Abstract
This study evaluated the efficacy of low-level laser therapy (LLLT) and aluminum hydroxide (AH) in the prevention of oral mucositis (OM). A prospective, comparative and non-randomized study was conducted with 25 patients with head and neck cancer subjected to radiotherapy (RT) or radiochemotherapy (RCT). Twelve patients received LLLT (830 nm, 15 mW, 12 J/cm²) daily from the 1st day until the end of RT before each sessions during 5 consecutive days, and the other 13 patients received AH 310 mg/5 mL, 4 times/day, also throughout the duration of RT, including weekends. OM was measured using an oral toxicity scale (OTS) and pain was measured using the visual analogue scale (VAS). EORTC questionnaires were administered to the evaluate impact of OM on quality of life. The LLLT group showed lower mean OTS and VAS scores during the course of RT. A significant difference was observed in pain evaluation in the 13th RT session (p=0.036). In both groups, no interruption of RT was needed. The prophylactic use of both treatments proposed in this study seems to reduce the incidence of severe OM lesions. However, the LLLT was more effective in delaying the appearance of severe OM.
Highlights
Oral mucositis (OM) is a common complication in patients subjected to chemotherapy (CT) and/or radiotherapy (RT), affecting approximately 80% of patients undergoing RT for treatment of tumors of the head and neck [1]
The present study evaluated the capacity of level laser therapy (LLLT) and prophylactic aluminum hydroxide (AH) in preventing or delaying the appearance of CT- and RT-induced OM, and the pain deriving from the lesions
Data referring to OM severe grades as defined by the National Cancer Institute (NCI), time of appearance of severe OM, severe pain according to the visual analogue scale (VAS), swallowing capacity according to the NCI and quality of life according to the EORTC’s questionnaires, were analyzed statistically by the MannWhitney and Wilcoxon tests (α=0.05)
Summary
Oral mucositis (OM) is a common complication in patients subjected to chemotherapy (CT) and/or radiotherapy (RT), affecting approximately 80% of patients undergoing RT for treatment of tumors of the head and neck [1]. Double-blind, randomized, prospective studies [6,7,8] have evaluated patients subjected to RT in the region of the head and neck in which the study group was treated with sucralfate and the control group received placebo. Barasch et al [11] and Cowen et al [12] conducted double-blind and randomized studies in patients undergoing bone marrow transplant In both studies, the patients were divided into 2 groups: the study group received LLLT to evaluate its effect on the prevention of OM and the control group received placebo. The literature presents effective results of LLLT in the reduction of OM severity, the scarcity of studies with patients subjected to RT in the region of the head and neck, and the morbidity of the treatment have stimulated the development of the present investigation. The impact of OM on the ability to swallow and the patients’ life quality were evaluated
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