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Photobiomodulation effects on head and neck squamous cell carcinoma (HNSCC) in an orthotopic animal model. Support Care Cancer 2019; 28:2721-2727. [PMID: 31705378 DOI: 10.1007/s00520-019-05060-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/28/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Photobiomodulation (PBM) has shown efficacy in preventing and treating cancer therapy-induced mucositis and dermatitis. However, there is contradictory information regarding the effect of PBM on (pre)malignant cells, which has led to questions regarding the safety of this technique. We address this issue using an orthotopic mouse model (Cal-33) with human squamous cell carcinoma of the oral cavity. METHODS Mice with actively growing orthotopic Cal-33 head and neck carcinoma tumors were divided into 4 groups: control, PBM only, radiation therapy (RT) only, and PBM + RT. We performed three experiments: (1) PBM at 660 nm, 18.4 J/cm2, and 5 RT × 4 Gy doses delivered daily; (2) PBM at 660 nm, 18.4 J/cm2, and 1 × 15 Gy RT; and (3) PBM at 660 nm + 850 nm, 45 mW/cm2, 3.4 J/cm2, and 1 × 15 Gy RT. Mice were weighed daily and tumor volumes were evaluated by IVIS. Survival time was also evaluated. RESULTS Animals treated with RT survived significantly longer and had significantly smaller tumor volume when compared with the control and PBM-only treatment groups. No significant differences were noted between the RT alone and PBM + RT groups in any of the experiments. CONCLUSION Our results suggest that PBM at the utilized parameters does not provide protection to the tumor from the killing effects of RT.
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Stuani VT, Santos PSS, Damante CA, Zangrando MSR, Greghi SLA, Rezende MLR, Sant'Ana ACP. Oral health impact profile of head and neck cancer patients after or before oncologic treatment: an observational analytic case-control study. Support Care Cancer 2018; 26:2185-2189. [PMID: 29383509 DOI: 10.1007/s00520-018-4066-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/22/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE The objective of this study was to investigate the impact of oral health on the quality of life of patients with head and neck cancer (HNC) before and after oncologic treatment. METHODS Forty cancer-free individuals (Cf group) and 40 HNC patients (Hnc group) were included in this study. Hnc group was also divided into two subgroups: Hnc 1 (pre-cancer therapy, n = 20) and Hnc 2 (post-cancer therapy, n = 20). Participants were asked to complete a short form of Oral Health Impact Profile (OHIP-14). The results were statistically analyzed with the multivariate analysis of variance with post-hoc Scheffé multiple comparison. RESULTS It was observed a moderate impact on the quality of life on HNC patients, with values on Hnc 2 group significantly higher in the functional limitation when compared to the Hnc 1 group (p < 0.05). When compared to the Cf group, the values found on Hnc group were higher on functional limitation (p < 0.01) and at the total score (p < 0.05), whereas Hnc 2 group had significant superior values on functional limitation (p < 0.01), physical pain (p < 0.05), and total score (p < 0.01) CONCLUSION: These results show that there is an oral impairment that depreciates the quality of life of patients with an experience of HNC, principally after treatment, indicating the importance of the inclusion of professionals responsible for dental and oral care with the oncologic team to monitor the oral condition of these patients.
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Affiliation(s)
- Vitor T Stuani
- Department of Prosthodontics and Periodontology/Discipline of Periodontology, Bauru School of Dentistry - University of Sao Paulo, Al. Octavio Pinheiro Brisolla 9-75, Bauru, 17012-901, Brazil.
| | - Paulo Sérgio S Santos
- Department of Surgery, Stomatology, Pathology and Radiology/Discipline of Stomatology, Bauru School of Dentistry - University of São Paulo, Al. Octavio Pinheiro Brisolla 9-75, Bauru, 17012-901, Brazil
| | - Carla A Damante
- Department of Prosthodontics and Periodontology/Discipline of Periodontology, Bauru School of Dentistry - University of Sao Paulo, Al. Octavio Pinheiro Brisolla 9-75, Bauru, 17012-901, Brazil
| | - Mariana S R Zangrando
- Department of Prosthodontics and Periodontology/Discipline of Periodontology, Bauru School of Dentistry - University of Sao Paulo, Al. Octavio Pinheiro Brisolla 9-75, Bauru, 17012-901, Brazil
| | - Sebastião Luiz A Greghi
- Department of Prosthodontics and Periodontology/Discipline of Periodontology, Bauru School of Dentistry - University of Sao Paulo, Al. Octavio Pinheiro Brisolla 9-75, Bauru, 17012-901, Brazil
| | - Maria Lúcia R Rezende
- Department of Prosthodontics and Periodontology/Discipline of Periodontology, Bauru School of Dentistry - University of Sao Paulo, Al. Octavio Pinheiro Brisolla 9-75, Bauru, 17012-901, Brazil
| | - Adriana C P Sant'Ana
- Department of Prosthodontics and Periodontology/Discipline of Periodontology, Bauru School of Dentistry - University of Sao Paulo, Al. Octavio Pinheiro Brisolla 9-75, Bauru, 17012-901, Brazil
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Vered Y, Chetrit A, Sgan-Cohen HD, Amitai T, Mann J, Even-Nir H, Sadetzki S. Caries Experience among Adults Exposed to Low to Moderate Doses of Ionizing Radiation in Childhood - The Tinea Capitis Cohort. Front Public Health 2016; 4:18. [PMID: 26942172 PMCID: PMC4763082 DOI: 10.3389/fpubh.2016.00018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/01/2016] [Indexed: 12/12/2022] Open
Abstract
While the impact of therapeutic levels of ionizing radiation during childhood on dental defects has been documented, the possible effect of low doses on dental health is unknown. The study aim was to assess the association between childhood exposure to low-moderate doses of therapeutic radiation and caries experience among a cohort of adults 50 years following the exposure. The analysis was based on a sample of 253 irradiated (in the treatment of tinea capitis) and 162 non-irradiated subjects. The decayed, missing, and filled teeth (DMFT) index was assessed during a clinical dental examination and questions regarding dental care services utilization, oral hygiene behavior, current self-perceived mouth dryness, socio-demographic parameters, and health behavior variables were obtained through a face-to-face interview. An ordered multivariate logistic regression model was used to assess the association of the main independent variable (irradiation status) and other relevant independent variables on the increase in DMFT. Mean caries experience levels (DMFT) were 18.6 ± 7.5 for irradiated subjects compared to 16.4 ± 7.2 for the non-irradiated (p = 0.002). Controlling for gender, age, education, income, smoking, dental visit in the last year, and brushing teeth behavior, irradiation was associated with a 72% increased risk for higher DMFT level (95% CI: 1.19-2.50). A quantification of the risk by dose absorbed in the salivary gland and in the thyroid gland showed adjusted ORs of 2.21 per 1 Gy (95% CI: 1.40-3.50) and 1.05 per 1 cGy (95% CI: 1.01-1.09), respectively. Childhood exposure to ionizing radiation (0.2-0.4 Gy) might be associated with late outcomes of dental health. In line with the guidelines of the American Dental Association, these results call for caution when using dental radiographs.
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Affiliation(s)
- Yuval Vered
- Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University , Jerusalem , Israel
| | - Angela Chetrit
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Harold D Sgan-Cohen
- Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University , Jerusalem , Israel
| | - Tova Amitai
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Jonathan Mann
- Department of Community Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University , Jerusalem , Israel
| | - Hadas Even-Nir
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Siegal Sadetzki
- Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Barasch A, Raber-Durlacher J, Epstein JB, Carroll J. Effects of pre-radiation exposure to LLLT of normal and malignant cells. Support Care Cancer 2015; 24:2497-501. [PMID: 26670917 DOI: 10.1007/s00520-015-3051-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 12/07/2015] [Indexed: 01/05/2023]
Abstract
PURPOSE Low-level laser therapy (LLLT) efficacy for the prevention of cancer treatment-induced oral mucositis (OM) has been amply described. However, potential protection of malignant cells remains a legitimate concern for clinicians. We tested LLLT-induced protection from ionizing radiation killing in both malignant and normal cells. METHODS We treated six groups each of normal human lymphoblasts (TK6) and human leukemia cells (HL60) with He-Ne LLLT (632.8 nm, 35 mW, CW, 1 cm(2), 35 mW/cm(2) for 3-343 s, 0.1-12 J/cm(2)) prior to exposure to ionizing radiation (IR). Cells were then incubated and counted daily to determine their survival. Optimization of IR dose and incubation time was established prior to testing the effect of LLLT. RESULTS Growth curves for both cell lines showed significant declines after exposure to 50-200 cGy IR when compared to controls. Pre-radiation exposure to LLLT (4.0 J/cm(2)) followed by 1-h incubation blocked this decline in TK6 but not in HL60 cells. The latter cells were sensitized to the killing effects of IR in a dose-dependent manner. CONCLUSION This study shows that pre-IR LLLT treatment results in a differential response of normal vs. malignant cells, suggesting that LLLT does not confer protection and may even sensitize cancer cells to IR killing.
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Affiliation(s)
- Andrei Barasch
- Department of Medicine, Weill Cornell Medical College, 528 E 68th Street, New York, NY, 10065, USA.
- Department of Periodontology, ACTA University of Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
| | - Judith Raber-Durlacher
- Department of Periodontology, ACTA University of Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Joel B Epstein
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA, USA
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Sadetzki S, Chetrit A, Sgan-Cohen HD, Mann J, Amitai T, Even-Nir H, Vered Y. Long-Term Effects of Exposure to Ionizing Irradiation on Periodontal Health Status - The Tinea capitis Cohort Study. Front Public Health 2015; 3:226. [PMID: 26539423 PMCID: PMC4610133 DOI: 10.3389/fpubh.2015.00226] [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: 06/29/2015] [Accepted: 09/22/2015] [Indexed: 12/19/2022] Open
Abstract
Studies among long-term survivors of childhood cancer who had received high-dose irradiation therapy of 4–60 Gy, demonstrated acute and chronic dental effects, including periodontal diseases. However, the possible effects of low to moderate doses of radiation on dental health are sparse. The aim of this study is to investigate the association between childhood exposure to low–moderate doses of ionizing radiation and periodontal health following 50 years since exposure. The study population included 253 irradiated subjects (treated for Tinea capitis in the 1950s) and, 162 non-irradiated subjects. The estimated dose to the teeth was 0.2–0.4 Gy. Dental examination was performed according to the community periodontal index (CPI). Socioeconomic and health behavior variables were obtained through a personal questionnaire. Periodontal disease was operationally defined as “deep periodontal pockets.” A multivariate logistic regression model was used for the association of irradiation status and other independent variables with periodontal status. The results showed that among the irradiated subjects, 23%, (95% CI 18–28%) demonstrated complete edentulousness or insufficient teeth for CPI scoring as compared to 13% (95% CI 8–19%) among the non-irradiated subjects (p = 0.01). Periodontal disease was detected among 54% of the irradiated subjects as compared to 40% of the non-irradiated (p = 0.008). Controlling for education and smoking, the ORs for the association between radiation and periodontal disease were 1.61 (95% CI 1.01–2.57) and 1.95 (95% CI 1.1–3.5) for ever never and per 1 Gy absorbed in the salivary gland, respectively. In line with other studies, a protective effect for periodontal diseases among those with high education and an increased risk for ever smokers were observed. In conclusion, childhood exposure to low-moderate doses of ionizing radiation might be associated with later outcomes of dental health. The results add valuable data on the long-term health effects of exposure to ionizing radiation and support the implementation of the ALARA principle in childhood exposure to diagnostic procedure involving radiation.
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Affiliation(s)
- Siegal Sadetzki
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center , Tel Hashomer , Israel ; Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel
| | - Angela Chetrit
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center , Tel Hashomer , Israel
| | - Harold D Sgan-Cohen
- Department of Community Dentistry, Faculty of Dental Medicine, The Hebrew University Hadassah Medical School , Jerusalem , Israel
| | - Jonathan Mann
- Department of Community Dentistry, Faculty of Dental Medicine, The Hebrew University Hadassah Medical School , Jerusalem , Israel
| | - Tova Amitai
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center , Tel Hashomer , Israel
| | - Hadas Even-Nir
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center , Tel Hashomer , Israel
| | - Yuval Vered
- Department of Community Dentistry, Faculty of Dental Medicine, The Hebrew University Hadassah Medical School , Jerusalem , Israel
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Fernandes LLD, Torres SR, Garnica M, de Souza Gonçalves L, Junior AS, de Vasconcellos ÁC, Cavalcanti W, Maiolino A, de Barros Torres MCM. Oral status of patients submitted to autologous hematopoietic stem cell transplantation. Support Care Cancer 2013; 22:15-21. [DOI: 10.1007/s00520-013-1940-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Accepted: 08/05/2013] [Indexed: 10/26/2022]
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Güneş Z, Denat Y, Müezzinoğlu M, Şen Ş, Yılmaz S, Atlı E. The risk factors effecting the dry mouth in inpatients in Hospital in west Anatolia. J Clin Nurs 2011; 21:408-14. [DOI: 10.1111/j.1365-2702.2011.03898.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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