Effect of photobiomodulation on the severity of oral mucositis and molecular changes in head and neck cancer patients undergoing radiotherapy: a study protocol for a cost-effectiveness randomized clinical trial

Martins, Allisson Filipe Lopes; Nogueira, Túlio Eduardo; Morais, Marília Oliveira; Oton-Leite, Angélica Ferreira; Valadares, Marize Campos; Batista, Aline Carvalho; Freitas, Nilceana Maya Aires; Leles, Cláudio Rodrigues

doi:10.1186/s13063-019-3196-8

Cited by 32 publications

(27 citation statements)

References 55 publications

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“…The PBM protocol recommended to prevent OM is the use of a low-power laser with a wavelength of 660nm, energy density of 6.2J, in 72 application points, 10 seconds per point, during 03 days a week, alternately [11]. Other studies [38][39][40][41][42] presented different PBM protocols, which ranged in energy density from 1J to 6J, with application points from 09 to 58 points, alternating to continuous and different conductive media. Previous data from our group [43], whose PBM protocol included low-power AsGaAl laser, 660nm, 86.7 mW, energy density of 2J, applied to 28 points in the oral cavity for 3 seconds at each point, was also unable to prevent the emergence of OM.…”

Section: Gonçalves Et Al (2018)mentioning

confidence: 99%

Impact of photobiomodulation for oral mucositis on body weight and BMI of patients with head and neck cancer

Melo

Andrade

Dantas

et al. 2022

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To evaluate the impact of photobiomodulation for oral mucositis on body weight and Body Mass Index (BMI) of patients with head and neck cancer. MethodsPatients were divided into two distinct groups: Photobiomodulation -PBM (n = 17) and SHAM (n = 19). Participants in the PBM group received the low-power aluminum gallium arsenide (AsGaAl) laser device with maximum output power of 86.7 mW, wavelength of 660 nm (red) and laser applications at 33 different points of the oral mucosa, on alternate days. Patients in the SHAM group were found to be using the same procedure but with the device turned off. During the rst and twenty-fourth session of radiotherapy, participants from both groups underwent an intraoral examination to assess the presence or absence of mucositis and its respective degree according to WHO scale, and were assessed by measuring weight and height and for BMI calculation. ResultsAll patients presented signi cant differences on weight and BMI throughout the study. Patients in the PBM group had less weight loss (p<0.01) and reduced BMI loss (p<0.01) when compared to patients in the SHAM group. PBM did not prevent oral mucositis, however, it decreased its severity (p<0.01). ConclusionPhotobiomodulation for oral mucositis reduces weight loss and prevented the reduction of BMI in patients who underwent radiochemotherapy treatment for head and neck cancer. Although it did not avoid the appearance of oral mucositis, PBM was able to reduce its degrees, preventing the progress of this condition. Retrospectively registered: https://data.

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Section: Gonçalves Et Al (2018)mentioning

confidence: 99%

Impact of photobiomodulation for oral mucositis on body weight and BMI of patients with head and neck cancer

Melo

Andrade

Dantas

et al. 2022

Support Care Cancer

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“…Although in our case the laser was applied only for advanced lesions, studies also show the possibility of preventive use of the laser before and during CT and RT conducted on the entire mucous membrane, which significantly reduces the risk of advanced OM and reduces its duration [ 23 , 24 , 25 ]. Martins et al analyzed the cost-effectiveness of OM treatment of a cycle of PBM treatments compared to pharmacological therapy based on a mouthwash with 0.12% chlorhexidine and oral ointment with hydrocortisone 5 mg, neomycin 5 mg, troxerutin 20 mg, ascorbic acid 0.5 mg, and benzocaine 2 mg. PBM therapy is not only a more effective treatment, but is also advantageous in terms of costs which are much lower for a single oncological patient and the entire health care system [ 22 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Photobiomodulation Therapy in the Treatment of Oral Mucositis—A Case Report

et al. 2022

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In 2021, our group published a laboratory study on the impact of PBM on human gingival fibroblasts. The in vitro results confirmed the fact that the appropriately selected wavelength and properly selected parameters of the laser settings can increase cell proliferation, modulate inflammatory markers, and decrease the susceptibility of human gingival fibroblasts to apoptosis. Therefore, this case report was aimed at the clinical evaluation of the proposed settings and treatment regimen in a very difficult situation of an immunocompromised patient with extensive changes and stagnation of symptoms for many weeks. A 65-year-old man, during his oncological treatment, was diagnosed with oral mucositis grade 3 according to the World Health Organization and National Cancer Institute scales. Due to pain sensation, long-lasting and not healing oral lesions, and problems with solid food intake, he was qualified for laser photobiomodulation therapy. For the management of oral lesions, a diode laser 635 nm (SmartMPro, Lasotronix, Poland) was intraorally applied at an energy density of 4 J/cm2, the 20 s of irradiation, the output power of 100 mW, and in continuous wave mode. Seven treatment procedures were performed two times a week using the spot technique in contact and non-contact mode. Within 21 days of monotherapy, all ailments disappeared. The patient was also able to reuse dental dentures and return to a solid diet. The obtained results confirm the efficiency of at least 3 PBM protocols. Our case shows that the use of PMB therapy contributes to faster healing of painful oral lesions in oncological patients, and thus the treatment time and return to the appropriate quality of life is shorter.

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“…The protocol for this research has been previously reported [39]. This study was registered in the Brazilian Registry of Clinical Trials (REBEC—RBR‐5h4y4n) and was approved by the Ethics Research Committee of Universidade Federal de Goiás (Protocol 2.053.687/2017) and Araujo Jorge Cancer Hospital (Protocol 2.131.323/2017).…”

Section: Methodsmentioning

confidence: 99%

The Effect of Photobiomodulation on Nitrite and Inflammatory Activity in Radiotherapy‐Induced Oral Mucositis: A Randomized Clinical Trial

et al. 2020

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Background and Objectives: To investigate pro-and anti-inflammatory cytokines and nitrite salivary levels in patients with head and neck cancer receiving photobiomodulation therapy (PBMT) associated with a Preventive Oral Care Program (POCP), for prevention and control of oral mucositis (OM) during radiotherapy (RT) associated or not with chemotherapy protocol. Study Design/Materials and Methods: In this randomized double-blinded clinical trial, 48 patients were randomly assigned to two groups: PBMT (n = 25) and Control (n = 23). In the PBMT group, patients were submitted to PBMT associated with the POCP. In the Control group, patients were submitted only to the POCP. Saliva samples were collected in the 1st (baseline), 7th, 14th, 21st, and 30th sessions of RT, and the levels of interleukin-6 (IL-6), IL-8, IL-10, IL-12p70, IL-1β, and tumoral necrosis factor-α (TNF-α) were measured using the cytometric bead array. Nitrite levels were measured by colorimetric method. OM was assessed using the World Health Organization and the National Cancer Institute scales. Results: Patients in the PBMT group presented less severe OM. PBMT tended to stabilize nitrite concentration levels during the RT regimen. The IL-1β concentration was associated with higher OM scores. PBMT promoted an increase in IL-12p70, TNF-α, and IL-10 concentration. Conclusion: PBMT was effective in the prevention and control of severe OM, and its mechanism of action may be related to a better balance of inflammatory response that may favor injury control. Lasers Surg. Med.

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Effect of photobiomodulation on the severity of oral mucositis and molecular changes in head and neck cancer patients undergoing radiotherapy: a study protocol for a cost-effectiveness randomized clinical trial

Cited by 32 publications

References 55 publications

Impact of photobiomodulation for oral mucositis on body weight and BMI of patients with head and neck cancer

Impact of photobiomodulation for oral mucositis on body weight and BMI of patients with head and neck cancer

Photobiomodulation Therapy in the Treatment of Oral Mucositis—A Case Report

The Effect of Photobiomodulation on Nitrite and Inflammatory Activity in Radiotherapy‐Induced Oral Mucositis: A Randomized Clinical Trial

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