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Heimlich FV, de Arruda JAA, Pereira NM, Faria LDS, Abreu LG, Ferreira MVL, Kakehasi FM, Travassos DV, Silva TA, Mesquita RA. Proposal of a prophylactic photobiomodulation protocol for chemotherapy-induced oral and oropharyngeal mucositis: a randomized clinical trial. Lasers Med Sci 2023; 38:245. [PMID: 37889325 DOI: 10.1007/s10103-023-03916-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023]
Abstract
Photobiomodulation therapy (PBMT) is widely used in oncology settings, but lack of assessment standardization is the main barrier to optimization of clinical protocols. This study analyzed three PBMT protocols for preventing oral and oropharyngeal mucositis (OM) in patients undergoing chemotherapy (CT) and/or hematopoietic stem cell transplantation (HSCT). This is a preliminary randomized blind clinical trial. Group 1 received intraoral prophylactic PBMT, Group 2 received intraoral and oropharyngeal PBMT, and Group 3 received intraoral, oropharyngeal, and extraoral PBMT. The applications were from the first day of CT to day + 10. Clinicodemographic data, CT regimens, types of HSCT, hematological exams, occurrence/severity of OM, odynophagia, and OM-related opportunistic infections were assessed. Sixty participants (age range: 18-74 years) were included; 70% of them underwent CT and 30% HSCT. About 43.3% of patients had OM, while odynophagia was reported by 23.3%. Both Groups 1 and 2 revealed better results. Multivariate analysis showed that HSCT directly influenced the occurrence of OM. Individuals who had undergone allogeneic HSCT were 1.93 times more likely to develop OM (p < 0.001). Group 3 exhibited a higher frequency of OM, albeit of lower grades. This group consisted of half the population who had undergone HSCT, had the highest percentage of melphalan use, and had the lowest mean leukocyte count. The three proposed protocols were effective in preventing and reducing OM, with good tolerance and no reported adverse effects. PBMT is a safe and effective approach to OM prophylaxis in adults undergoing CT/HSCT.
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Affiliation(s)
- Fernanda Vieira Heimlich
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Nickolas Mendes Pereira
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Dos Santos Faria
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcus Vinícius Lucas Ferreira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fabiana Maria Kakehasi
- Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Denise Vieira Travassos
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Cruz AR, Minicucci EM, Betini M, Almeida-Lopes L, Tieghi Neto V, Cataneo AJM. Efficacy of photobiomodulation in the treatment of oral mucositis in patients undergoing antineoplastic therapy: systematic review and meta-analysis. Support Care Cancer 2023; 31:645. [PMID: 37853254 DOI: 10.1007/s00520-023-08105-7] [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: 06/18/2023] [Accepted: 10/04/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE To evaluate the effectiveness of photobiomodulation in the treatment of oral mucositis. METHODS Systematic review and meta-analysis encompassing in the electronic databases: LILACS, MEDLINE, EMBASE, COCHRANE, SCOPUS, WEB OF SCIENCE, and CINAHL and in http://clinicaltrials.gov . Eligibility criteria were randomized, non-randomized, and observational studies that used photobiomodulation for the treatment of oral mucositis. The endpoints were reduction in the severity of oral mucositis, duration of lesions, and pain reduction. For data analysis, the Review Manager 5.4 program was used. RESULTS A total of 316 studies were identified, 297 in the electronic databases and 19 in http://clinicaltrials.gov . After removing duplicates, 260 studies were selected for title and abstract reading, of which 223 were excluded. A total of 37 studies were chosen for full reading, of which 6 were included in the review, totaling 299 patients. The treatment used was photobiomodulation. The patients were divided into two groups: the laser group used only photobiomodulation or associated with other therapies, and the control group did not use photobiomodulation. For the endpoint reduction in the severity of oral mucositis (OM), the chance of reduction of the OM was greater in the laser group as compared to the control group. For the endpoints duration of OM lesions and pain reduction, it was not possible to carry out a meta-analysis due to the high heterogeneity between studies. In the interpretation of the meta-analysis, the reduction in the severity of oral mucositis was greater in the group that received photobiomodulation. CONCLUSION Photobiomodulation was effective in the treatment of oral mucositis.
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Affiliation(s)
- Adriana Regina Cruz
- Program of Surgery and Translational Medicine, University Unesp, Medical School, Botucatu, São Paulo, Brazil.
| | - Eliana Maria Minicucci
- Clinical Hospital of São Paulo State University Unesp, Medical School, Botucatu, São Paulo, Brazil
| | - Marluci Betini
- Reference Technical Section, University Unesp, Medical School, Botucatu, São Paulo, Brazil
| | - Luciana Almeida-Lopes
- Institute of Research and Learning in the Area of Health - NUPEN, São Carlos, São Paulo, Brazil
| | - Victor Tieghi Neto
- Department of Dentistry, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
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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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Abstract
INTRODUCTION Oral mucositis is one of the most common complications following chemotherapy and/or head and neck radiotherapy. Various treatments for oral mucositis have been proposed. However, there has still been no review of the most frequent and most effective type of therapy to treat oral mucositis. This systematic review aims to determine the most frequent and effective types of therapy to treat and reduce the severity of oral mucositis. EVIDENCE ACQUISITION The literature search was carried out using PRISMA guidelines. Publications included from 2010 to June 2021 with a clinical trial, prospective, and retrospective observational research design. The following databases were used: PubMed, Cochrane Library, and Wiley Online Library. The search was for limited articles published in English, which were screened and analyzed by three authors. The risk of bias of each study was also assessed by three authors simultaneously, using different types of instruments depending on its study design. EVIDENCE SYNTHESIS Forty-seven of 1274 journals were included. From 3577 subjects, oral mucositis was more common in males than females (2.12: 1), with a mean age of 56.39 (18-90 years). The most commonly used types of therapy are low-level laser therapy (396 subjects) and lysozyme-based compounds (314 subjects). Meanwhile, the most effective type of therapy is low-level laser therapy. CONCLUSIONS Low-level laser therapy is the most commonly used oral mucositis therapy and is also the most effective in reducing the degree of oral mucositis and associated pain.
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Affiliation(s)
- Joey Danwiek
- Department of Oral Medicine, Universitas Trisakti, Jakarta, Indonesia
| | - Rahmi Amtha
- Department of Oral Medicine, Universitas Trisakti, Jakarta, Indonesia -
| | - Indrayadi Gunardi
- Department of Oral Medicine, Universitas Trisakti, Jakarta, Indonesia
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Lee TL, Ding Z, Chan AS. Can transcranial photobiomodulation improve cognitive function? A systematic review of human studies. Ageing Res Rev 2023; 83:101786. [PMID: 36371017 DOI: 10.1016/j.arr.2022.101786] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/12/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Transcranial photobiomodulation (tPBM) has been studied for over a decade as a possible cognitive intervention. OBJECTIVE To evaluate the effect of tPBM for enhancing human cognitive function in healthy adults and remediating impaired cognitive function in adults with cognitive disorders. METHODS A systematic literature search from three electronic databases (PubMed, Scopus, Web of Science) was conducted from 1987 to May 2022. The cognitive function being evaluated included learning and memory, attention, executive function, language, and global cognitive function. RESULTS Of the 35 studies identified, 29 (82.9 %) studies reported positive improvement in cognitive functions after tPBM. All nine studies on participants with subjective memory complaints, mild cognitive impairment, and dementia, showed positive outcomes. Seven (87.5 %) studies on traumatic brain injury (TBI) patients also showed positive results. A series of clinical trials on stroke patients showed positive trends on improved neurological deficit at first, but was prematurely terminated later at phase III due to the lack of statistical significance. One of the most common protocols for clinical populations employed devices delivering near-infrared light (810 nm), the irradiance of 20-25 mW/cm2, and fluence of 1-10 J/cm2. While this was common, the reviewed protocols also included other wavelengths of light ranging from visible, red (630-635 nm) to invisible near-infrared maximum wavelengths of 1060-1068 nm. CONCLUSIONS tPBM seems to improve cognitive function. However, only half of the reviewed clinical trials were randomized control trials, further investigation is warranted.
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Affiliation(s)
- Tsz-Lok Lee
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Zihan Ding
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Agnes S Chan
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China; Research Centre for Neuropsychological Well-Being, The Chinese University of Hong Kong, Hong Kong, China.
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Twenty-year analysis of photobiomodulation clinical studies for oral mucositis: a scoping review. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:626-641. [PMID: 36870898 DOI: 10.1016/j.oooo.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/12/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Our objective was to review the first 20 years of photobiomodulation (PBM) clinical studies for oral mucositis (OM) mitigation. STUDY DESIGN A scoping review screened controlled clinical studies. The PBM devices, protocols, and clinical outcomes were analyzed. RESULTS Seventy-five studies met the inclusion criteria. The first study dated from 1992, and the term "PBM" was first published in 2017. Public services, placebo-controlled randomized trials, and patients with head and neck chemoradiation were predominant among included studies. Prophylactic red intraoral laser protocols were mostly used. Comparing the outcomes of all protocols was unfeasible due to missing treatment parameters and nonhomogeneous measurements. CONCLUSIONS The main barrier to optimizing clinical protocols of PBM for OM was the lack of standardization in clinical studies. Although PBM use is now globally present in oncology settings and generally marked by good outcomes reported, additional randomized clinical trials with well-described methods are necessary.
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Sardo AVN, Andrade MF, Figueiredo A, Rosin FCP, Corrêa L, Zezell DM. Does Photobiomodulation Affects CK10 and CK14 in Oral Mucositis Radioinduced Repair? Int J Mol Sci 2022; 23:ijms232415611. [PMID: 36555260 PMCID: PMC9779304 DOI: 10.3390/ijms232415611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 12/14/2022] Open
Abstract
The mechanisms of action of photobiomodulation (PBM) in oral mucositis (OM) are not completely elucidated. To enlighten the role of PBM in the evolution of epithelial maturity in OM ulcers, the present study evaluated the effect of PBM with red (λ) wavelength of 660 nanometers (nm) and infrared of 780 nm in radio-induced OM wounds on the tongue of rats, eight and twenty days after irradiation with single dose of 20 Gy. The percentage area corresponding to positive staining for cytokeratin 10 (CK10) and 14 (CK14) proteins was evaluated in the epithelial area of the lesions, using an immunohistochemical technique (IHC), 8 and 20 days after the induction of lesions, and compared with an untreated control group. CK10 was significantly more expressed in the group treated with 660 nm PBM. CK14 did not show quantitative differences between the groups evaluated. However, whereas in the groups treated with PBM, CK14 was already restricted to the basal layer of the epithelium, as expected in healthy epithelia, in control group it was also expressed in upper layers of the epithelium. In this work, PBM was able to improve epithelial maturity of the repaired OM wound, especially in the 660 nm group.
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Affiliation(s)
- Ariane Venzon Naia Sardo
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucelares IPEN-CNEN, São Paulo CEP 05508-000, SP, Brazil
| | - Maíra Franco Andrade
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucelares IPEN-CNEN, São Paulo CEP 05508-000, SP, Brazil
| | - Anaeliza Figueiredo
- School of Dentistry, University of São Paulo, São Paulo CEP 05508-000, SP, Brazil
| | | | - Luciana Corrêa
- School of Dentistry, University of São Paulo, São Paulo CEP 05508-000, SP, Brazil
| | - Denise Maria Zezell
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucelares IPEN-CNEN, São Paulo CEP 05508-000, SP, Brazil
- Correspondence:
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Effect of low-level light therapy before radiotherapy in oral squamous cell carcinoma: An in vitro study. Lasers Med Sci 2022; 37:3527-3536. [PMID: 36001245 DOI: 10.1007/s10103-022-03632-x] [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: 06/07/2022] [Accepted: 08/14/2022] [Indexed: 10/15/2022]
Abstract
Radiation therapy for head and neck squamous cell carcinoma (HNSCC) is associated with several complications. Although photobiomodulation (PBM) has radioprotective effects in normal tissue, it could also enhance the growth of neoplastic cells. Thus, the present study aimed to investigate the cellular response of oral squamous cell carcinoma with pre-exposure to low-level phototherapy before radiotherapy. SCC9, Cal-27, A431, and HaCaT cell lines were subjected to low-level light therapy and radiotherapy. The cells were treated with a single energy density (300 J/cm2) of a light-emitting diode (660 nm) prior to ionizing radiation at different doses (0, 2, 4, and 6 Gy). After 24 h, wound scratch, proliferation, clonogenic cell survival, cell death, and reactive oxygen species (ROS) analyses were performed to evaluate cell response. The cell lines pre-exposed to PBM at the analyzed dosage were radiosensitive. The treatment significantly reduced cell proliferation and clonogenic cell survival. Migration and cell death assays also revealed positive results, with the treatment group showing lower rate of migration and higher cell death than did the control group. Moreover, PBM effectively increased the intracellular levels of ROS. PBM at 300 J/cm2 is a promising radiosensitizing modality to reduce the radiation dose and avoid the intolerable side effects of radiotherapy for HNSCC, thus increasing the probability of successful treatment. However, further studies are needed to support and confirm the results.
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Fonseca LL, Durães CP, Menezes ASDS, Tabosa ATL, Barbosa CU, Filho ADPS, Souza DPSDP, Guimarães VHD, Santos SHS, de Paula AMB, Farias LC, Guimarães EALS. Comparison Between Two Antimicrobial Photodynamic Therapy Protocols for Oral Candidiasis in Patients Undergoing Treatment for Head and Neck Cancer: A two-arm, single-blind clinical trial. Photodiagnosis Photodyn Ther 2022; 39:102983. [PMID: 35772622 DOI: 10.1016/j.pdpdt.2022.102983] [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: 06/03/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to compare the efficacy of Antimicrobial Photodynamic Therapy (aPDT) with 300 µmol/L of methylene blue and 8 µmol/L of curcumin on oral candidiasis patients with HNSCC undergoing treatment. METHODS A two-arm, single-blind clinical trial was performed. Following verification for eligibility (n = 447), 108 patients were included in the study. The study consisted of a group that received aPDT with methylene blue (n = 57) and another that received aPDT with curcumin (n = 51). The patients rinsed their mouths with an aqueous solution of 300 µmol/L of methylene blue and 8 µmol/L of curcumin in four sessions, and then the lesion was scraped for the subsequent RT-qPCR. The primary outcome was that no cure was presented for oral candidiasis after treatment. The secondary result was reducing the number of sites affected by oral candidiasis. RESULTS There was no difference in treatment failure evaluated by the necessity of drug prescription or Candida sp DNA quantification. However, clinically the methylene blue protocol reduced the number of infected anatomical sites compared to the curcumin protocol. CONCLUSION Methylene Blue aPDT reduced the number of infected anatomical sites compared to curcumin.
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Affiliation(s)
- Larissa Lopes Fonseca
- Department of Dentistry, Universidade Estadual de Montes Claros (Unimontes), Montes Claros, Minas Gerais, Brazil
| | - Cristina Paixão Durães
- Department of Dentistry, Universidade Estadual de Montes Claros (Unimontes), Montes Claros, Minas Gerais, Brazil
| | - Agna Soares da Silva Menezes
- Department of Dentistry, Universidade Estadual de Montes Claros (Unimontes), Montes Claros, Minas Gerais, Brazil
| | | | - Chelsea Uramoto Barbosa
- Department of Dentistry, Universidade Estadual de Montes Claros (Unimontes), Montes Claros, Minas Gerais, Brazil
| | | | | | - Victor Hugo Dantas Guimarães
- Institute of Agricultural Sciences, Universidade Federal de Minas Gerais (UFMG), Montes Claros, Minas Gerais, Brazil
| | - Sérgio Henrique Sousa Santos
- Institute of Agricultural Sciences, Universidade Federal de Minas Gerais (UFMG), Montes Claros, Minas Gerais, Brazil
| | | | - Lucyana Conceição Farias
- Department of Dentistry, Universidade Estadual de Montes Claros (Unimontes), Montes Claros, Minas Gerais, Brazil
| | - E André Luiz Sena Guimarães
- Department of Dentistry, Universidade Estadual de Montes Claros (Unimontes), Montes Claros, Minas Gerais, Brazil; Dilson Godinho Hospital, Montes Claros, Minas Gerais, Brazil.
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Labrosse G, Graillon N, Maladiere E, Lan R, Campana F. Update of photobiomodulation in oral mucositis: a systematic review. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2022. [DOI: 10.1051/mbcb/2022016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: Oral mucositis (OM) is a common side effect of radiotherapy (RT) or radio-chemotherapy (RT/CT) for head and neck cancers. It causes lesions leading to impairment of the quality of life, dysphagia, pain, and in up to 20% of cases, a dosimetry concession, decreasing local tumor control, thereby impacting the survival rate. Positive results of photobiomodulation (PBM) to treat it have been reported in the literature. PBM has multiple parameters (type of laser, emission mode, number of sessions to be performed, wavelength, power, energy, fluence, exposure time, number of points) making it difficult to implement in clinical practice. Materials and methods: A literature search strategy was applied in Medline by selecting articles published between 2010 and 2020 to answer the following research question: “In patients treated with RT or RT/CT, what is the place of PBM in the management of OM?”, in accordance with PICO (patient, intervention, comparison and outcomes) criteria. The inclusion criteria were all original articles (clinical cases and clinical studies) which answered the research question. Meta-analyses, systematic reviews of the literature and journals, animal or in vitro studies, studies published in a language other than French or English, and full-text articles not accessible via inter-university credits were excluded. Results: Seventeen articles were included, representing 1576 patients. The PBM was intraoral in 16 papers and combined intra- and extra-oral emission in 1 paper. InGaAlP diode laser and HeNe laser significantly reduced OM compared with placebo in 62.5% and 75% of the studies, respectively. Pain reduction was poorly or not documented and when it was, it did not correlate with the reduction of analgesics. Temporary or permanent interruption of radiotherapy was also poorly documented. Discussion: The MASCC/ISOO (2019) report is an important step forward to establish a reproducible protocol for PBM, which as our results show, is heterogeneous in use. Our results showed that the studies started PBM on the first day of RT, using a wavelength of 660 nm for diode laser and 632.8 nm for HeNe laser. However, there is no scientific evidence vis-à-vis the values for power, energy, fluence, exposure time, or number of points. Although PBM appears to be effective in reducing OM scores, its effectiveness on improving patient quality of life, pain, painkiller consumption, compliance with treatment and the occurrence of complications remains to be defined. The relationship between PBM and survival rate was not an objective of this work. We found that of the 17 articles, 15 stated that they did not illuminate the tumor site during PBM sessions. Conclusion: The main objective of this work was to determine the place of PBM in the treatment of OM. Overall, the results on OM scores were favorable in almost ¾ of the studies. Despite its efficacy, the questions of the adjustment of the parameters of PBM, the harmonization on OM scale and its safety on carcinologic recurrence remain to be studied. In view of the lack of comparability of studies and the lack of reported data, studies that harmonize endpoints and follow-up criteria are needed to establish a standard protocol.
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Bezinelli LM, Corrêa L, Vogel C, Kutner JM, Ribeiro AF, Hamerschlak N, Eduardo CDP, Migliorati CA, Eduardo FDP. Long-term safety of photobiomodulation therapy for oral mucositis in hematopoietic cell transplantation patients: a 15-year retrospective study. Support Care Cancer 2021; 29:6891-6902. [PMID: 34021422 DOI: 10.1007/s00520-021-06268-9] [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: 02/26/2021] [Accepted: 04/30/2021] [Indexed: 12/27/2022]
Abstract
Photobiomodulation therapy (PBMT) has demonstrated efficacy in the prevention and treatment of oral mucositis (OM) in hematopoietic cell transplantation (HCT). However, based on the cell stimulation properties, its long-term safety has been questioned, mainly in relation to risk for secondary malignancies in the oral cavity. The aim of this study was to investigate if different PBMT protocols for OM control have association with immediate and late adverse effects in HCT patients. Data on autologous and allogeneic transplantation, conditioning regimen, PBMT protocols, and OM severity were retrospectively collected from medical and dental records. Presence of secondary malignancies in the oral cavity was surveyed during a 15-year follow-up. Impact of OM on overall survival was also analyzed. Different PBMT protocols for prevention and treatment of OM were recorded over the years. Severe OM (grades 3 and 4) was infrequently observed. When present, we observed a significant decrease of the overall survival. No immediate adverse effect and secondary malignancy was associated to PBMT. In conclusion, the PBMT protocols used in the study were considered safe. The low frequency of severe OM observed encourages the implementation of this technique, with a special emphasis on the dosimetry adjustments focused on the HCT context.
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Affiliation(s)
- Letícia Mello Bezinelli
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil
| | - Luciana Corrêa
- School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cristina Vogel
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil
| | - Jose Mauro Kutner
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil
| | - Andreza Feitosa Ribeiro
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil
| | - Nelson Hamerschlak
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil
| | | | - Cesar Augusto Migliorati
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Fernanda de Paula Eduardo
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil.
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Fuchs C, Schenk MS, Pham L, Cui L, Anderson RR, Tam J. Photobiomodulation Response From 660 nm is Different and More Durable Than That From 980 nm. Lasers Surg Med 2021; 53:1279-1293. [PMID: 33998008 DOI: 10.1002/lsm.23419] [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: 12/23/2020] [Revised: 03/28/2021] [Accepted: 04/24/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Photobiomodulation (PBM) therapy uses light at various wavelengths to stimulate wound healing, grow hair, relieve pain, and more-but there is no consensus about optimal wavelengths or dosimetry. PBM therapy works through putative, wavelength-dependent mechanisms including direct stimulation of mitochondrial respiration, and/or activation of transmembrane signaling channels by changes in water activity. A common wavelength used in the visible red spectrum is ~660 nm, whereas recently ~980 nm is being explored and both have been proposed to work via different mechanisms. We aimed to gain more insight into identifying treatment parameters and the putative mechanisms involved. STUDY DESIGN/MATERIALS AND METHODS Fluence-response curves were measured in cultured keratinocytes and fibroblasts exposed to 660 or 980 nm from LED sources. Metabolic activity was assessed using the MTT assay for reductases. ATP production, a major event triggered by PBM therapy, was assessed using a luminescence assay. To measure the role of mitochondria, we used an ELISA to measure COX-1 and SDH-A protein levels. The respective contributions of cytochrome c oxidase and ATP synthase to the PBM effects were gauged using specific inhibitors. RESULTS Keratinocytes and fibroblasts responded differently to exposures at 660 nm (red) and 980 nm (NIR). Although 980 nm required much lower fluence for cell stimulation, the resulting increase in ATP levels was short-term, whereas 660 nm stimulation elevated ATP levels for at least 24 hours. COX-1 protein levels were increased following 660 nm treatment but were unaffected by 980 nm. In fibroblasts, SDH-A levels were affected by both wavelengths, whereas in keratinocytes only 660 nm light impacted SDH-A levels. Inhibition of ATP synthase nearly completely abolished the effects of both wavelengths on ATP synthesis. Interestingly, inhibiting cytochrome c oxidase did not prevent the rise in ATP levels in response to PBM treatment. CONCLUSION To the best of our knowledge, this is the first demonstration of differing kinetics in response to PBM therapy at red versus NIR wavelength. We also found cell-type-specific differences in PBM therapy response to the two wavelengths studied. These findings confirm that different response pathways are involved after 660 and 980 nm exposures and suggest that 660 nm causes a more durable response. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Christiane Fuchs
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114.,Department of Dermatology, Harvard Medical School, Boston, Massachusetts, 02115
| | - Merle Sophie Schenk
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114
| | - Linh Pham
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114
| | - Lian Cui
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114
| | - Richard Rox Anderson
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114.,Department of Dermatology, Harvard Medical School, Boston, Massachusetts, 02115
| | - Joshua Tam
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114.,Department of Dermatology, Harvard Medical School, Boston, Massachusetts, 02115
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13
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Liu S, Zhao Q, Zheng Z, Liu Z, Meng L, Dong L, Jiang X. Status of Treatment and Prophylaxis for Radiation-Induced Oral Mucositis in Patients With Head and Neck Cancer. Front Oncol 2021; 11:642575. [PMID: 33816293 PMCID: PMC8013721 DOI: 10.3389/fonc.2021.642575] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
Radiation-induced oral mucositis (RIOM) is one of the most frequent complications in head and neck cancer (HNC) patients undergoing radiotherapy (RT). It is a type of mucosal injury associated with severe pain, dysphagia, and other symptoms, which leads to the interruption of RT and other treatments. Factors affecting RIOM include individual characteristics of HNC patients, concurrent chemoradiation therapy, and RT regimen, among others. The pathogenesis of RIOM is not yet fully understood; however, the release of inflammatory transmitters plays an important role in the occurrence and development of RIOM. The five biological stages, including initiation, primary damage response, signal amplification, ulceration, and healing, are widely used to describe the pathophysiology of RIOM. Moreover, RIOM has a dismal outcome with limited treatment options. This review will discuss the epidemiology, pathogenesis, clinical appearance, symptomatic treatments, and preventive measures related to this disease. We hope to provide a reference for the clinical treatment and prevention of RIOM in HNC patients after RT.
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Affiliation(s)
- Shiyu Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China.,Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China.,National Health Commission (NHC) Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Qin Zhao
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China.,Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China.,National Health Commission (NHC) Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Zhuangzhuang Zheng
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China.,Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China.,National Health Commission (NHC) Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Zijing Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China.,Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China.,National Health Commission (NHC) Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Lingbin Meng
- Department of Hematology and Medical Oncology, Moffitt Cancer Center, Tampa, FL, United States
| | - Lihua Dong
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China.,Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China.,National Health Commission (NHC) Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
| | - Xin Jiang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China.,Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China.,National Health Commission (NHC) Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China
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14
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Menezes ASDS, Sanches GLG, Gomes ESB, Soares RG, Durães CP, Fonseca LL, Filho ADPS, Ribeiro AAADA, Nascimento JE, Santos SHS, de Paula AMB, Farias LC, Guimarães ALS. The combination of traditional and auricular acupuncture to prevent xerostomia and anxiety in irradiated patients with HNSCC: a preventive, parallel, single-blind, 2-arm controlled study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:675-683. [PMID: 33839061 DOI: 10.1016/j.oooo.2021.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/16/2021] [Accepted: 02/19/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The purpose of the present study was to investigate the effect of acupuncture on xerostomia in irradiated patients with head and neck squamous cell carcinoma (HNSCC). STUDY DESIGN A preventive, 2-arm, parallel, single-blind trial was performed. Patients with HNSCC (N = 296) were checked for eligibility, and 107 patients were enrolled in the study. The study comprised 1 group that did not receive the intervention (n = 55) and the interventional group that received traditional and auricular acupuncture (n = 52). The primary outcome was the reduction of the patients' xerostomia after treatment. In addition, the secondary outcome was the reduction of anxiety. RESULTS The current acupuncture protocol reduced the xerostomia score and increased saliva volume and density without changing salivary pH. Additionally, acupuncture decreased the Beck Anxiety Inventory (BAI) score after radiation therapy. CONCLUSION Combining traditional and auricular acupuncture reduced xerostomia and increased saliva volume without changing the saliva's pH in irradiated patients with HNSCC. Additionally, the combination of traditional and auricular acupuncture reduced BAI scores.
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Affiliation(s)
| | | | | | - Raquel Gusmão Soares
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Cristina Paixão Durães
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Larissa Lopes Fonseca
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | | | | | | | | | - Lucyana Conceição Farias
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - André Luiz Sena Guimarães
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil; Dilson Godinho Hospital, Montes Claros, Minas Gerais, Brazil.
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15
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Gkantaifi A, Vardas E, Alongi F, Tsoukalas N, Saraireh HH, Charalampakis N, Lövey J, Hajiioannou J, Kyrodimos E, Tsanadis K, Mauri D, Christopoulos C, Iliadis G, Tolia M. Radiation-Induced Oral Mucositis in Head and Neck Cancer Patients. Five Years Literature Review. Rev Recent Clin Trials 2020; 16:151-165. [PMID: 32735527 DOI: 10.2174/1574887115666200731182708] [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: 03/29/2020] [Revised: 06/26/2020] [Accepted: 07/14/2020] [Indexed: 12/24/2022]
Abstract
Backround: Radiation-induced oral mucositis consists of a series of relatively frequent side effects after head and neck cancer radiotherapy and has an adverse impact on both regular treatment process and the quality of life of patients. OBJECTIVE The purpose of the present review is to optimize the current management of radiation-induced oral mucositis in head and neck cancer patients. METHODS PubMed database research was performed on articles published since 2015 that demonstrated efficacy in the management of radiation-induced oral mucositis in head and neck cancer patients. The study selection included observational, prospective, comparative, randomized, double- blind, placebo-controlled or uncontrolled, and retrospective studies, as well as systematic reviews and metanalyses. RESULTS From the 931 citations obtained from the search, only 94 articles met the inclusion criteria, including mucosal protectants, anti-inflammatory agents, growth factors, and various miscellaneous and natural agents. Several methods, including both pharmacological and natural agents, have been proposed for the management of oral mucositis. In addition to the already known interventions with strong evidence, according to the Multinational Association of Supportive Care in Cancer and he International Society of Oral Oncology guidelines, further agents have been used. However, a great number of them lack clear evidence, which surely requires the design of more controlled clinical trials for a better assessment of the ideal methods. CONCLUSION The management of oral mucositis constitutes an active area of research. In light of these results, it is aimed to illustrate those treatment strategies that are most effective regarding the treatment approach of oral mucositis.
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Affiliation(s)
- Areti Gkantaifi
- Radiotherapy Department, Interbalkan Medical Center, 10 Asclepioustr, 57001 Pylaia, Thessaloniki, Greece
| | - Emmanouil Vardas
- Clinic of Hospital Dentistry, Dental School, National and Kapodistrian University of Athens, 2 Thivonstr, Goudi, 11527Athens, Greece
| | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS SacroCuore Don Calabria, Hospital, Negrar, Verona, University of Brescia, Brescia, Italy
| | - Nikolaos Tsoukalas
- Oncology Department, General Military Hospital 401, 138 Avenue Mesogeion & Katechaki, 11525, Athens, Greece
| | - Haytham Hamed Saraireh
- Radiation Oncology Department, Jordanian Royal Medical Services, King Hussein, Medical Center, King Abdullah II St 230, Amman, Jordan
| | | | - Jozsef Lövey
- Department of Oncology, Center of Radiotherapy, National Institute of Oncology, Semmelweis University, Budapest, Hungary
| | - Jiannis Hajiioannou
- Department of Otolaryngology, Faculty of Medicine, School of Health Sciences, University of Thessaly, University Hospital of Larissa, Biopolis,41110, Larissa, Greece
| | - Efthymios Kyrodimos
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippocration Hospital, University of Athens, Athens, Greece
| | - Konstantinos Tsanadis
- Department of Radiotherapy, University Hospital of Larisa, Biopolis, 41110, Larisa, Greece
| | - Davide Mauri
- Medical Oncology, University of Ioannina, Ioannina, Greece
| | - Christos Christopoulos
- Radiation Oncology Department, Groupe Hospitalier Intercommunal Le Raincy, Montfermeil, 10 Rue du General Leclerc, 93370 Montfermeil, France
| | - George Iliadis
- Radiotherapy Department, Interbalkan Medical Center, 10 Asclepioustr, 57001 Pylaia, Thessaloniki, Greece
| | - Maria Tolia
- Department of Radiotherapy, University of Thessaly, School of Health Sciences, Faculty of Medicine, Biopolis,41110, Larisa, Greece
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16
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Local tissue electrical parameters predict oral mucositis in HNSCC patients: A diagnostic accuracy double-blind, randomized controlled trial. Sci Rep 2020; 10:9530. [PMID: 32533013 PMCID: PMC7293345 DOI: 10.1038/s41598-020-66351-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/19/2020] [Indexed: 01/10/2023] Open
Abstract
Oral Mucositis (OM) is a common adverse effect of head and neck squamous cell carcinoma (HNSCC) treatment. The purpose of this study was to investigate the significance of early changes in tissue electrical parameters (TEPs) in predicting the development of OM in HNSCC patients receiving radiation therapy (RT). The current study combined two study designs. The first was a case-control study. The control group comprised of RT patients who did not receive head and neck RT, and patients with HNSCC who received RT comprised the case group. In the second part of the study, the case group was included in a parallel cohort. A total of 320 patients were assessed for eligibility, and 135 patients were enrolled. Double blinding was performed, and neither the patients nor the care providers knew the measured parameters. The primary outcome was the detection of between-group changes in local TEPs over the follow-up period. The secondary outcome was the appearance of OM grades II, III, or IV and the predictive value of local TEPs in determining the incidence of OM after RT. The variables, impedance module, resistance, reactance, phase angle, and capacitance, were analyzed by the receiver operator curves (ROC). The case and control groups did not differ in demographic and clinical characteristics. Radiation therapy increased the local impedance module, resistance, reactance, and phase angle and reduced the local tissue capacitance in both groups. Evaluation of TEPs in the first week of RT correlated with the development of OM lesions during cancer therapy. ROC analysis showed that local impedance module and resistance presented higher specificity than did other parameters in predicting OM. In conclusion, local tissue electrical parameters measured at the first RT week can be useful tools to predict oral mucositis.
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17
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Dal Prá KJ, de Assis Tristão SDSS, Franco JB, Matias DT, Carrillo CM, de Melo Peres MPS, Ribas PF. Oral management of pemphigus vulgaris in the intensive care unit. SPECIAL CARE IN DENTISTRY 2020; 40:280-284. [PMID: 32162360 DOI: 10.1111/scd.12454] [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: 01/30/2020] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 01/13/2023]
Abstract
Pemphigus vulgaris (PV) is a rare and potentially lethal autoimmune disease that affects the skin and mucous membranes. Injuries caused by the disease cause pain, risk of infection, and other complications that result in a high mortality rate. Frequently, management of the PV requires intensive care and a multidisciplinary approach. Oral lesions of PV are usually the first clinical signs of the disease and the last lesions to heal, requiring treatment by a specialized dental team. The aim of this study was to report two clinical cases of PV with involvement of the oral mucosa. The patients were admitted to an intensive care unit, and underwent multidisciplinary management of their condition along with low-level laser therapy. Both cases demonstrated the importance of specialized dental care in improving the quality of life of patients with PV.
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Affiliation(s)
- Ketelin Juliane Dal Prá
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Juliana Bertoldi Franco
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Diogo Toledo Matias
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Camila Merida Carrillo
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Priscila Fernandes Ribas
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
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18
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Kryukov AI, Garov EV, Klimentov SM, Sidorina NG, Kucherov AG, Mishchenko VV, Tsarapkin GY, Zemlanckaya AS. [Application of semiconductor LED laser generators in otorhinolaryngology]. Vestn Otorinolaringol 2020; 84:77-82. [PMID: 32027328 DOI: 10.17116/otorino20198406177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The review article provides brief data on the classification of lasers in medicine, the history of the use of therapeutic lasers. The problems of the use of semiconductor lasers in inflammatory diseases of various etiologies, as well as in various diseases of ENT organs, in particular, in diseases of the middle ear are considered.
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Affiliation(s)
- A I Kryukov
- The Sverzhevskiy's Research clinical Institute of Otorhinolaryngology, Moscow, Russia, 117152
| | - E V Garov
- The Sverzhevskiy's Research clinical Institute of Otorhinolaryngology, Moscow, Russia, 117152
| | - S M Klimentov
- National Research Nuclear University, Moscow, Russia, 115409
| | - N G Sidorina
- The Sverzhevskiy's Research clinical Institute of Otorhinolaryngology, Moscow, Russia, 117152
| | - A G Kucherov
- The Sverzhevskiy's Research clinical Institute of Otorhinolaryngology, Moscow, Russia, 117152
| | - V V Mishchenko
- The Sverzhevskiy's Research clinical Institute of Otorhinolaryngology, Moscow, Russia, 117152
| | - G Yu Tsarapkin
- The Sverzhevskiy's Research clinical Institute of Otorhinolaryngology, Moscow, Russia, 117152
| | - A S Zemlanckaya
- The Sverzhevskiy's Research clinical Institute of Otorhinolaryngology, Moscow, Russia, 117152
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19
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Abstract
Mucositis is a common and feared complication of anticancer therapy that can affect up to 90% of certain populations of patients with cancer. Even seemingly uncomplicated mucositis, which is often self-limited, can result in intense patient discomfort and decline in quality of life. Severe mucositis can be complicated by uncontrolled pain, superinfection or systemic infection, bleeding, and dehydration, and severe mucositis can lead to interruptions or de-escalation in anticancer treatment, resulting in worse oncologic outcomes. This article provides an evidence-based summary to guide practicing oncologists in the assessment, prevention, and management of mucositis induced by chemotherapy, radiotherapy, and targeted therapy.
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Affiliation(s)
- Timothy J Brown
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Arjun Gupta
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD
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20
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Zadik Y, Arany PR, Fregnani ER, Bossi P, Antunes HS, Bensadoun RJ, Gueiros LA, Majorana A, Nair RG, Ranna V, Tissing WJE, Vaddi A, Lubart R, Migliorati CA, Lalla RV, Cheng KKF, Elad S. Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer 2019; 27:3969-3983. [DOI: 10.1007/s00520-019-04890-2] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/22/2019] [Indexed: 02/02/2023]
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21
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de Pauli Paglioni M, Alves CGB, Fontes EK, Lopes MA, Ribeiro ACP, Brandão TB, Migliorati CA, Santos-Silva AR. Is photobiomodulation therapy effective in reducing pain caused by toxicities related to head and neck cancer treatment? A systematic review. Support Care Cancer 2019; 27:4043-4054. [DOI: 10.1007/s00520-019-04939-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/11/2019] [Indexed: 01/20/2023]
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22
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Jehn P, Stier R, Tavassol F, Dittmann J, Zimmerer R, Gellrich NC, Krüskemper G, Spalthoff S. Physical and Psychological Impairments Associated with Mucositis after Oral Cancer Treatment and Their Impact on Quality of Life. Oncol Res Treat 2019; 42:342-349. [PMID: 30970370 DOI: 10.1159/000499720] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/19/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Posttherapeutic mucositis is a common secondary effect of oral cancer treatment. Mucositis affects the oral mucosa, which leads to specific physical impairments in oral function and a negative impact on quality of life. OBJECTIVE To evaluate the impairments associated with oral mucositis and their impact on posttherapeutic quality of life. METHODS A retrospective analysis was conducted on 1,652 patients treated for oral cancer during the multicenter rehabilitation study of the German-Austrian-Swiss Cooperative Group on Tumors of the Maxillofacial Region (DÖSAK), which included 43 clinics from Germany, Austria, and Switzerland. The analysis was based on questionnaires filled out by patients following treatment. RESULTS Approximately 10% of 1,652 patients included in our study had physical or psychological impairments due to increased posttreatment oral mucositis; this was mainly due to adjuvant radiotherapy or radiochemotherapy administered. Oral mucositis was significantly associated with specific physical impairments, especially xerostomia and pain (p = 0.000), which required supportive care and analgesia (p = 0.000). Additionally, impaired ingestion and speech significantly led to psychological disorders such as public avoidance behavior and social isolation (p = 0.001). Depressive coping of disease (p = 0.001) and concomitant depressive tendencies (p = 0.004) were highly associated with mucositis, which was accompanied by diminished general condition (p = 0.001), bleak future prospects (p = 0.006), and a reduction in quality of life (p = 0.002). CONCLUSION Minimizing mucositis-related impairments should be a main effort in oral cancer treatment to optimize patient outcome and improve quality of life after therapy.
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Affiliation(s)
- Philipp Jehn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany,
| | - Rebecca Stier
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Frank Tavassol
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Jan Dittmann
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Rüdiger Zimmerer
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Gertrud Krüskemper
- Department of Medical Psychology, Ruhr University of Bochum, Bochum, Germany
| | - Simon Spalthoff
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
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