Patterns of oral mucositis in advanced oral squamous cell carcinoma patients managed with prophylactic photobiomodulation therapy-insights for future protocol development.


Journal

Lasers in medical science
ISSN: 1435-604X
Titre abrégé: Lasers Med Sci
Pays: England
ID NLM: 8611515

Informations de publication

Date de publication:
Mar 2021
Historique:
received: 07 05 2019
accepted: 28 06 2020
pubmed: 7 7 2020
medline: 26 2 2021
entrez: 7 7 2020
Statut: ppublish

Résumé

To characterize oral sites affected by radiation-induced oral mucositis (OM) and related clinical outcomes in oral cancer patients subjected to prophylactic photobiomodulation therapy (PBMT). This study included advanced oral squamous cell carcinoma (OSCC) patients treated with prophylactic PBMT for OM. The site distribution of OM, OM grading (CTCAE NCI, Version 4.0, 2010), OM-related pain (VAS), analgesic protocol (WHO Analgesic Ladder), and use of enteral nutrition were evaluated weekly during treatment. Data analysis was performed using descriptive statistics expressed as median values and percentages. A total of 145 OSCC patients were included. OM most frequently affected the lateral border of the tongue (44.1%), buccal mucosa (37.2%), and labial mucosa (33.8%). Keratinized oral mucosa sites, including the tongue dorsum (6.21%), retromolar trigone (8.3%), and hard palate (2.76%), were less frequently affected. Peak OM scores were observed at weeks 5, 6, and 7, with severe OM (NCI grades 3 and 4) rates of 11%, 20%, and 25%, respectively. The cumulative occurrence of severe OM was 23%, which developed as early as week 3 and as late as week 7. The highest mean value of OM-related pain (2.7) was observed at the sixth week, and 13.8% of the patients required feeding support. This study showed, compared with studies that did not provide PBMT, reduced severity of mucositis, reduced pain and analgesic use, and reduced tube feeding in patients treated with PBMT. OM involving keratinized and non-keratinized surfaces should be included in the prophylactic PBMT to reduce severe OM in future studies.

Identifiants

pubmed: 32627112
doi: 10.1007/s10103-020-03091-2
pii: 10.1007/s10103-020-03091-2
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

429-436

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Auteurs

Mariana de Pauli Paglioni (M)

Oral Diagnosis Departament, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.

Karina Morais Faria (KM)

Dental Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), São Paulo, Brazil. karinamoraiskmf@gmail.com.

Natália Rangel Palmier (NR)

Oral Diagnosis Departament, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.

Ana Carolina Prado-Ribeiro (AC)

Oral Diagnosis Departament, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
Dental Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), São Paulo, Brazil.

Reinaldo Brito E Dias (RB)

Department of Bucomaxillofacial Prosthesis, University of São Paulo Dental School, São Paulo, Brazil.

Henrique da Graça Pinto (H)

Department of Bucomaxillofacial Prosthesis, University of São Paulo Dental School, São Paulo, Brazil.

Nathaniel Simon Treister (NS)

Division of Oral Medicine and Dentistry, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA, USA.

Joel B Epstein (JB)

City of Hope National Medical Center, Duarte, CA, USA.
Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Hospital System, Los Angeles, CA, USA.

César Augusto Migliorati (CA)

College of Dentistry, University of Florida, Gainesville, FL, USA.

Alan Roger Santos-Silva (AR)

Oral Diagnosis Departament, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.

Thais Bianca Brandão (TB)

Oral Diagnosis Departament, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
Dental Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), São Paulo, Brazil.

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