Long-term survival of a randomized phase III trial of head and neck cancer patients receiving concurrent chemoradiation therapy with or without low-level laser therapy (LLLT) to prevent oral mucositis

Antunes, Héliton Spíndola; Herchenhorn, Daniel; Small, I. A.; Araújo, Carlos; Viégas, Célia M.; Ramos, Gabriela de Assis; Dias, Fernando Luiz; Ferreira, Carlos Gil

doi:10.1016/j.oraloncology.2017.05.018

Cited by 99 publications

(81 citation statements)

References 16 publications

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“…Our study supports these observations in terms of noninferiority of PBM vs no PBM for overall survival, diseasefree survival, and time of local recurrence interestingly, in analogy with Antunes et al [26] Our study has some strong aspects. Firstly, it has been done on a relatively large number (361) of patients with a median follow-up of 9.3 years.…”

Section: Discussionsupporting

confidence: 91%

“…Recently, Brandão et al [24] reported on 152 patients with advanced oral squamous cell carcinoma who received both PBM Fig. 3 Progression-free survival [25] has been recently updated with respect to long-term survival [26]. With a median follow-up of 41 months, the patients who received PBM had a statistically significant better complete response to treatment and increased progression-free survival as well as a tendency for better overall survival.…”

Section: Discussionmentioning

confidence: 99%

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Retrospective evaluation of the safety of low-level laser therapy/photobiomodulation in patients with head/neck cancer

Genot-Klastersky

Paesmans

Ameye

et al. 2019

Support Care Cancer

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Background The standard therapeutic approach for locally advanced head and neck cancer is optimal use of radiation therapy with or without concomitant chemotherapy. The most common and distressing acute complication of such therapies is oral/pharyngeal mucositis that may be associated with severe morbidity and can interfere with the planned administration of therapy. Methods We have identified all patients diagnosed with head/neck cancer between 2005 and 2009, having received radiotherapy with or without cisplatin-based chemotherapy. Radiotherapy consisted of intensity-modulated radiation therapy (IMRT) in all patients. In patients with grade > 2 mucositis, photobiomodulation (PBM) consisted of three sessions of low-level laser irradiation weekly, in accordance with recently published recommendations for PBM. Patients who did not receive PBM were those for whom that approach was not requested by the radiotherapists and those who declined it. Results Two hundred twenty-two patients (62%) received PBM and 139 did not (39%). The patient's characteristics were equally distributed between the two groups. For overall survival, time to local recurrence, and progression-free survival, there was no statistical evidence for a difference in prognosis between patients with and without PBM. In a multivariate analysis, after adjusting for known prognostic factors, we found no statistical evidence that PBM was related to overall survival, progression-free survival, or local recurrence. Conclusions Our results show evidence of no effect of PBM upon overall survival, time to local recurrences, and disease-free survival of patients with head and neck cancer treated with radiotherapy with/without chemotherapy.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Retrospective evaluation of the safety of low-level laser therapy/photobiomodulation in patients with head/neck cancer

Genot-Klastersky

Paesmans

Ameye

et al. 2019

Support Care Cancer

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“…Initial clinical studies show promising results in the reduction of pain and improvement of the quality of life after LLLT treatment (7–12). However, no guidelines for LLLT delivery in HNSCC patients undergoing RT have been established so far partly because the molecular basis on several cell types is not fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

Low-Level Laser Therapy Stimulates Proliferation in Head and Neck Squamous Cell Carcinoma Cells

2018

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Objectives: Low-level laser therapy (LLLT) is a promising non-invasive treatment option for oropharyngeal mucositis, which is a common side effect of many oncological treatments. LLLT is known for its wound healing properties due to the stimulation of cellular processes, such as proliferation, migration and differentiation. Controversy exists on the possible stimulatory effect of LLLT on head and neck cancer (HNSCC) cells in patients treated with radiotherapy. The aim of this study was to evaluate the biostimulatory effect together with the underlying mechanisms of LLLT on HNSCC cancer cells and normal epithelial cells.Materials and methods: HNSCC cell lines (SCC154, SQD9, and SCC61) and human tonsil epithelial cells were exposed to a Gallium-Aluminum-Arsenide diode laser (830 nm, 150 mW) with energy densities of 0, 1, and 2 J/cm2. The proliferation potential of the cells was assessed by Sulforhodamine B assay, immunoblotting (mitogenic pathways), immunocytochemistry (Ki67), and flow cytometry (PI cell cycle staining).Results: Cell proliferation was increased in HNSCC cell lines after laser irradiation with 1 J/cm2, whereas no significant increase was seen after laser irradiation with 2 J/cm2. In contrast, no effect on cell proliferation was seen in the human tonsil epithelial cells after laser irradiation with any of the energy densities. The increased proliferation was associated with elevated levels of pAKT, pERK, and Ki67 protein expression and cell cycle progression.Conclusion: Our results show that LLLT increases cell proliferation in a dose-dependent manner in HNSCC cells but not in normal epithelial tonsil cells. These results suggest that LLLT has to be used with caution when treating oropharyngeal mucositis in HNSCC patients since tumor cells present in the LLLT irradiation field could be triggered by LLLT.

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“…Several studies have reported the benefits of LLLT in oral mucositis and suggested that the combination of infrared and red lasers enhances tissue repair and reduces pain, the need for painkillers, and additional hospital costs 15,16 . Although there are few studies using LLLT as a treatment for PV, some have already reported improvement in the healing of oral lesions and the analgesic effect, so it can be used in addition to drug treatments 9,17,18 .…”

Section: Discussionmentioning

confidence: 99%

Oral management of pemphigus vulgaris in the intensive care unit

Prá

Tristão

Matias

et al. 2020

Special Care in Dentistry

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Pemphigus vulgaris (PV) is a rare and potentially lethal autoimmune disease that affects the skin and mucous membranes. Injuries caused by the disease cause pain, risk of infection, and other complications that result in a high mortality rate. Frequently, management of the PV requires intensive care and a multidisciplinary approach. Oral lesions of PV are usually the first clinical signs of the disease and the last lesions to heal, requiring treatment by a specialized dental team. The aim of this study was to report two clinical cases of PV with involvement of the oral mucosa. The patients were admitted to an intensive care unit, and underwent multidisciplinary management of their condition along with low-level laser therapy. Both cases demonstrated the importance of specialized dental care in improving the quality of life of patients with PV.

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Long-term survival of a randomized phase III trial of head and neck cancer patients receiving concurrent chemoradiation therapy with or without low-level laser therapy (LLLT) to prevent oral mucositis

Cited by 99 publications

References 16 publications

Retrospective evaluation of the safety of low-level laser therapy/photobiomodulation in patients with head/neck cancer

Retrospective evaluation of the safety of low-level laser therapy/photobiomodulation in patients with head/neck cancer

Low-Level Laser Therapy Stimulates Proliferation in Head and Neck Squamous Cell Carcinoma Cells

Oral management of pemphigus vulgaris in the intensive care unit

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