Proposal of a prophylactic photobiomodulation protocol for chemotherapy-induced oral and oropharyngeal mucositis: a randomized clinical trial

被引:0
作者
Fernanda Vieira Heimlich
José Alcides Almeida de Arruda
Nickolas Mendes Pereira
Larissa dos Santos Faria
Lucas Guimarães Abreu
Marcus Vinícius Lucas Ferreira
Fabiana Maria Kakehasi
Denise Vieira Travassos
Tarcília Aparecida Silva
Ricardo Alves Mesquita
机构
[1] Universidade Federal de Minas Gerais,Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry
[2] Multiprofessional Integrated Residency in Health,Department of Child and Adolescent Oral Health, School of Dentistry
[3] Hospital das Clínicas,Department of Restorative Dentistry, School of Dentistry
[4] Universidade Federal de Minas Gerais,Department of Pediatrics, School of Medicine
[5] Universidade Federal de Minas Gerais,Department of Social and Preventive Dentistry, School of Dentistry
[6] Universidade Federal de Minas Gerais,undefined
[7] Universidade Federal de Minas Gerais,undefined
[8] Universidade Federal de Minas Gerais,undefined
来源
Lasers in Medical Science | / 38卷
关键词
Chemotherapy; Hematopoietic stem cell transplantation; Oral mucositis; Oropharyngeal mucositis; Photobiomodulation;
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摘要
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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