively, which received two (LG7) or four (LG14) LLLT applications (40 mW; 660 nm; 4 J/cm2). A dorsal skin sample in the wound area (measuring 2 cm2) was removed after the experimental period, and then the animals were euthanized. The specimens were processed for qualitative and quantitative histological analyses and measurement of MMP-2 expression in the dermis and epidermis. A persistent crust and moderate number of inflammatory cells were found in CG7 and CG14 groups. In the LG14 group, wounds demonstrated complete re-epithelization at the remodeling phase. Angiogenesis and MMP-2 expression were higher in LLLT-treated groups, particularly the LG14 group, which correlated according to the Spearman correlation test. LLLT improves wound healing by enhancing neocollagenesis, increasing the amount of new vessels formed in the tissue (neoangiogenesis), and modulating MMP-2 expression. Epidermal overexpression of MMP-2 was correlated to angiogenic processes.
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37
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Zecha JAEM, Raber-Durlacher JE, Nair RG, Epstein JB, Sonis ST, Elad S, Hamblin MR, Barasch A, Migliorati CA, Milstein DMJ, Genot MT, Lansaat L, van der Brink R, Arnabat-Dominguez J, van der Molen L, Jacobi I, van Diessen J, de Lange J, Smeele LE, Schubert MM, Bensadoun RJ. Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations. Support Care Cancer 2016. [PMID: 26984240 DOI: 10.1007/s00520-016-3152-z.low] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
PURPOSE There is a large body of evidence supporting the efficacy of low level laser therapy (LLLT), more recently termed photobiomodulation (PBM), for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved, may expand the applications for PBM in the management of other complications associated with HNC treatment. This article (part 1) describes PBM mechanisms of action, dosimetry, and safety aspects and, in doing so, provides a basis for a companion paper (part 2) which describes the potential breadth of potential applications of PBM in the management of side-effects of (chemo)radiation therapy in patients being treated for HNC and proposes PBM parameters. METHODS This study is a narrative non-systematic review. RESULTS We review PBM mechanisms of action and dosimetric considerations. Virtually, all conditions modulated by PBM (e.g., ulceration, inflammation, lymphedema, pain, fibrosis, neurological and muscular injury) are thought to be involved in the pathogenesis of (chemo)radiation therapy-induced complications in patients treated for HNC. The impact of PBM on tumor behavior and tumor response to treatment has been insufficiently studied. In vitro studies assessing the effect of PBM on tumor cells report conflicting results, perhaps attributable to inconsistencies of PBM power and dose. Nonetheless, the biological bases for the broad clinical activities ascribed to PBM have also been noted to be similar to those activities and pathways associated with negative tumor behaviors and impeded response to treatment. While there are no anecdotal descriptions of poor tumor outcomes in patients treated with PBM, confirming its neutrality with respect to cancer responsiveness is a critical priority. CONCLUSION Based on its therapeutic effects, PBM may have utility in a broad range of oral, oropharyngeal, facial, and neck complications of HNC treatment. Although evidence suggests that PBM using LLLT is safe in HNC patients, more research is imperative and vigilance remains warranted to detect any potential adverse effects of PBM on cancer treatment outcomes and survival.
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Affiliation(s)
- Judith A E M Zecha
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Judith E Raber-Durlacher
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Medical Dental Interaction and Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Raj G Nair
- Department of Haematology and Oncology/Cancer Services, Gold Coast University Hospital, Queensland Health, Gold Coast, QLD, Australia
| | - Joel B Epstein
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA, 91010, USA
| | - Stephen T Sonis
- Division of Oral Medicine, Brigham and Women's Hospital and the Dana-Farber Cancer Institute and Biomodels LLC, Boston, MA, 02115, USA
| | - Sharon Elad
- Division of Oral Medicine, Eastman Institute for Oral Health, and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, 14620, USA
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, MA, 02115, USA
- Harvard-MIT Division of Health Science and Technology, Cambridge, MA, 02139, USA
| | - Andrei Barasch
- Weill Cornell Medical Center, Division of Oncology, New York, NY, USA
| | - Cesar A Migliorati
- Department of Diagnostic Sciences and Oral Medicine, University of Tennessee Health Science Center, College of Dentistry, 875 Union Ave. Suite N231, Memphis, TN, 38163, USA
| | - Dan M J Milstein
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Marie-Thérèse Genot
- Laser Therapy Unit, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, Brussels, Belgium
| | - Liset Lansaat
- Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | | | - Lisette van der Molen
- Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Irene Jacobi
- Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Judi van Diessen
- Antoni van Leeuwenhoek Department Radiation Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Ludi E Smeele
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Mark M Schubert
- Seattle Cancer Care Alliance (SCCA), 825 Eastlake Ave E Ste G6900, Seattle, WA, 98109, USA
| | - René-Jean Bensadoun
- World Association for Laser Therapy (WALT) Scientific Secretary, Centre de Haute Energie (CHE), 10 Bd Pasteur, 06000, Nice, France.
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38
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The effect of He–Ne and Ga–Al–As lasers on the healing of oral mucosa in diabetic mice. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 159:149-54. [DOI: 10.1016/j.jphotobiol.2016.03.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 03/12/2016] [Accepted: 03/14/2016] [Indexed: 11/23/2022]
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39
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Zecha JAEM, Raber-Durlacher JE, Nair RG, Epstein JB, Sonis ST, Elad S, Hamblin MR, Barasch A, Migliorati CA, Milstein DMJ, Genot MT, Lansaat L, van der Brink R, Arnabat-Dominguez J, van der Molen L, Jacobi I, van Diessen J, de Lange J, Smeele LE, Schubert MM, Bensadoun RJ. Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations. Support Care Cancer 2016; 24:2781-92. [PMID: 26984240 PMCID: PMC4846477 DOI: 10.1007/s00520-016-3152-z] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE There is a large body of evidence supporting the efficacy of low level laser therapy (LLLT), more recently termed photobiomodulation (PBM), for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved, may expand the applications for PBM in the management of other complications associated with HNC treatment. This article (part 1) describes PBM mechanisms of action, dosimetry, and safety aspects and, in doing so, provides a basis for a companion paper (part 2) which describes the potential breadth of potential applications of PBM in the management of side-effects of (chemo)radiation therapy in patients being treated for HNC and proposes PBM parameters. METHODS This study is a narrative non-systematic review. RESULTS We review PBM mechanisms of action and dosimetric considerations. Virtually, all conditions modulated by PBM (e.g., ulceration, inflammation, lymphedema, pain, fibrosis, neurological and muscular injury) are thought to be involved in the pathogenesis of (chemo)radiation therapy-induced complications in patients treated for HNC. The impact of PBM on tumor behavior and tumor response to treatment has been insufficiently studied. In vitro studies assessing the effect of PBM on tumor cells report conflicting results, perhaps attributable to inconsistencies of PBM power and dose. Nonetheless, the biological bases for the broad clinical activities ascribed to PBM have also been noted to be similar to those activities and pathways associated with negative tumor behaviors and impeded response to treatment. While there are no anecdotal descriptions of poor tumor outcomes in patients treated with PBM, confirming its neutrality with respect to cancer responsiveness is a critical priority. CONCLUSION Based on its therapeutic effects, PBM may have utility in a broad range of oral, oropharyngeal, facial, and neck complications of HNC treatment. Although evidence suggests that PBM using LLLT is safe in HNC patients, more research is imperative and vigilance remains warranted to detect any potential adverse effects of PBM on cancer treatment outcomes and survival.
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Affiliation(s)
- Judith A. E. M. Zecha
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Judith E. Raber-Durlacher
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Department of Medical Dental Interaction and Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Raj G. Nair
- Department of Haematology and Oncology/Cancer Services, Gold Coast University Hospital, Queensland Health, Gold Coast, QLD, Australia
| | - Joel B. Epstein
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA 91010, USA
| | - Stephen T. Sonis
- Division of Oral Medicine, Brigham and Women’s Hospital and the Dana-Farber Cancer Institute and Biomodels LLC, Boston, MA 02115, USA
| | - Sharon Elad
- Division of Oral Medicine, Eastman Institute for Oral Health, and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY 14620, USA
| | - Michael R. Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA
- Harvard-MIT Division of Health Science and Technology, Cambridge, MA 02139, USA
| | - Andrei Barasch
- Weill Cornell Medical Center, Division of Oncology, New York, NY, USA
| | - Cesar A. Migliorati
- Department of Diagnostic Sciences and Oral Medicine, University of Tennessee Health Science Center, College of Dentistry, 875 Union Ave. Suite N231, Memphis, TN 38163, USA
| | - Dan M. J. Milstein
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Marie-Thérèse Genot
- Laser Therapy Unit, Institut Jules Bordet, Centre des Tumeurs de l’Université Libre de Bruxelles, Brussels, Belgium
| | - Liset Lansaat
- Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | | | - Lisette van der Molen
- Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Irene Jacobi
- Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Judi van Diessen
- Antoni van Leeuwenhoek Department Radiation Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Ludi E. Smeele
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Antoni van Leeuwenhoek Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Mark M. Schubert
- Seattle Cancer Care Alliance (SCCA), 825 Eastlake Ave E Ste G6900, Seattle, WA 98109, USA
| | - René-Jean Bensadoun
- World Association for Laser Therapy (WALT) Scientific Secretary, Centre de Haute Energie (CHE), 10 Bd Pasteur, 06000 Nice, France
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Theodoro LH, Longo M, Ervolino E, Duque C, Ferro-Alves ML, Assem NZ, Louzada LM, Garcia VG. Effect of low-level laser therapy as an adjuvant in the treatment of periodontitis induced in rats subjected to 5-fluorouracil chemotherapy. J Periodontal Res 2016; 51:669-80. [DOI: 10.1111/jre.12347] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2015] [Indexed: 01/04/2023]
Affiliation(s)
- L. H. Theodoro
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - M. Longo
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - E. Ervolino
- Department of Basic Science; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - C. Duque
- Department of Paediatric and Social Dentistry; São Paulo State University (“Univ Estadual Paulista” - UNESP; Araçatuba SP Brazil
| | - M. L. Ferro-Alves
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - N. Z. Assem
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - L. M. Louzada
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
| | - V. G. Garcia
- Department of Surgery and Integrated Clinic; Division of Periodontics; São Paulo State University (“Univ. Estadual Paulista” - UNESP); Araçatuba SP Brazil
- University Centre of the Educational Foundation of Barretos (UNIFEB); Barretos SP Brazil
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Soto M, Lalla RV, Gouveia RV, Zecchin VG, Seber A, Lopes NNF. Pilot Study on the Efficacy of Combined Intraoral and Extraoral Low-Level Laser Therapy for Prevention of Oral Mucositis in Pediatric Patients Undergoing Hematopoietic Stem Cell Transplantation. Photomed Laser Surg 2015; 33:540-6. [DOI: 10.1089/pho.2015.3954] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Marcos Soto
- Pediatric Oncology Institute, GRAACC, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rajesh V. Lalla
- Section of Oral Medicine, University of Connecticut Health Center, Farmington, Connecticut
| | | | | | - Adriana Seber
- Pediatric Oncology Institute, GRAACC, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Nilza Nelly Fontana Lopes
- Division of Dentistry, Pediatric Oncology Institute, GRAACC, Universidade Federal de São Paulo, São Paulo, Brazil
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42
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Bensadoun RJ, Nair RG. Low-Level Laser Therapy in the Management of Mucositis and Dermatitis Induced by Cancer Therapy. Photomed Laser Surg 2015; 33:487-91. [DOI: 10.1089/pho.2015.4022] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Raj G. Nair
- Oral Medicine Oral Pathology and Human Diseases, Menzies Health Institute, Queensland, Australia
- Department of Haematology and Oncology, Gold Coast University Hospital Queensland, Gold Coast, Australia
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43
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Oton-Leite AF, Silva GBL, Morais MO, Silva TA, Leles CR, Valadares MC, Pinezi JCD, Batista AC, Mendonça EF. Effect of low-level laser therapy on chemoradiotherapy-induced oral mucositis and salivary inflammatory mediators in head and neck cancer patients. Lasers Surg Med 2015; 47:296-305. [DOI: 10.1002/lsm.22349] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Angélica F. Oton-Leite
- Department of Oral Medicine (Oral Pathology); Dental School; Federal University of Goiás; Goiânia Goiás 74605-220 Brazil
| | - Geisa Badauy L. Silva
- Department of Oral Medicine (Oral Pathology); Dental School; Federal University of Goiás; Goiânia Goiás 74605-220 Brazil
| | - Marília O. Morais
- Department of Oral Medicine (Oral Pathology); Dental School; Federal University of Goiás; Goiânia Goiás 74605-220 Brazil
| | - Tarcília A. Silva
- Department of Oral Medicine (Oral Pathology); Dental School; Federal University of Minas Gerais; Belo Horizonte Minas Gerais 31270-901 Brazil
| | - Cláudio R. Leles
- Department of Prevention and Oral Rehabilitation, Dental School; Federal University of Goiás; Goiânia Goiás 74605-220 Brazil
| | - Marize Campos Valadares
- Laboratory of Cellular Pharmacology and Toxicology; Faculty of Pharmacy; Federal University of Goiás; Goiânia Goiás 74605-220 Brazil
| | - Juliana Castro D. Pinezi
- Radiotherapy Department of the Araújo Jorge Hospital; Association of Cancer Combat of Goiás; Goiânia Goiás 74605-070 Brazil
| | - Aline C. Batista
- Department of Oral Medicine (Oral Pathology); Dental School; Federal University of Goiás; Goiânia Goiás 74605-220 Brazil
| | - Elismauro F. Mendonça
- Department of Oral Medicine (Oral Pathology); Dental School; Federal University of Goiás; Goiânia Goiás 74605-220 Brazil
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de Carvalho FB, Andrade AS, Rasquin LC, de Castro IV, Cangussu MCT, Pinheiro ALB, dos Santos JN. Effect of laser (λ 660 nm) and LED (λ 630 nm) photobiomodulation on formocresol-induced oral ulcers: a clinical and histological study on rodents. Lasers Med Sci 2014; 30:389-96. [PMID: 25354753 DOI: 10.1007/s10103-014-1680-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 10/16/2014] [Indexed: 12/15/2022]
Abstract
The aim of this study was to evaluate, clinically and histologically, the influence of laser and LED photobiomodulation in the healing of formocresol-induced oral mucosa ulcers of rats. We used 60 Wistar rats in which oral ulcers were induced on the gingiva of the lower incisors. Forty-eight hours after inducing the ulcers, the animals were divided into three groups: laser, LED, and untreated. Animals from the laser group received irradiation with GaAlAs, 660 nm, CW, 40 mW, φ 4 mm(2), 4.8 J/cm(2). Animals from the LED group received irradiation with InGaAIP, 630 nm, 150 mW, 4.8 J/cm(2), 0.8 cm spot. Forty-eight hours after oral ulcer induction, both irradiations were applied in a punctuate manner in the center of the ulcer at 48-h interval until the end of the experimental period. The animals were killed at 3, 5, 7, and 11 days after day 0. The results of the clinical evaluation showed that the laser and LED phototherapies were able to accelerate the healing of formocresol-induced oral ulcers, which occurred first in the laser group (ANOVA, p < 0.05). Histologically, there was a slight variation between LED and laser therapy; therefore, the laser group proved to be effective in accelerating wound healing, especially at 5 days, whereas the LED group was more effective at the end of the experimental period. It was concluded that laser and LED photobiomodulation were effective in accelerating the healing of formocresol-induced oral ulcers in both clinical and histological aspects.
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Affiliation(s)
- Fabiola Bastos de Carvalho
- Center of Biophotonic and Division of Endodontic, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
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Maioli TU, de Melo Silva B, Dias MN, Paiva NC, Cardoso VN, Fernandes SO, Carneiro CM, Dos Santos Martins F, de Vasconcelos Generoso S. Pretreatment with Saccharomyces boulardii does not prevent the experimental mucositis in Swiss mice. J Negat Results Biomed 2014; 13:6. [PMID: 24721659 PMCID: PMC4004512 DOI: 10.1186/1477-5751-13-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 04/07/2014] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The antimetabolite chemotherapy 5-Fluorouracil is one of the most commonly prescribed drugs in clinical cancer treatment. Although this drug is not specific for cancer cells and also acts on healthy cells, it can cause mucositis, a common collateral effect. Dysbiosis has also been described in 5-fluorouracil-induced mucositis and is likely to contribute to the overall development of mucositis. In light of this theory, the use of probiotics could be a helpful strategy to alleviate mucositis. So the aim of this study was evaluate the impact of the probiotic Saccharomyces boulardii in a model of mucositis. RESULTS After induced of mucositis, mice from the Mucositis groups showed a decrease in food consumption (p < 0.05) and therefore had a greater weight loss (p < 0.05). The treatment with Saccharomyces boulardii did not reverse this effect (p > 0.05). Mucositis induced an increase in intestinal permeability and intestinal inflammation (p < 0.05). There were no differences in mucosal lesions, intestinal permeability and sIgA secretion (p > 0.05) in mice pretreated with S. boulardii. CONCLUSIONS S. boulardii was not able to prevent the effects of experimental mucositis induced by 5- Fluorouracil.
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Abstract
Oral mucositis is a significant toxicity of systemic chemotherapy and of radiation therapy to the head and neck region. The morbidity of oral mucositis can include pain, nutritional compromise, impact on quality of life, alteration in cancer therapy, risk for infection, and economic costs. Management includes general symptomatic support and targeted therapeutic interventions for the prevention or treatment of oral mucositis. Evidence-based clinical practice guidelines are available to guide clinicians in the selection of effective management strategies.
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Affiliation(s)
- Rajesh V Lalla
- Section of Oral Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-1605, USA.
| | - Deborah P Saunders
- Department of Dental Oncology, Northeast Cancer Centre, Health Sciences North, Northern Ontario School of Medicine, 41 Ramsey Lake Road, Sudbury, ON P3E 5J1, Canada
| | - Douglas E Peterson
- Section of Oral Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-1605, USA
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47
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Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, McGuire DB, Migliorati C, Nicolatou-Galitis O, Peterson DE, Raber-Durlacher JE, Sonis ST, Elad S. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 2014; 120:1453-61. [PMID: 24615748 PMCID: PMC4164022 DOI: 10.1002/cncr.28592] [Citation(s) in RCA: 688] [Impact Index Per Article: 68.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/21/2013] [Accepted: 12/20/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Mucositis is a highly significant, and sometimes dose‐limiting, toxicity of cancer therapy. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for mucositis. METHODS A literature search was conducted to identify eligible published articles, based on predefined inclusion/exclusion criteria. Each article was independently reviewed by 2 reviewers. Studies were rated according to the presence of major and minor flaws as per previously published criteria. The body of evidence for each intervention, in each treatment setting, was assigned a level of evidence, based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. RESULTS The literature search identified 8279 papers, 1032 of which were retrieved for detailed evaluation based on titles and abstracts. Of these, 570 qualified for final inclusion in the systematic reviews. Sixteen new guidelines were developed for or against the use of various interventions in specific treatment settings. In total, the MASCC/ISOO Mucositis Guidelines now include 32 guidelines: 22 for oral mucositis and 10 for gastrointestinal mucositis. This article describes these updated guidelines. CONCLUSIONS The updated MASCC/ISOO Clinical Practice Guidelines for mucositis will help clinicians provide evidence‐based management of mucositis secondary to cancer therapy. Cancer 2014;120:1453–1461. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Mucositis is a highly significant, and sometimes dose‐limiting, toxicity of cancer therapy. This article presents evidence‐based clinical practice guidelines for the management of mucositis.
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48
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Assessment of immediate pain relief with laser treatment in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:189-93. [DOI: 10.1016/j.oooo.2013.02.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 02/05/2013] [Accepted: 02/15/2013] [Indexed: 11/18/2022]
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49
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Lopez TCC, Martins MD, Pavesi VCS, Ferreira LS, Bussadori SK, Moreira MS, Marques MM. Effect of laser phototherapy in the prevention and treatment of chemo-induced mucositis in hamsters. Braz Oral Res 2013; 27:342-8. [DOI: 10.1590/s1806-83242013005000019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 03/13/2013] [Indexed: 11/22/2022] Open
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50
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Babaee N, Moslemi D, Khalilpour M, Vejdani F, Moghadamnia Y, Bijani A, Baradaran M, Kazemi MT, Khalilpour A, Pouramir M, Moghadamnia AA. Antioxidant capacity of calendula officinalis flowers extract and prevention of radiation induced oropharyngeal mucositis in patients with head and neck cancers: a randomized controlled clinical study. ACTA ACUST UNITED AC 2013; 21:18. [PMID: 23497687 PMCID: PMC3623793 DOI: 10.1186/2008-2231-21-18] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 02/26/2013] [Indexed: 12/20/2022]
Abstract
This study was designed to determine the effect of Calendula officinalis flowers extract mouthwash as oral gel on radiation-induced oropharyngeal mucositis (OM) in patients with head-and-neck cancer. Forty patients with neck and head cancers under radiotherapy or concurrent chemoradiotherapy protocols were randomly assigned to receive either 2% calendula extract mouthwash or placebo (20 patients in each group). Patients were treated with telecobalt radiotherapy at conventional fractionation (200 cGy/fraction, five fractions weekly, 30–35 fractions within 4–7 weeks). The oropharyngeal mucositis was evaluated by two clinical investigators (a radiation oncologist and a dentist), using the oral mucositis assessment scale (OMAS). Trying to find out the possible mechanism of action of the treatment, total antioxidant, polyphenol and flavonoid contents, and quercetin concentration of the mouth wash were measured. Calendula mouthwash significantly decreased the intensity of OM compared to placebo at week 2 (score: 5.5 vs. 6.8, p = 0.019), week 3 (score: 8.25 vs. 10.95, p < 0.0001) and week 6 (score: 11.4 vs. 13.35, p = 0.031). Total antioxidant, polyphenol and flavonoid contents and quercetin concentration of the 2% extract were 2353.4 ± 56.5 μM, 313.40 ± 6.52 mg/g, 76.66 ± 23.24 mg/g, and 19.41 ± 4.34 mg/l, respectively. Calendula extract gel could be effective on decreasing the intensity of radiotherapy- induced OM during the treatment and antioxidant capacity may be partly responsible for the effect.
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Affiliation(s)
- Neda Babaee
- Division of Radiation Oncology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
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