A cirurgia e a radioterapia são os principais métodos de tratamento das neoplasias de cabeça e pescoço. Dentre os efeitos colaterais resultantes da interação da radiação ionizante sobre os tecidos, temos dermatite, mucosite, xerostomia, candidíase, alteração do paladar, disfagia, cárie, trismo e osteorradionecrose. OBJETIVO: Avaliar a condição odontológica dos pacientes, através de protocolo que permita impedir ou minimizar os efeitos da radiação sobre os tecidos da cavidade bucal. MATERIAIS E MÉTODOS: Realizou-se acompanhamento odontológico, antes, durante e até 180 dias após a radioterapia, em 12 pacientes submetidos a cirurgia e radioterapia, ou radioterapia exclusiva. RESULTADOS: Efeitos como dermatite, mucosite, alteração do paladar e disfagia cresceram em proporção a partir da segunda semana de tratamento até o final das aplicações, decrescendo visivelmente quando do término, chegando próximos aos valores basais após 180 dias. Quanto à xerostomia, a redução ocorreu mais lentamente e com menor efetividade. Cárie, trismo e osteorradionecrose não foram observados durante o período de avaliação. CONCLUSÃO: O acompanhamento odontológico sistemático, junto com medidas preventivas como adequação bucal prévia, orientações sobre higienização, utilização de bochechos de água bicarbonatada, chá de camomila, aplicação tópica de flúor, contribuíram para promover melhores condições de restabelecimento em pacientes com neoplasia da região de cabeça e pescoço submetidos à radioterapia.

The objective of present study was to classify oral mucositis according to the Common Toxicity Criterion (CTC) international parameters in head and neck tumor patients simultaneously treated with radio and chemotherapy, and characterize a patient profile in our area, observing the individuals' habits, tumor characteristics, treatment protocol and acute reaction intensity. Fifty patients undergoing simultaneous 66 to 70 Gy megavoltage radiotherapy and cisplatin/carboplatin chemotherapy were evaluated in this study. Weekly evaluations of the degree of mucositis were perfoemed according to CTC, a four-degree ordinal scale; 36% of all patients and 100% of those with diabetes discontinued treatment due to mucositis, showing that this pathology contributes to the severity of mucositis.

ObjectiveTo determine whether low-level laser therapy can prevent salivary hypofunction after radiotherapy and chemotherapy in head and neck cancer patients.Materials and MethodsWe evaluated 23 head and neck cancer patients, of whom 13 received laser therapy and 10 received clinical care only. An InGaAlP laser was used intra-orally (at 660 nm and 40 mW) at a mean dose of 10.0 J/cm2 and extra-orally (at 780 nm and 15 mW) at a mean dose of 3.7 J/cm2, three times per week, on alternate days. Stimulated and unstimulated sialometry tests were performed before the first radiotherapy and chemotherapy sessions (N0) and at 30 days after the end of treatment (N30).ResultsAt N30, the mean salivary flow rates were significantly higher among the laser therapy patients than among the patients who received clinical care only, in the stimulated and unstimulated sialometry tests (p = 0.0131 and p = 0.0143, respectively).ConclusionLow-level laser therapy, administered concomitantly with radiotherapy and chemotherapy, appears to mitigate treatment-induced salivary hypofunction in patients with head and neck cancer.

Late effects of radiotherapy for head and neck cancer treatment have been increasingly investigated due to its impact on patients' quality of life. The purpose of this study was to evaluate the effect of low-level laser therapy on hyposalivation, low salivary pH, and quality of life in head and neck cancer patients post-radiotherapy. Twenty-nine patients with radiation-induced xerostomia received laser sessions twice a week, during 3 months (24 sessions). For this, a continuous wave Indium-Gallium-Aluminium-Phosphorus diode laser device was used punctually on the major salivary glands (808 nm, 0.75 W/cm, 30 mW, illuminated area 0.04 cm, 7.5 J/cm, 10 s, 0.3 J). Six extraoral points were illuminated on each parotid gland and three on each submandibular gland, as well as two intraoral points on each sublingual gland. Stimulated and unstimulated salivary flow rate, pH (two scales with different gradations), and quality of life (University Of Washington Quality of Life Questionnaire for Patients with Head and Neck Cancer) were assessed at baseline and at the end of the treatment. There were significant increases in both mean salivary flow rates (unstimulated: p = 0.0012; stimulated: p < 0.0001), mean pH values (p = 0.0002 and p = 0.0004), and mean score from the quality of life questionnaire (p < 0.0001). Low-level laser therapy seems to be effective to mitigate salivary hypofunction and increase salivary pH of patients submitted to radiotherapy for head and neck cancer, thereby leading to an improvement in quality of life.