Photobiomodulation with Low-Level Laser in the Treatment of Trismus After Radiotherapy: A Case Report

Rodriguez, Christian Giancarlo Bernal; Eduardo, Carlos; Aranha, Ana Cecília Corrêa; Freitas, Patrícia Moreira de

doi:10.1089/photob.2018.4524

Cited by 5 publications

(6 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At the final PBM session, the patient’s mouth opening increased from 20 to 30 mm, and the pain decreased from a visual analog score (VAS) from 9 to 1. These positive results persisted up to one year after the final PBM session ( 164 ). The main rationale for a possible clinical benefit of PBM in the management of trismus is the potential of PBM to reduce fibrosis and promote muscle regeneration.…”

Section: Resultsmentioning

confidence: 95%

Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022

et al. 2022

View full text Add to dashboard Cite

DisclaimerThis article is based on recommendations from the 12th WALT Congress, Nice, October 3-6, 2018, and a follow-up review of the existing data and the clinical observations of an international multidisciplinary panel of clinicians and researchers with expertise in the area of supportive care in cancer and/or PBM clinical application and dosimetry. This article is informational in nature. As with all clinical materials, this paper should be used with a clear understanding that continued research and practice could result in new insights and recommendations. The review reflects the collective opinion and, as such, does not necessarily represent the opinion of any individual author. In no event shall the authors be liable for any decision made or action taken in reliance on the proposed protocols.ObjectiveThis position paper reviews the potential prophylactic and therapeutic effects of photobiomodulation (PBM) on side effects of cancer therapy, including chemotherapy (CT), radiation therapy (RT), and hematopoietic stem cell transplantation (HSCT).BackgroundThere is a considerable body of evidence supporting the efficacy of PBM for preventing oral mucositis (OM) in patients undergoing RT for head and neck cancer (HNC), CT, or HSCT. This could enhance patients’ quality of life, adherence to the prescribed cancer therapy, and treatment outcomes while reducing the cost of cancer care.MethodsA literature review on PBM effectiveness and dosimetry considerations for managing certain complications of cancer therapy were conducted. A systematic review was conducted when numerous randomized controlled trials were available. Results were presented and discussed at an international consensus meeting at the World Association of photobiomoduLation Therapy (WALT) meeting in 2018 that included world expert oncologists, radiation oncologists, oral oncologists, and oral medicine professionals, physicists, engineers, and oncology researchers. The potential mechanism of action of PBM and evidence of PBM efficacy through reported outcomes for individual indications were assessed.ResultsThere is a large body of evidence demonstrating the efficacy of PBM for preventing OM in certain cancer patient populations, as recently outlined by the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Building on these, the WALT group outlines evidence and prescribed PBM treatment parameters for prophylactic and therapeutic use in supportive care for radiodermatitis, dysphagia, xerostomia, dysgeusia, trismus, mucosal and bone necrosis, lymphedema, hand-foot syndrome, alopecia, oral and dermatologic chronic graft-versus-host disease, voice/speech alterations, peripheral neuropathy, and late fibrosis amongst cancer survivors.ConclusionsThere is robust evidence for using PBM to prevent and treat a broad range of complications in cancer care. Specific clinical practice guidelines or evidence-based expert consensus recommendations are provided. These recommendations are aimed at improving the clinical utilization of PBM therapy in supportive cancer care and promoting research in this field. It is anticipated these guidelines will be revised periodically.

show abstract

Section: Resultsmentioning

confidence: 95%

Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Below are the sociodemographic data of the participants (Table 1). (1,2,3,4,5,6). *Difference between the preintervention and after 3 months of Follow-Up.…”

Section: Interventionsmentioning

confidence: 99%

“…Radiotherapy can be started with the curative objective, adjuvant (pre or postoperatively) or as palliative treatment, but the side effects that occur when normal cells located within the treatment area suffer temporary or permanent damage. The sequelae resulting from this treatment depend on the number of doses and intensity of exposure and may manifest during or after treatment conclusion [2]. Among the most prevalent complications is trismus, defined as a restriction in mouth opening that can be caused by tumor infiltration into the masticatory muscles and/or the temporomandibular joint; by radiotherapy itself when it involves these muscles in the radiation field; or even a combination of both [3].…”

Section: Introductionmentioning

confidence: 99%

Orofacial Myofunctional Therapy with and without Photobiomodulation in the Rehabilitation of Radiation-Induced Trismus: Case Series

Paim¹,

Goulart²,

Martins³

et al. 2022

IJCST

View full text Add to dashboard Cite

Photobiomodulation (PBM) as a therapeutic technology is justified by the biochemical changes caused in the intracellular environment, such as increased production of adenosine triphosphate and activation of antioxidant enzymes, allowing early recovery and maintenance of the homeostasis and proper functioning. This case report aimed to describe the effect of orofacial myofunctional therapy associated or not with photobiomodulation in the rehabilitation of radio-induced trismus in 6 patients. Two intervention modalities were performed, with three patients undergoing OMT isolated and the other two subjects undergoing oral myofunctional therapy associated with photobiomodulation therapy (OMT+PBM). All participants completed the radiotherapy between 3 and 15 months before starting the trismus rehabilitation. The mouth opening was 21.00mm for the patients who underwent exclusive OMT and reached 30.25mm at the end of the rehabilitation (difference of 9.25mm), but for the other three patients submitted to OMT+PBM, it went from 8.4mm to 31.5mm (difference of 23,1mm). It was observed that patients who performed PBM+OMT had greater tolerance to the protocol exercises and less pain report. OMT+PBM was a good combination for trismus rehabilitation and could be considered in further randomized clinical trials.

show abstract

“…Following the protocol described by Rodrigues [12] using energy density and application points and Melchior [18] using application points to cover all masticatory muscles. The infrared laser (~ 808nm) was used extra-oral, with 0.1W power, 3J energy, 30s (30.61/cm2) per point; totaling 270 seconds of application and 24J energy per side, the extra-oral points were applied near the region of the temporomandibular joint described by: (A) superior, (B) posterior and (C) anterior to the mandibular condyle, for the application of point (D) the patient will be asked to open the mouth and the laser will be applied intraauricular towards the tragus.…”

Section: Intervention Protocolmentioning

confidence: 99%

“…Recently, a clinical case report has begun to bring tenuous evidence of the e cacy of photobiomodulation therapy (PBMT) in treating trismus after radiotherapy. Daily application of laser with infrared wavelength Rodriguez [12] almost wholly reversed the limitation of mouth opening, reduced pain in masticatory muscles, and suggested a low-cost protocol for treating radio-induced trismus [12]. PBMT induces immediate oxygen in ux on target tissues and the respiratory chain resumption, accelerating intracellular adenosine triphosphate synthesis [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

The role of Photobiomodulation therapy in the treatment of head and neck radiotherapy-related trismus: a single-arm clinical trial

Borges

Malta

Carlos

et al. 2022

Preprint

View full text Add to dashboard Cite

Background Trismus is a common adverse effect in patients with head and neck cancer. Patients have a limitation of mouth opening (< 35mm), which can compromise maxillomandibular function. The cancer treatment itself can lead to its emergence, with surgery and radiotherapy being the most involved. This study aimed to evaluate the efficacy of a PBMT protocol for treating and reducing the severity of trismus in patients undergoing radiotherapy for head and neck cancer. Material and Methods Sixteen patients who had a mouth opening < 35mm and were undergoing RT were included. The patients were evaluated daily before and after the PBMT application, measuring mouth opening and performing pain scores for the masticatory muscles using the VAS scale. We used the infrared laser (~ 808nm) extraoral, 0.1W power, 3J energy, 30s (30.61/cm2) per point, applied to temporalis anterior, masseter, and TMJ muscles. We used one intraoral point with the same wavelength and energy density as the others for the medial pterygoid muscle. Results The mean mouth opening of the patients increased by more than 7 mm throughout the treatment. The pain scores on the initial days showed an immediate reduction after PBMT on the ipsilateral side in the muscles and TMJ. Throughout PBMT applications, there was a significant reduction in pain scores in all muscles and the TMJ. The radiation dose of all patients was above 40Gy, which is the threshold dose for the risk of developing trismus. PBMT in patients with mouth opening < 35mm has been responsible for long-term improvement in mouth opening limitation and pain during mouth opening. Conclusion It is suggested that PBMT helps in pain control by anti-inflammatory muscle pathways. Further studies are needed to evaluate the preventive capacity of this or other PBMT protocols in trismus related to RT of HNC.

show abstract

Photobiomodulation with Low-Level Laser in the Treatment of Trismus After Radiotherapy: A Case Report

Cited by 5 publications

References 10 publications

Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022

Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022

Orofacial Myofunctional Therapy with and without Photobiomodulation in the Rehabilitation of Radiation-Induced Trismus: Case Series

The role of Photobiomodulation therapy in the treatment of head and neck radiotherapy-related trismus: a single-arm clinical trial

Contact Info

Product

Resources

About