Photobiomodulation reduces the impact of radiotherapy on oral health-related quality of life due to mucositis-related symptoms in head and neck cancer patients

Martins, Allisson Filipe Lopes; Morais, Marília Oliveira; Sousa-Neto, Sebastião Silvério; Jesus, Ana Paula Gonçalves de; Nogueira, Túlio Eduardo; Valadares, Marize Campos; Júnior, Ruffo de Freitas; Batista, Aline Carvalho; Leles, Cláudio Rodrigues

doi:10.1007/s10103-020-03167-z

Cited by 28 publications

(22 citation statements)

References 33 publications

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“…The variability of QoL is directly associated with cancer treatment toxicities alterations in swallowing, chewing, saliva changes, taste and especially OM-related pain [38]. Our study shows better social-emotional QoL in those treated with PBM, which could be explained by the positive impact in OM symptoms attenuation speci cally decreased pain levels [34,39].…”

Section: Discussionmentioning

confidence: 58%

“…Oral and oropharyngeal cancer is associated with reduced QoL due to the effects of primary tumor and treatment side effects impairing patient's daily functional and self-image [10,38]. Worsening levels of general QoL were observed at the end of the treatment, as reported in previously published studies [33,34,38,39]. The variability of QoL is directly associated with cancer treatment toxicities alterations in swallowing, chewing, saliva changes, taste and especially OM-related pain [38].…”

Section: Discussionmentioning

confidence: 80%

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Extraoral Photobiomodulation for Prevention of Oral and Oropharyngeal Mucositis in Head and Neck Cancer Patients: Interim Analysis of A Randomized, Double-Blind, Clinical Trial

Kauark‐Fontes

Migliorati

Epstein

et al. 2021

Preprint

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PurposeTo assess the safety and efficacy of prophylactic extraoral photobiomodulation (PBM) for the prevention of oral and oropharyngeal mucositis (OM) on clinical outcomes and survival in patients with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC).MethodsOOPSCC patients who received radiotherapy (RT) were prospectively randomized to two groups: prophylactic extraoral PBM and placebo. OM grade (NCI), pain (VAS), analgesia, and anti-inflammatory prescriptions were assessed weekly. Quality of life questionnaires (QoL) were performed at the first and last day of RT. Following RT, participants were evaluated quarterly for oncological outcomes follow-up.Results55 patients met the inclusion criteria. The first occurrence of OM was observed at week 1, for the placebo group (p = 0.014). Later OM onset and severity was observed for the PBM group, with first occurrence at week 2 (p = 0.009). No difference in severe OM incidence was observed (p > 0.05). Lower mean pain score was noted at week 7 for the PBM group (2.1) compared to placebo group (4.5) (p = 0.009). Less analgesics (week 3; p = 0.009/week 7; p = 0.02) and anti-inflammatory prescription (week 5; p = 0.0346) were observed for the PBM group. Better QoL scores were observed for the PBM group at last day of RT (p = 0.0034). No difference in overall survival among groups, was observed in one year of follow-up (p = 0.889).ConclusionProphylactic extraoral PBM can delay OM onset, reduce pain, as well as reduced analgesic and anti-inflammatory prescription requirements. Extraoral PBM was associated with better QoL. There was no evidence of PBM impact on oncological outcomes. TRN:RBR-4w4swx (date of registration: 01/20/2020)

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 80%

Extraoral Photobiomodulation for Prevention of Oral and Oropharyngeal Mucositis in Head and Neck Cancer Patients: Interim Analysis of A Randomized, Double-Blind, Clinical Trial

Kauark‐Fontes

Migliorati

Epstein

et al. 2021

Preprint

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“…It is imperative that an intervention used to support cancer patients during therapy does not adversely affect tumor behavior, or tumor response to treatment [ 5 , 25 , 28 , 37 , 39 ]. Data about PBM impact on tumor activity and oncological treatment response based on in vitro studies are conflicting.…”

Section: Discussionmentioning

confidence: 99%

Extraoral photobiomodulation for prevention of oral and oropharyngeal mucositis in head and neck cancer patients: interim analysis of a randomized, double-blind, clinical trial

Kauark‐Fontes

Migliorati

Epstein

et al. 2021

Support Care Cancer

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“…77 Other benefits of PBM include its cost-effectiveness and positive effects on quality of life. 78,79 However, its use is limited to patients with access to facilities with PBM equipment and trained medical staff. Furthermore, long-term safety data are lacking, especially with respect to tumorigenesis and metastasis.…”

Section: Paliferminmentioning

confidence: 99%

Noninvasive Systemic Modalities for Prevention of Head and Neck Radiation-Associated Soft Tissue Injury: A Narrative Review

Kim

Rubenstein

Chu

et al. 2022

J Reconstr Microsurg

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Background Radiation-associated soft tissue injury is a potentially devastating complication for head and neck cancer patients. The damage can range from minor sequelae such as xerostomia, which requires frequent daily maintenance, to destructive degenerative processes such as osteoradionecrosis, which can contribute to flap failure and delay or reverse oral rehabilitation. Despite the need for effective radioprotectants, the literature remains sparse, primarily focused on interventions beyond the surgeon's control, such as maintenance of good oral hygiene or modulation of radiation dose. Methods This narrative review aggregates and explores noninvasive, systemic treatment modalities for prevention or amelioration of radiation-associated soft tissue injury. Results We highlighted nine modalities with the most clinical potential, which include amifostine, melatonin, palifermin, hyperbaric oxygen therapy, photobiomodulation, pentoxifylline–tocopherol–clodronate, pravastatin, transforming growth factor-β modulators, and deferoxamine, and reviewed the benefits and limitations of each modality. Unfortunately, none of these modalities are supported by strong evidence for prophylaxis against radiation-associated soft tissue injury. Conclusion While we cannot endorse any of these nine modalities for immediate clinical use, they may prove fruitful areas for further investigation.

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Photobiomodulation reduces the impact of radiotherapy on oral health-related quality of life due to mucositis-related symptoms in head and neck cancer patients

Cited by 28 publications

References 33 publications

Extraoral Photobiomodulation for Prevention of Oral and Oropharyngeal Mucositis in Head and Neck Cancer Patients: Interim Analysis of A Randomized, Double-Blind, Clinical Trial

Extraoral Photobiomodulation for Prevention of Oral and Oropharyngeal Mucositis in Head and Neck Cancer Patients: Interim Analysis of A Randomized, Double-Blind, Clinical Trial

Extraoral photobiomodulation for prevention of oral and oropharyngeal mucositis in head and neck cancer patients: interim analysis of a randomized, double-blind, clinical trial

Noninvasive Systemic Modalities for Prevention of Head and Neck Radiation-Associated Soft Tissue Injury: A Narrative Review

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