Oral mucositis (OM) is a frequent and severe adverse effect of therapy against head and neck cancer. Photobiomodulation with the low-power laser is known to be effective against OM, but the diversity of protocols and the possibility of stimulating residual tumor cells are still obstacles. The present study aimed to compare two doses of laser energy delivered to the oral mucosa of patients under oncologic treatment for head and neck cancer, looking for differences in the control of mucositis, as well as in the frequency of tumoral recurrences. Fifty-eight patients undergoing radiotherapy were randomized into two groups, distinguished according to the energy delivered by laser irradiation, namely, 0.25 J and 1.0 J. The groups were compared according to frequency, severity, or duration of OM, as well as the frequency of tumoral recurrences. OM was significantly less frequent in patients receiving 1.0 J of energy, but the groups did not differ regarding severity or duration of OM. Tumoral recurrence also did not vary significantly between the groups. Photobiomodulation with a higher dose of energy (1.0 J versus 0.25 J) is associated with better control of radiotherapy-induced OM and does not significantly increase the risk of neoplastic recurrence.
Verificar qual o melhor protocolo de aplicação da laserterapia de baixa potência para prevenção e tratamento da mucosite oral químio e rádio induzida. Revisão sistemática de literatura sobre laserterapia na prevenção e tratamento da mucosite oral rádio e químio induzida. Foram utilizadas as indexações “mucositis”, “lowpower laser therapy”, na busca de estudos clínicos randomizados dos últimos 10 anos nas bases de dados de referência: PubMed, LILACS e Cochrane Library. A pesquisa resultou em 16 estudos clínicos randomizados sobre laserterapia de baixa potência, sendo consenso a aplicação 5 vezes por semana, com densidade de energia variada entre 1,3 e 6,0 J/cm². O presente estudo identificou que a laserterapia reduz o tempo de cicatrização e os graus de mucosite oral, apesar de ainda serem necessários mais estudos para definir o protocolo de atuação. Palavras-chave: Estomatite. Mucosite. Quimioterapia. Radioterapia. Terapia a laser de baixa intensidade.
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