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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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Jornsamer C, Theerawattanawit C, Wichayachakorn C, Panchaprateep R, Kerr SJ, Asawanonda P, Rerknimitr P. Red light emitting diode as an adjuvant treatment for epidermal growth factor receptor inhibitors-induced paronychia. J DERMATOL TREAT 2021; 33:1990-1994. [PMID: 33961534 DOI: 10.1080/09546634.2021.1927950] [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: 10/21/2022]
Abstract
We evaluated the efficacy and safety of red light LED as an adjuvant treatment for epidermal growth factor receptor inhibitor-induced paronychia. Eight patients were recruited in this randomized, single-blinded controlled trial. They were randomized to receive red-light on one hand or foot 2-3 times/week for 6 weeks while the contralateral side served as controls. The standard treatments were continued. Erythema and lesion elevation observed by Anthera® 3D, severity and pain scores were obtained at weeks 0, 2, 4, 6, and 8. The red light group showed significantly lower erythema, severity, and pain scores at weeks 4, 6, and 8. The elevation was significantly lower in the red light group at every follow-up visit. No adverse events occurred. Red light therapy may be an option as adjunctive treatment for EGFRi-induced paronychia.
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Affiliation(s)
- Chanoknan Jornsamer
- Department of Medicine, Faculty of Medicine, Division of Dermatology, Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Chinathip Theerawattanawit
- Department of Medicine, Faculty of Medicine, Division of Dermatology, Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Chanitwan Wichayachakorn
- Department of Medicine, Division of Dermatology, Nail Clinic, Sclerotherapy Clinic, Dermatologic Surgery Unit, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ratchathorn Panchaprateep
- Department of Medicine, Faculty of Medicine, Division of Dermatology, Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Stephen J Kerr
- Center for Excellence in Biostatistics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pravit Asawanonda
- Department of Medicine, Faculty of Medicine, Division of Dermatology, Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Pawinee Rerknimitr
- Department of Medicine, Faculty of Medicine, Division of Dermatology, Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
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Courtois E, Bouleftour W, Guy JB, Louati S, Bensadoun RJ, Rodriguez-Lafrasse C, Magné N. Mechanisms of PhotoBioModulation (PBM) focused on oral mucositis prevention and treatment: a scoping review. BMC Oral Health 2021; 21:220. [PMID: 33926421 PMCID: PMC8086292 DOI: 10.1186/s12903-021-01574-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 04/19/2021] [Indexed: 01/10/2023] Open
Abstract
Background Oral mucositis (OM) is a severe complication cancer patients undergo when treated with chemoradiotherapy. Photobiomodulation (PBM) therapy also known as low-level laser therapy has been increasingly used for the treatment of such oral toxicity. The aim of this review is to discuss the mechanisms of photobiomodulation (PBM) regarding OM prevention and treatment, and more precisely to focus on the effect of PBM on tumor and healthy cells. Methods MEDLINE/PubMed, and google scholar were searched electronically. Selected studies were focusing on PBM effects on tumor and healthy cells. Results PBM interactions with the tissue and additional mechanism in OM therapy were detailed in this review. Moreover, this review highlighted a controversy about the carcinogenic effect of PBM. Indeed, Many studies reported that PBM could enhance malignant cell proliferation; suggesting that PBM would have no protective effect. In addition to acting on cancer cells, PBM may damage healthy cells. Conclusion More prospective studies are needed to assess the effect of PBM on cancer cells in order to improve its use for OM prevention and treatment.
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Affiliation(s)
| | - Wafa Bouleftour
- Département de Radiothérapie, Institut de Cancérologie de La Loire - Lucien Neuwirth, 42270, St Priest en Jarez, France.
| | - Jean-Baptiste Guy
- Département de Radiothérapie, Institut de Cancérologie de La Loire - Lucien Neuwirth, 42270, St Priest en Jarez, France
| | - Safa Louati
- Département de Radiothérapie, Institut de Cancérologie de La Loire - Lucien Neuwirth, 42270, St Priest en Jarez, France
| | | | - Claire Rodriguez-Lafrasse
- UMR CNRS 5822 /IN2P3, IPNL, PRISME, Laboratoire de Radiobiologie Cellulaire Et Moléculaire, Faculté de Médecine Lyon-Sud, Université Lyon 1, 69921, Oullins Cedex, France
| | - Nicolas Magné
- Département de Radiothérapie, Institut de Cancérologie de La Loire - Lucien Neuwirth, 42270, St Priest en Jarez, France.,UMR CNRS 5822 /IN2P3, IPNL, PRISME, Laboratoire de Radiobiologie Cellulaire Et Moléculaire, Faculté de Médecine Lyon-Sud, Université Lyon 1, 69921, Oullins Cedex, France
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Guimaraes DM, Ota TMN, Da Silva DAC, Almeida FDLDS, Schalch TD, Deana AM, Junior JMA, Fernandes KPS. Low-level laser or LED photobiomodulation on oral mucositis in pediatric patients under high doses of methotrexate: prospective, randomized, controlled trial. Support Care Cancer 2021; 29:6441-6447. [PMID: 33893842 DOI: 10.1007/s00520-021-06206-9] [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: 06/24/2020] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The objective of the present study was to compare the efficacy of photobiomodulation with low-level laser therapy (LLLT) or light-emitting diode therapy (LEDT) devices for the prevention and treatment of oral mucositis in pediatric patients diagnosed with acute lymphoblastic leukemia undergoing chemotherapy with high doses of methotrexate (MTX). METHODS Eighty patients were randomly divided into two groups: LLLT and LEDT. Both protocols were applied with the same energy and radiant exposure. The protocols started in the beginning of high doses MTX and finished when the patients were discharged from the hospital or there was oral mucositis resolution. The oral mucositis was assessed during each session in accordance to the World Health Organization (WHO) score. The patients' self-assessed pain was scored on a visual analog scale (VAS). RESULTS The incidence of oral mucositis was similar to LLLT and LEDT, 10% and 12.5%, respectively. Both groups required the same number of days to reach score of zero for mucositis and pain (p > 0. 05), and there was no significant difference in mean VAS between the groups. CONCLUSIONS These findings suggest that LEDT has similar effects to LLLT to avoid and treat oral mucositis. Brazilian Clinical Trial Registry with #U1111-1221-5943.
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Affiliation(s)
- Douglas Magno Guimaraes
- Pediatric Oncologic Hospital "Octavio Lobo", 1394 Quatorze de Abril side street, Belém, Pará, 66063-005, Brazil. .,Dental School, University Center of Pará, 927 Nove de Janeiro street, Belém, Pará, 66060-575, Brazil. .,Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University- UNINOVE, 249 Vergueiro street, São Paulo, São Paulo, 01504-001, Brazil.
| | - Tamara Melo Nunes Ota
- Dental School, University Center of Pará, 927 Nove de Janeiro street, Belém, Pará, 66060-575, Brazil
| | | | | | - Tatiana Dias Schalch
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University- UNINOVE, 249 Vergueiro street, São Paulo, São Paulo, 01504-001, Brazil
| | - Alessandro Melo Deana
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University- UNINOVE, 249 Vergueiro street, São Paulo, São Paulo, 01504-001, Brazil
| | - Jose Miguel Alves Junior
- Pediatric Oncologic Hospital "Octavio Lobo", 1394 Quatorze de Abril side street, Belém, Pará, 66063-005, Brazil
| | - Kristianne Porta Santos Fernandes
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University- UNINOVE, 249 Vergueiro street, São Paulo, São Paulo, 01504-001, Brazil
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Vieira AR, Prinz MCO. Patient Centeredness in Orthognathic Surgery. Clin Pract 2021; 11:92-100. [PMID: 33562459 PMCID: PMC7930993 DOI: 10.3390/clinpract11010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/20/2021] [Accepted: 02/03/2021] [Indexed: 11/28/2022] Open
Abstract
Patient centeredness in planning treatment and research has become paramount. The goal of this report was to describe a complex case in which untreated chronic pain was not properly addressed to reflect on the need to establish alternative protocols for controlling chronic orofacial pain. When a female underwent orthognathic surgery to correct her occlusion, she not only ended up with a worse occlusion, she developed chronic orofacial pain that could not be treated by opioids and only improved after the use of neuropathic medication, and finally disappeared after the use of low-level laser therapy. There is a need to incorporate alternative nonpharmacological approaches to manage chronic pain. Further, what the patient’s goals are for their treatments should be given priority in case of elective procedures.
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Campos L, Cotomacio CC, Arana-Chavez VE, Simões A. Phototherapy With LED as an Effective Treatment for Chemotherapy-Induced Oral Mucositis in Hamsters. J Lasers Med Sci 2021; 11:475-480. [PMID: 33425300 DOI: 10.34172/jlms.2020.74] [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: 11/09/2022]
Abstract
Introduction: Oral mucositis (OM) has been considered one of the most feared collateral effects of oncological treatments. Some therapies have been used, such as light-emitting diode (LED), with promising results, but with no sufficient evidence in the literature. Objective: Our study aimed to evaluate, by clinical and histological analysis, the effect of LED on the treatment of chemotherapy-induced OM (CIOM) in an animal model. Methods: Twenty male hamsters were equally distributed to two groups: control (C), which received anesthesia and CIOM induction; and LED (L), which received anesthesia, CIOM induction, and LED treatment (635 nm, 120 mW, 0.48 J). The clinical analysis was performed through two specific scales for OM analysis on days 5, 7 and 10 of the experiment. In addition, the injured area of all hamsters check pouch mucosa was removed and processed for histological analysis on the last experimental day. Results: After statistical analysis, group L showed less severity of OM when compared with the C group (P <0.05); beyond that, both healed completely on day 10. Conclusion: Our results suggested that the phototherapy with LED had a positive effect on accelerating repair, reducing the severity of CIOM.
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Affiliation(s)
- Luana Campos
- Department of post-graduation, School of Dentistry, University of Santo Amaro, São Paulo 04829-300, Brazil.,Department of Oral Medicine, Brazilian Institute of Cancer Control, São Paulo 03102-002, Brazil
| | - Claudia Carrara Cotomacio
- Laboratory of Oral Biology, Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo 05508-000, Brazil
| | - Victor Elias 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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Conditioned media from blue light-emitting diode-exposed fibroblasts have an anti-inflammatory effect in vitro. Lasers Med Sci 2020; 36:99-109. [PMID: 32363436 DOI: 10.1007/s10103-020-03018-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/06/2020] [Indexed: 12/13/2022]
Abstract
We have previously reported the protective effects of blue light-emitting diode (BLED)-stimulated cell metabolites on cell injury. To further examine the effect of conditioned media (CM) derived from BLED (5 J/cm2)-exposed human normal fibroblasts (CMBL5) for clinical application, we have used the choline chloride and phenol red-free media and then concentrated CMBL5 using a centrifugal filter unit. The collected CMBL5-lower part (CMBL5-LO) has evaluated the inflammatory protein expression profile in LPS-stimulated RAW264.7 cells. Comprehensive metabolomic profiling of CMBL5-LO was carried out using hybrid tandem mass spectrometry. Treatment with CMBL5-LO showed the cytoprotective effect on apoptotic cell death, but rather increased apoptotic cells after treatment with CMBL5-upper part (CMBL5-UP). In addition, CMBL5-LO inhibited several chemo-attractants, including interleukin (IL)-6, macrophage inflammatory protein (MIP)-2, chemokine (C-C motif) ligand 5 (CCL5), granulocyte colony-stimulating factor (GCSF), and monocyte chemoattractant protein-1 (MCP-1) expression. Pro-inflammatory nitric oxide was decreased after CMBL5-LO treatment, but not by CMBL5-UP treatment. Interestingly, treatment with CMBL5-LO stimulated expression of heme oxygenase-1, indicating its anti-inflammatory property. Most endoplasmic reticulum (ER) stress proteins except for transcription factor C/EBP homologous protein (CHOP) were highly expressed after irradiation with BLED in cells. Further studies are needed to examine the precise mechanism by CMBL5-LO in cells.
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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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Oh PS, Jeong HJ. Therapeutic application of light emitting diode: Photo-oncomic approach. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 192:1-7. [DOI: 10.1016/j.jphotobiol.2019.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/28/2018] [Accepted: 01/08/2019] [Indexed: 01/07/2023]
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Anschau F, Webster J, Capra MEZ, de Azeredo da Silva ALF, Stein AT. Efficacy of low-level laser for treatment of cancer oral mucositis: a systematic review and meta-analysis. Lasers Med Sci 2019; 34:1053-1062. [DOI: 10.1007/s10103-019-02722-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 01/14/2019] [Indexed: 12/22/2022]
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Tenis CA, Martins MD, Gonçalves MLL, da Silva DDFT, da Cunha Filho JJ, Martins MAT, Mesquita-Ferrari RA, Bussadori SK, Fernandes KPS. Efficacy of diode-emitting diode (LED) photobiomodulation in pain management, facial edema, trismus, and quality of life after extraction of retained lower third molars: A randomized, double-blind, placebo-controlled clinical trial. Medicine (Baltimore) 2018; 97:e12264. [PMID: 30212961 PMCID: PMC6156019 DOI: 10.1097/md.0000000000012264] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In dentistry, one of the most common surgical procedures is the removal of retained third molars. This surgery generates great morbidity to the participants for causing pain, edema, and trismus due to surgical trauma. The objective of the present study is to evaluate the efficacy of photobiomodulation with light emitting diode (LED) in the control of pain, facial edema, trismus, and quality of life resulting from the extraction of retained lower third molars. METHODS A randomized, double-blind, placebo-controlled clinical trial involving 38 adult participants, who meet the criteria of eligibility and agree to participate in the study. Before the surgeries are performed, the facial and mouth opening measures of all the participants will be taken. Immediately after the surgeries, participants will be randomized into 2 groups. In the LED group, participants will receive LED applications (intra oral with 660 nm, 12J and extraoral with 850 nm, 108J) in the immediate postoperative, first and second days after the surgical procedure. In the control group, the participants will be attended in the same way as in the LED group, however, the person in charge of the application will simulate the irradiation. Pain (EVA and NRS-101), postoperative edema, trismus, temperature, dysphagia, and hematoma will be evaluated after 1, 2, 5, and 7 days. The oral health impact profile (OHIP-14 Questionnaire) and anxiety analysis (Beck anxiety inventory -BAI) questionnaires will be applied preoperatively and 7 days after treatment. The appropriate statistical tests will be applied for each specific analysis in a significance level of 5%. DISCUSSION Although the use of low-power laser in the postoperative has shown good results in the control of postoperative sequelae, this is the first study on the efficacy of the use of LED in this situation.
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Affiliation(s)
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul, Universidade Estadual de Campinas, Paulo Gama Avenue, Farroupilha , Porto Alegre, RS
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Banava S, Houshyari M, Safaie T. The effect of casein phosphopeptide amorphous calcium phosphate fluoride paste (CPP-ACPF) on oral and salivary conditions of patients undergoing chemotherapy: A randomized controlled clinical trial. Electron Physician 2015; 7:1535-41. [PMID: 26767110 PMCID: PMC4700902 DOI: 10.19082/1535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/14/2015] [Indexed: 11/20/2022] Open
Abstract
Background Oral and saliva conditions of patients undergoing chemotherapy is often affected by the medication they receive. Up to now, no appropriate medication that possesses the positive effects of chemotherapy without presenting oral complications has been introduced. Objective The aim of this study was to assess the clinical effects of CPP-ACPF paste on the oral and salivary status of patients undergoing chemotherapy. Methods From October 2013 to April 2014, 20 patients in chemotherapy treatment plans and who met the inclusion criteria enrolled in this randomized parallel single-blind controlled clinical trial in Shohada-e-Tajrish Hospital in Tehran, Iran. Patients were divided into two groups: 1) patients received their daily medication of cancer therapy center (group 1, control); 2) patients applied CPP-ACPF Crème (MI paste plus, GC USA) twice a day as instructed (group 2). The baseline status of oral conditions of patients (mucositis, dry mouth, infection, diminished tasting sense, difficulty in food intake, burning sensation of mucosa, saliva and dental plaque pH, rest and stimulated saliva, buffering capacity of saliva) were recorded and reevaluated after 21 and 42 days. The data were analyzed with a Mann-Whitney U-test. Results A total of 20 patients were allocated randomly to groups 1 and 2. The Mann-Whitney U-test showed that application of CPP-ACPF paste twice daily did not cause any significant difference in oral complication of the subject group compared with the control group (p>0.05). Among salivary signs, resting and stimulated saliva rates and saliva buffering capacity had significantly altered in the CPP-ACPF group in day 21 and 42 in comparison with those of the control group (p<0.05). Conclusion Application of CPP-ACPF paste before and during chemotherapy can improve the salivary status of patients undergoing this treatment.
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Affiliation(s)
- Sepideh Banava
- DDS, M.Sc. in Restorative Dentistry and Dental Materials, Assistant Professor, Islamic Azad University, Dental Branch, Tehran, Iran
| | - Mohammad Houshyari
- Assistant Professor, Shohada-e-Tajrish Hospital, Department of Radiation Oncology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zigmond E, Varol C, Kaplan M, Shapira O, Melzer E. Low-Level Light Therapy Induces Mucosal Healing in a Murine Model of Dextran-Sodium-Sulfate Induced Colitis. Photomed Laser Surg 2014; 32:450-7. [DOI: 10.1089/pho.2013.3626] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Ehud Zigmond
- Research Center for Digestive Tract and Liver Diseases, Sourasky Medical Center & the Sackler Faculty of Medicine, Tel-Aviv, Israel
| | - Chen Varol
- Research Center for Digestive Tract and Liver Diseases, Sourasky Medical Center & the Sackler Faculty of Medicine, Tel-Aviv, Israel
| | - Michail Kaplan
- Research Center for Digestive Tract and Liver Diseases, Sourasky Medical Center & the Sackler Faculty of Medicine, Tel-Aviv, Israel
| | - Oz Shapira
- Department of Cardiothoracic Surgery, Hebrew University, Hadassah Medical Center, Jerusalem, Israel
| | - Ehud Melzer
- Gastroenterology and Hepatology, Kaplan Medical Center, Rehovot & Hebrew University Jerusalem, Israel
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Freitas ACC, Campos L, Brandão TB, Cristófaro M, Eduardo FDP, Luiz AC, Marques MM, Eduardo CDP, Simões A. Chemotherapy-induced oral mucositis: effect of LED and laser phototherapy treatment protocols. Photomed Laser Surg 2014; 32:81-7. [PMID: 24476495 DOI: 10.1089/pho.2013.3576] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Over the last few decades, many studies have focused on the effect of lasers on the management of oral mucositis in oncologic patients treated with chemotherapy and/or radiotherapy. However, the effect of light-emitting diode (LED) has been poorly studied, and was not compared with that of laser phototherapy (LPT). For this reason, the aim of the present study was to clinically compare the effect of these two therapies on chemotherapy-induced oral mucositis (CIOM) and pain. METHODS Forty patients with CIOM were divided into two groups: G1, patients treated with LPT; G2, patients treated with LED. The treatment was administered during 10 consecutive days, with exception of weekends. LPT was applied using an InGaAlP laser (660 nm/40 mW/6.6 J cm-(2)/0.24 J per point/0.036 cm(2) of spot size). LED phototherapy was applied using 0.24 J per point/80 mW/630 nm/1 cm(2) of spot size. CIOM was assessed during each session in accordance to the World Health Organization (WHO) score. The patient self-assessed pain was scored on a visual analog scale (VAS). RESULTS The mean VAS and WHO scores were significantly smaller in the LED group (p<0.05). However, both groups required the same number of days to reach score zero for mucositis and pain (p>0.05). Moreover, in the group with severe mucositis (score III), there was a lower frequency of patients with complete healing and pain relief, with the exception of analgesia in G2, in which almost all patients were completely relieved from pain. CONCLUSIONS These findings suggest that LED therapy is more effective than LPT in the treatment of COIM, with the parameters used in the present study.
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Affiliation(s)
- Ana Carolina Carneiro Freitas
- 1 Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia - Universidade de São Paulo , São Paulo, SP, Brazil
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Rímulo AL, Ferreira MC, Abreu MH, Aguirre-Neto JC, Paiva SM. Chemotherapy-induced oral mucositis in a patient with acute lymphoblastic leukaemia. Eur Arch Paediatr Dent 2012; 12:124-7. [DOI: 10.1007/bf03262792] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Migliorati C, Hewson I, Lalla RV, Antunes HS, Estilo CL, Hodgson B, Lopes NNF, Schubert MM, Bowen J, Elad S. Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Support Care Cancer 2012; 21:333-41. [PMID: 23001179 DOI: 10.1007/s00520-012-1605-6] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 09/10/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND The aim of this study was to review the available literature and define clinical practice guidelines for the use of laser and other light therapies for the prevention and treatment of oral mucositis. METHODS A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, and no guideline possible. RESULTS A new recommendation was made for low-level laser (wavelength at 650 nm, power of 40 mW, and each square centimeter treated with the required time to a tissue energy dose of 2 J/cm(2) (2 s/point)) for the prevention of oral mucositis in adult patients receiving hematopoietic stem cell transplantation conditioned with high-dose chemotherapy, with or without total body irradiation. A new suggestion was made for low-level laser (wavelength around 632.8 nm) for the prevention of oral mucositis in patients undergoing radiotherapy, without concomitant chemotherapy, for head and neck cancer. No guideline was possible in other populations and for other light sources due to insufficient evidence. CONCLUSIONS The increasing evidence in favor of low-level laser therapy allowed for the development of two new guidelines supporting this modality in the populations listed above. Evidence for other populations was also generally encouraging over a range of wavelengths and intensities. However, additional well-designed research is needed to evaluate the efficacy of laser and other light therapies in various cancer treatment settings.
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Affiliation(s)
- Cesar Migliorati
- Department of Diagnostic Sciences and Oral Medicine, College of Dentistry, University of Tennessee Health Sciences Center, 875 Union Avenue, suite N231, Memphis, TN 38163, USA.
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Holder MJ, Milward MR, Palin WM, Hadis MA, Cooper PR. Effects of red light-emitting diode irradiation on dental pulp cells. J Dent Res 2012; 91:961-6. [PMID: 22879579 DOI: 10.1177/0022034512456040] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Light irradiation activates a range of cellular processes in a variety of cell types, including stem cells, and can promote tissue repair. This study investigated the effects of light-emitting diode (LED) exposure on dental pulp cells (DPCs). Dose response analysis at 20-second intervals up to 120 seconds demonstrated that a LED array emitting 653-nm red light stimulated significantly increased cell growth at 3 and 7 days post-irradiation with 40 (149 mJ/cm(2)) and 60 (224 mJ/cm(2)) seconds of radiant exposure. Double-dosing cells at days 1 and 4 of a 7-day culture period with 60-second (224 mJ/cm(2)) LED exposure significantly increased cell growth compared with a single dosing regime. BrdU analysis demonstrated significantly increased proliferation rates associated with significantly increased ATP, nitric oxide (NO), and mitochondrial metabolic activity. LED-stimulated NO levels were not reduced by inhibition of NO-synthase activity. Light exposure also rescued the inhibition of mitochondrial dysfunction and increased levels of in vitro mineralization compared with control. Media exchange experiments indicated that autocrine signaling was not likely responsible for red-light-induced DPC activity. In conclusion, data analysis indicated that 653-nm LED irradiation promoted DPC responses relevant to tissue repair, and this is likely mediated by increased mitochondrial activity.
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Affiliation(s)
- M J Holder
- Oral Biology, School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Effect of laser and LED phototherapies on the healing of cutaneous wound on healthy and iron-deficient Wistar rats and their impact on fibroblastic activity during wound healing. Lasers Med Sci 2012; 28:799-806. [DOI: 10.1007/s10103-012-1161-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 07/06/2012] [Indexed: 12/25/2022]
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Lim W, Kim J, Lim C, Kim S, Jeon S, Karna S, Cho M, Choi H, Kim O. Effect of 635 nm light-emitting diode irradiation on intracellular superoxide anion scavenging independent of the cellular enzymatic antioxidant system. Photomed Laser Surg 2012; 30:451-9. [PMID: 22775489 DOI: 10.1089/pho.2011.3199] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE The aim of this study was to examine the reactive oxygen species (ROS) that are dissipated by 635 nm irradiation, and the effect of 635 nm irradiation on ROS scavenging system. BACKGROUND DATA Intracellular ROS are produced in the form of superoxide anion by either nicotinamide adenine dinucleotide phosphate (NADPH) oxidase or xanthine oxidase in response to a number of stimuli. Low-level light irradiation decreases the intracellular ROS level and has been used in clinical situations for reducing the level of oxidative stress. METHODS Human epithelial cells were exposed to exogenous and endogenous oxidizing agents that promote the generation of harmful ROS. These were then irradiated with 635 nm LED light, 5 mW/cm(2) for 1 h, 18 J/cm(2) or by 470 nm LED light, also 5 mW/cm(2) for 1 h, 18 J/cm(2) on a 9 cm cell culture dish. After irradiation, the MTT reduction method and malondialdehyde (MDA) colorimetric assay were performed in xanthine/xanthine oxidase (XXO)- or hydrogen peroxide (H(2)O(2))-treated HaCaT cells. The superoxide anion was detected by an electron spin resonance (ESR) spectrometer using 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) as the spin trap and H(2)O(2) was assayed by flow cytometry using 2',7'-dichlorodihydrofluorescein diacetate (H(2)DCF-DA). RESULTS Irradiation at 635 nm enhanced cell viability in the XXO-treated HaCaT cells. Also, irradiation had a much lesser effect on cell viability in the HaCaT cells treated with exogenous H(2)O(2) as compared with that in cells treated with N-acetyl-L-cysteine. The level of the superoxide anion increased in response to XXO treatment, and then decreased after 635 nm irradiation. Irradiation with 635 nm led to a decrease in superoxide anion and lipid peroxidation levels in the presence or absence of diethyldithiocarbamate. CONCLUSIONS These results highlight the potential role of 635 nm irradiation in protection against oxidative stress by scavenging superoxide anions. Also, a pathway that is independent of the activities of intracellular enzymatic ROS scavengers, such as superoxide dismutase, glutathione peroxidase and catalase might be involved in its mechanism of action.
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Affiliation(s)
- WonBong Lim
- Department of Oral Pathology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Bug-Gu, Gwangju, Korea
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Hodgson BD, Margolis DM, Salzman DE, Eastwood D, Tarima S, Williams LD, Sande JE, Vaughan WP, Whelan HT. Amelioration of oral mucositis pain by NASA near-infrared light-emitting diodes in bone marrow transplant patients. Support Care Cancer 2011; 20:1405-15. [PMID: 21725826 DOI: 10.1007/s00520-011-1223-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 06/16/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE This study seeks to investigate the use of extra-orally applied near-infrared phototherapy for the reduction of oral pain secondary to chemotherapy- and radiation therapy-induced mucositis in adult and pediatric hematopoietic stem cell transplant (HSCT) patients. METHODS Eighty HSCT patients were divided into regular (R) and low (L) risk groups, then to experimental (E) and placebo (P) groups, resulting in four groups (ER, EL, PR, PL). Experimental subjects received 670 (± 10) nm gallium-aluminum-arsinide light-emitting diode device for 80 s at ~50 mW/cm(2) energy density and power exposure of 4 J/cm(2). Placebo patients received the same procedures, but with a placebo phototherapy (identical device but <5 mW/cm(2) energy density). Patients received their respective light therapy once per day starting on the day of the HSCT (day 0) and continued through day +14. Blinded evaluators examined the patients three times per week and scored their oral tissues and patient-reported pain assessments at each evaluation utilizing the WHO, NCI-CTCAE, and OMAS scales. RESULTS Analysis of the mean scores at each observation demonstrate that the extra-oral application of phototherapy resulted in a significant reduction in patient-reported pain between the ER and PR patients (p < 0.05) at day +14 when graded via the WHO criteria. The ER and EL patients were improved in almost all other categories and assessment scales, but the differences were not statistically significant. CONCLUSION Phototherapy demonstrated a significant reduction in patient-reported pain as measured by the WHO criteria in this patient population included in this study. Improvement trends were noted in most other assessment measurements.
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Affiliation(s)
- Brian D Hodgson
- Pediatric Dentistry, Marquette University School of Dentistry, 1801 W Wisconsin Ave, Rm 326, Milwaukee, WI 53233, USA.
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Volpato LER, de Oliveira RC, Espinosa MM, Bagnato VS, Machado MAAM. Viability of fibroblasts cultured under nutritional stress irradiated with red laser, infrared laser, and red light-emitting diode. JOURNAL OF BIOMEDICAL OPTICS 2011; 16:075004. [PMID: 21806261 DOI: 10.1117/1.3602850] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Phototherapy is noninvasive, painless and has no known side effect. However, for its incorporation into clinical practice, more well-designed studies are necessary to define optimal parameters for its application. The viability of fibroblasts cultured under nutritional stress irradiated with either a red laser, an infrared laser, or a red light-emitting diode (LED) was analyzed. Irradiation parameters were: red laser (660 nm, 40 mW, 1 W/cm(2)), infrared laser (780 nm, 40 mW, 1 W/cm(2)), and red LED (637 ± 15 nm, 40 mW, 1 W/cm(2)). All applications were punctual and performed with a spot with 0.4 mm(2) of diameter for 4 or 8 s. The Kruskal-Wallis test and analysis of variance of the general linear model (p ≤ 0.05) were used for statistical analysis. After 72 h, phototherapy with low-intensity laser and LED showed no toxicity at the cellular level. It even stimulated methylthiazol tetrazolium assay (MTT) conversion and neutral red uptake of fibroblasts cultured under nutritional stress, especially in the group irradiated with infrared laser (p = 0.004 for MTT conversion and p < 0.001 for neutral red uptake). Considering the parameters and protocol of phototherapy used, it can be concluded that phototherapy stimulated the viability of fibroblasts cultured under nutritional deficit resembling those found in traumatized tissue in which cell viability is reduced.
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Affiliation(s)
- Luiz Evaristo Ricci Volpato
- University of Cuiabá, Cuiabá School of Dentistry, Rua Estevão de Mendonça, 317 apto 501, Goiabeiras, Cuiabá, MT, 78065-480 Brazil.
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de Sousa APC, de Aguiar Valença Neto ADAP, Marchionni AMT, de Araújo Ramos M, dos Reis Júnior JA, Pereira MCMC, Cangussú MCT, de Almeida Reis SR, Pinheiro ALB. Effect of LED phototherapy (λ700 ± 20 nm) on TGF-β expression during wound healing: an immunohistochemical study in a rodent model. Photomed Laser Surg 2011; 29:605-11. [PMID: 21595552 DOI: 10.1089/pho.2010.2833] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of the present investigation was to evaluate transforming growth factor β (TGF-β) expression on cutaneous wounds in rodents treated or not treated with LED light. BACKGROUND TGF-β is a multifunctional cytokine that presents a central action during tissue repair. Although several studies both in vitro and in vivo have shown that LED phototherapy influences tissue repair, a full understanding of the mechanisms involved in its usage, such as in the modulation of some growth factors, remains unclear. MATERIALS AND METHODS Under general anesthesia, 24 young adult male Wistar rats weighing 200-250 g had one excisional wound created on the dorsum of each, and were randomly distributed into two groups: G0 (Control) and G1 (LED, λ700 ± 20 nm, 16 mW, SAEF = 5 J/cm(2), Illuminated Area = 2 cm(2), 8 mWcm(2), 626 s) Each group was subdivided into three subgroups according to the animal death timing (2, 4, and 6 days). LED phototherapy started immediately after surgery and was repeated every other day during the experimental time. Following animal death, specimens were removed, routinely processed to wax, cut and immunomarked with polyclonal anti-TGF-β, and underwent histological analysis by light microscopy. The mean area of expression of each group was calculated. The data were statistically analyzed using ANOVA and Tukey's test. RESULTS The area of the expression of TGF-β on LED-irradiated animals was significantly smaller than on controls at day 2 (p = 0.013). No significant difference was found at later times. It is concluded that the use of LED light, at these specific parameters, caused an inhibition of the expression of TGF-β at an early stage of the healing process.
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Correlation between light transmission and permeability of human dentin. Lasers Med Sci 2011; 27:191-6. [DOI: 10.1007/s10103-011-0931-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Accepted: 04/18/2011] [Indexed: 10/18/2022]
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A randomized controlled trial of visible-light therapy for the prevention of oral mucositis. Oral Oncol 2011; 47:125-30. [DOI: 10.1016/j.oraloncology.2010.11.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 11/16/2010] [Accepted: 11/22/2010] [Indexed: 01/01/2023]
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ELECTROPHYSICAL AGENTS - Contraindications And Precautions: An Evidence-Based Approach To Clinical Decision Making In Physical Therapy. Physiother Can 2011; 62:1-80. [PMID: 21886384 PMCID: PMC3031347 DOI: 10.3138/ptc.62.5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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de Sousa APC, Santos JN, Dos Reis JA, Ramos TA, de Souza J, Cangussú MCT, Pinheiro ALB. Effect of LED phototherapy of three distinct wavelengths on fibroblasts on wound healing: a histological study in a rodent model. Photomed Laser Surg 2010; 28:547-52. [PMID: 20001321 DOI: 10.1089/pho.2009.2605] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM The aim of the present investigation was to evaluate histologically fibroblastic proliferation on dorsal cutaneous wounds in a rodent model treated or not with light-emitting diodes (LEDs) of three wavelengths. BACKGROUND Fibroblasts secrete substances essential for wound healing. There are few reports of LED phototherapy on fibroblast proliferation, mainly in vivo. ANIMALS AND METHODS Following approval by the Animal Experimentation Committee of the School of Dentistry of the Federal University of Bahia, we obtained 16 young adult male Wistar rats weighing between 200 and 250 g. Under general anesthesia, one excisional wound was created on the dorsum of each animal; they were then randomly distributed into four groups of four animals each: G0, untreated control; G1, red LED (700 +/- 20 nm, 15 mW, 10 J/cm(2)); G2, green LED (530 +/- 20 nm, 8 mW, 10 J/cm(2)); and G3, blue LED (460 +/- 20 nm, 22 mW, 10 J/cm(2)). The irradiation started immediately after surgery and was repeated every other day for 7 days. Animals were killed 8 days after surgery. The specimens were removed, routinely processed to wax, cut, and stained with hematoxylin/eosin (HE). Fibroblasts were scored by measuring the percentage of these cells occupying the area corresponding to wound healing on stained sections. RESULTS The quantitative results showed that red LED (700 +/- 20 nm) and green LED (530 +/- 20 nm) showed a significant increase in fibroblast numbers (p < 0.01 and p = 0.02) when compared with the control group. CONCLUSION The use of green and red LED light is effective in increasing fibroblastic proliferation on rodents.
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Khouri VY, Stracieri ABPL, Rodrigues MC, Moraes DAD, Pieroni F, Simões BP, Voltarelli JC. Use of therapeutic laser for prevention and treatment of oral mucositis. Braz Dent J 2009; 20:215-20. [PMID: 19784467 DOI: 10.1590/s0103-64402009000300008] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Oral mucositis (OM) affects patients who are submitted to hematopoietic stem cell transplantation (HSCT) due to high doses of chemotherapy and/or radiotherapy. The purpose of this investigation was to perform a comparative study of the frequency and evolution of OM among patients subjected to therapeutic laser and to the conventional therapy (use of mouthwash called 'Mucositis Formula'). The patients were subjected to a myeloablative conditioning regimen before the allogeneic HSCT. Twenty-two patients were selected and divided into 2 groups: group I was irradiated with InGaAlP laser (660 nm) and GaAlAs laser (780 nm), 25 mW potency, 6.3J/cm(2) dose, in 10-s irradiation time, followed to conventional treatment; group II was subjected only to the conventional treatment. Both World Health Organization (WHO) scale and the Oral Mucositis Assessment Scale (OMAS) were used to evaluate the results. Data were analyzed by the non-parametric Wilcoxon test, with p<0.05 considered as statistically significant. Group I presented a lower frequency of OM (p=0.02) and lower mean scores, according to WHO and OMAS scales (p<0.01 and p=0.01, respectively). In conclusion, laser reduced the frequency and severity of OM, suggesting that therapeutic laser can be used both as a new form of prevention and treatment of OM.
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Lang-Bicudo L, Eduardo FDP, Eduardo CDP, Zezell DM. LED phototherapy to prevent mucositis: a case report. Photomed Laser Surg 2009; 26:609-13. [PMID: 19025412 DOI: 10.1089/pho.2007.2228] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this case report was to evaluate the efficacy of phototherapy using light-emitting diodes (LEDs) to prevent oral mucositis in a Hodgkin's disease patient treated with the ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine) chemotherapy regimen. BACKGROUND DATA Mucositis is a common dose-limiting complication of cancer treatment, and if severe it can lead to alterations in treatment planning or suspension of cancer therapy, with serious consequences for tumor response and survival. Therefore, low-power lasers and more recently LEDs, have been used for oral mucositis prevention and management, with good results. MATERIALS AND METHODS In this study, a 34-year-old man received intraoral irradiation with an infrared LED array (880 nm, 3.6 J/cm2, 74 mW) for five consecutive days, starting on chemotherapy day 1. In each chemotherapy cycle, he received the ABVD protocol on days 1 and 15, and received LED treatment for 5 d during each cycle. To analyze the results, the World Health Organization (WHO) scale was used to grade his mucositis, and a visual analogue scale (VAS) was used for pain evaluation, on days 1, 3, 7, 10, and 13 post-chemotherapy. RESULTS The results showed that the patient did not develop oral mucositis during the five chemotherapy cycles, and he had no pain symptoms. CONCLUSION LED therapy was a safe and effective method for preventing oral mucositis in this case report. However, further randomized studies with more patients are needed to prove the efficacy of this method.
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Affiliation(s)
- Leticia Lang-Bicudo
- Mestre Profissional em Lasers em Odontologia IPEN/USP, Universidade de São Paulo, São Paulo, Brazil.
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Eduardo FDP, Bezinelli L, Luiz AC, Correa L, Vogel C, Eduardo CDP. Severity of Oral Mucositis in Patients Undergoing Hematopoietic Cell Transplantation and an Oral Laser Phototherapy Protocol: A Survey of 30 Patients. Photomed Laser Surg 2009; 27:137-44. [DOI: 10.1089/pho.2007.2225] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Leticia Bezinelli
- Hospital Israelita Albert Einstein, Unit of Bone Marrow Transplantation, Sao Paulo, Brazil
| | - Ana Claudia Luiz
- Hospital Israelita Albert Einstein, Unit of Bone Marrow Transplantation, Sao Paulo, Brazil
| | - Luciana Correa
- Department of General Pathology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Cristina Vogel
- Hospital Israelita Albert Einstein, Unit of Bone Marrow Transplantation, Sao Paulo, Brazil
| | - Carlos de Paula Eduardo
- Department of Restorative Dentistry (LELO—Special Laboratory of Lasers in Dentistry), School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
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Sacono NT, Costa CA, Bagnato VS, Abreu-e-Lima FC. Light-emitting diode therapy in chemotherapy-induced mucositis. Lasers Surg Med 2008; 40:625-33. [DOI: 10.1002/lsm.20677] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Eduardo FDP, Bezinelli L, Luiz AC, Correa L, Vogel C, Eduardo CDP. Severity of oral mucositis in patients undergoing hematopoietic cell transplantation and an oral laser phototherapy protocol: a survey of 30 patients. Photomed Laser Surg 2008. [PMID: 18699729 DOI: 10.1089/pho.2008.2225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND DATA AND OBJECTIVE Oral mucositis (OM) is one of the worst cytotoxic effects of chemotherapy and radiotherapy in patients undergoing hematopoietic cell transplantation (HCT), and it causes severe morbidity. Laser phototherapy has been considered as an alternative therapy for prevention and treatment of OM. The aim of this study was to describe the incidence and severity of OM in HCT patients subjected to laser phototherapy, and to discuss its effect on the oral mucosa. PATIENTS AND METHODS Information concerning patient age and gender, type of basic disease, conditioning regimen, type of transplant, absence or presence of pain related to the oral cavity, OM grade, and adverse reactions or unusual events were collected from 30 patients undergoing HCT (allogeneic or autologous). These patients were given oral laser phototherapy with a InGaAIP laser (660 nm and 40 mW) daily. The data were tabulated and their frequency expressed as percentages. RESULTS In the analysis of those with OM, it was observed that 33.4% exhibited grade I, 40% grade II, 23.3% grade III, and 3.3% grade IV disease. On the most critical post-HCT days (D+5 and D+8), it was observed that 63.3% of patients had grade I and 33.3% had grade II disease; no patients had grade III or IV disease in this period. This severity of OM was similar to that seen in other studies of laser phototherapy and OM. CONCLUSION The low grades of OM observed in this survey show the beneficial effects of laser phototherapy, but randomized clinical trials are necessary to confirm these findings.
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Low-Level Laser Therapy in the Prevention and Treatment of Chemotherapy-Induced Oral Mucositis in Young Patients. Photomed Laser Surg 2008; 26:393-400. [DOI: 10.1089/pho.2007.2144] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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