Evaluation of Oral Mucositis Occurrence in Oncologic Patients under Antineoplastic Therapy Submitted to the Low-Level Laser Coadjuvant Therapy

Cavalcanti, Alessandro Leite; Macêdo, Dário José de; Dantas, Fernanda Suely Barros; Menezes, Karla dos Santos; Silva, Diego Filipe Bezerra; Melo, William Alves de

doi:10.3390/jcm7050090

Cited by 17 publications

(17 citation statements)

References 26 publications

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“…The incidence rate of OM in pediatric patients in our study was 73.5% for all grades and 23.5% for severe OM, which is in line with the results found in studies with the same population 2‐5 . The therapeutic approaches to avoid OM development are not available, but the prophylactic use of PDC 25‐27 and PBM 1,15,28‐31 has been reported to reduce the incidence and severity of this toxicity in cancer patients. Both incidence and severity of OM were shown to decrease after the application of PBM and PDC, 1 which was also confirmed in this study.…”

Section: Discussionsupporting

confidence: 90%

“…Meeting this reasoning, the use of active agents, such as chlorhexidine, has been indicated in oral care and prevention of OM 27,32 . The effectiveness of intraoral PBM in the treatment of OM has been reported in some studies with hematological and solid cancer paediatric patients undergoing chemotherapy and/or HSCT, in reducing either the severity or the duration of this adverse effect 28‐31 . Using an intraoral PBM, the incidence of OM in our sample was 73.5%, which is similar to the value (77%) was reported by Treister et al 5 using an extraoral approach, but lower than the value reported by Eduardo et al, 10 who observed mild mucositis (WHO grades I and II) in all of their 51 cases.…”

Section: Discussionsupporting

confidence: 84%

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Oral mucositis in paediatric cancer patients undergoing allogeneic hematopoietic stem cell transplantation preventively treated with professional dental care and photobiomodulation: Incidence and risk factors

Miranda-Silva

Fonseca

Gomes

et al. 2021

Int J Paed Dentistry

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Background Oral mucositis (OM) is an important side effect related to allogeneic hematopoietic stem cell transplantation (allo‐HSCT), and it has been associated with a significative reduction of quality of life. A negative impact of OM in paediatric patients could result in increased use of parenteral feeding and opioids, longer periods of hospitalization, and a higher risk of systemic infection. Aim To investigate the clinical features and clinical outcomes associated with OM development and severity in hematological cancer paediatric patients undergoing allo‐HSCT who underwent professional dental care (PDC) and photobiomodulation (PBM) as prophylactic treatment. Design Medical data and OM presentation were retrieved retrospectively from all patients younger than 18 years who received allo‐HSCT between 2013 and 2016. The incidence of OM was assessed and graded by two oral medicine specialists following the WHO guidelines, and it was correlated with clinical parameters. Results Forty‐nine consecutive paediatric patients were included. OM was diagnosed in 73.5% of patients, and in 36.1% of patients, OM was classified as severe. Acute lymphoblastic leukemia as a primary diagnosis and the use of a myeloablative regimen were associated with OM development. The primary diagnosis and use of total body irradiation (TBI) were associated with aggressive OM. Neither the incidence nor the severity of OM affected the overall survival, whereas only the use of a myeloablative regimen and a high body mass index (BMI) were determinants of lower OM‐free survival rates. Conclusions A myeloablative conditioning and a high BMI were observed to be independent prognostic determinants of a lower OMFS rate. The cluster analysis allowed us to outline patient profiles with greater susceptibility to the development and severity of oral mucositis, which seems to be a useful tool to determine the risk of OM in paediatric patients.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 84%

Oral mucositis in paediatric cancer patients undergoing allogeneic hematopoietic stem cell transplantation preventively treated with professional dental care and photobiomodulation: Incidence and risk factors

Miranda-Silva

Fonseca

Gomes

et al. 2021

Int J Paed Dentistry

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“…The jugal / palate mucosa and the labial mucosa were the sites most commonly compromised. A cross-sectional study with children and adolescents undergoing CT observed that the tongue and jugal mucosa areas were most frequently compromised by SOM ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

The incidence of severe oral mucositis and its occurrence sites in pediatric oncologic patients

Guimarães¹,

Carvalho²,

Damascena³

et al. 2021

Med Oral

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Background Childhood cancer is one of the main causes of child mortality and its treatment has debilitating effects on the oral cavity. Several oral mucositis (SOM) is one of the most common and may cause undesirable symptoms such as pain and risk of systemic infection. Material and Methods This was a longitudinal, retrospective, and observational study determining the incidence of severe oral mucositis (SOM) and its occurrence sites in pediatric oncologic patients, in João Pessoa, Brazil, between 2013 and 2018. Data from 56 patients aged 1 to 18 years were collected from their medical records and through an oral mucosa examination, from the 1st to 5th week of chemotherapy treatment (CT) using the modified Oral Assessment Guide, by previously calibrated examiners (Kappa index > 0.7). The data were analyzed by the Chi-square test, and Odds Ratios were calculated. Results Most patients were females (54.5%), aged 8.8 years (± 4.8), with hematologic tumors (73.2%), predominantly Acute Lymphoid Leukemia (50.0%). An increase in the occurrence of SOM was observed throughout the CT ( P = 0.05), ranging from 12.5% in the 1st to 35.7% in the 5th CT week. In the 1st CT week, there was a predominance of alterations in the lips (5.5%) and saliva (5.5%), while in the 5th, the jugal / palate mucosa (21.4%) remained the most affected site by SOM. Differences in the severity of SOM in the jugal / palate mucosa ( P = 0.01) and labial mucosa ( P = 0.04) were observed over time. In the 5th CT week, the likelihood of developing SOM was 13.3-fold higher (95% CI: 1.5 - 105.6) in patients with hematologic tumors. Conclusions The incidence of SOM was higher in the 5th CT week, most commonly affecting the jugal / palate mucosa, and patients with hematologic tumors were more prone to develop SOM. Key words: Mucositis, oncology, pediatric dentistry.

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“…Although there is not yet a universal protocol for the clinical management of this condition, the current available therapies involve mainly local and systemic anti-inflammatory and analgesic drugs, oral hygiene protocols, and photobiomodulation (PBM) [7]. PBM shows efficacy in the clinical management of OM, either in cases caused by chemotherapy [8,9] or radiotherapy [10,11], or in cases where OM was caused by the use of combination of these two treatment modalities [12]. PBM is currently considered the standard treatment for OM lesions, especially because it does not cause the systemic toxicity that pharmacological treatment can generate [1,13,14].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Two Light Wavelengths (λ = 660 nm and λ = 780 nm) in the Repair Process of Oral Mucositis Induced by Ionizing Radiation: Clinical and Microscopic Evaluations in Rats

Andrade¹,

Sardo²,

Benetti

et al. 2022

Photonics

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Photobiomodulation (PBM) has been clinically used for the prevention and treatment of oral mucositis (OM). The effect of red and near-infrared wavelengths on OM repair is still misunderstood. The aim of this study was to compare the clinical effect and tissue changes caused by 660 nm and 780 nm exposure in an experimental model of OM. Rats were submitted to gamma irradiation for induction of OM lesions and treated with 660 nm or 780 nm lasers with the same dosimetry parameters (30 mW, 7.5 J/cm2, 10 s, spot size = 0.04 mm, irradiation every two days). Clinical assessment of OM severity and histopathological analyses was performed after 8, 14, and 20 days of the ionizing radiation. OM severity was reduced in the PBM groups, especially when the red laser was used. The histopathological pattern was similar between the PBM groups, showing advanced re-epithelization and more pronounced angiogenesis and collagen deposition compared to the control. The 660 nm group showed a greater collagen matrix area than the 780 nm group at 14 days. In conclusion, PBM at 660 nm and 780 nm improved the repair of ionizing radiation-induced OM. Both wavelengths activated the angiogenesis and collagen deposition, but these tissue effects were more pronounced when 660 nm was used.

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Evaluation of Oral Mucositis Occurrence in Oncologic Patients under Antineoplastic Therapy Submitted to the Low-Level Laser Coadjuvant Therapy

Cited by 17 publications

References 26 publications

Oral mucositis in paediatric cancer patients undergoing allogeneic hematopoietic stem cell transplantation preventively treated with professional dental care and photobiomodulation: Incidence and risk factors

Oral mucositis in paediatric cancer patients undergoing allogeneic hematopoietic stem cell transplantation preventively treated with professional dental care and photobiomodulation: Incidence and risk factors

The incidence of severe oral mucositis and its occurrence sites in pediatric oncologic patients

Comparison of Two Light Wavelengths (λ = 660 nm and λ = 780 nm) in the Repair Process of Oral Mucositis Induced by Ionizing Radiation: Clinical and Microscopic Evaluations in Rats

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