Impact of low-level laser therapy on hyposalivation, salivary pH, and quality of life in head and neck cancer patients post-radiotherapy

Abstract

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.

Current alternatives in the prevention and treatment of xerostomia in cancer therapy

“…The stimulation of salivary secretion by acupuncture showed promising results in patients who are undergoing or will undergo head and neck RT [27]. Among the benefits of acupuncture in patients with xerostomia are increased salivary flow and improvement in eating, speech and sleep quality, providing better QoL to these patients [41,42].…”

Impact of radiotherapy on mandibular bone: A retrospective study of digital panoramic radiographs

“…Advanced cases, in contrast, commonly require chemotherapy and/or surgery. 1,2 The deleterious effects of radiation on bone tissue have been closely examined with the goal of elucidating the mechanisms leading to osteoradionecrosis, 3 but conclusive evidence is not yet available. Histomorphometric analysis of biopsies has proven to be a valuable laboratory method to evaluate bone quality, while clinical methods include digital radiography, ultrasonography, and computed tomography.…”

Efeito de uma formulação farmacêutica de pilocarpina em pacientes com xerostomia: estudo randomizado, controlado, duplo-cego e <i>crossover</i>

“…Não houve diferença significante ao comparar os tratamentos, entretanto, verificou-se uma toxicidade menor para os pacientes que receberam acupuntura Wolff et al (2012). ao avaliarem, por meio de um estudo duplocego, a eletroestimulação com o Saliwell GenNarino ® , uma placa dental com dispositivo que produz excitação elétrica na mucosa oral da região de terceiro molar inferior, onde o estímulo é direcionado às glândulas submandibulares e sublinguais pelo nervo lingual, obtiveram a produção aumentada de saliva por até onze meses de uso Palma et al (2017). realizaram um estudo para avaliar o efeito da terapia a laser de baixa intensidade sobre a hipossalivação, pH salivar e QV em pacientes com câncer de cabeça e pescoço pós-radioterapia.…”