Abstract
Background: Oral mucositis (OM) is an inflammation of the oral mucosa due to cancer therapy that compromises the patient’s quality of life. Laser Doppler flowmetry (LDF) is a non-invasive method to monitor microvascular blood flow (BF) in real-time. Purpose: Develop a method to evaluate BF in the genian region cheek in patients undergoing chemotherapy by LDF and compare the degrees of OM and pain with evaluation of BF. Material and methods: Evaluation of OM was performed using the World Health Organization (WHO) and Oral Mucositis Assessment Scale (OMAS) scales and the visual analog scale for pain evaluation. For flowmetry analysis, a laser Doppler flowmeter (moorVMSTM™, 780 nm wavelength and VP3 probe), fixed by an acrylic resin support was used; VP3 probe was positioned on the genian region and the patient’s head was stabilized with a neck pillow for an accurate measurement. The Wilcoxon test was used to compare the flowmetry results at the studied times. The Pearson correlation coefficient was used to evaluate relationships between BF and the WHO, OMAS and visual analog scales. Results: Eleven patients of both sexes, aged between 30 and 78 years, with OM were included. An increase in cutaneous BF was observed at the initial times of OM, with progressive reduction during the chemotherapy cycle. There was a statistical difference (p<0.05) between time point T0 (first consultation) and time point T6 (last consultation). Conclusion: The method developed in this pilot study is effective, reliable, and reproducible, and allows the evaluation of BF dynamics in the genian region using LDF of patients undergoing chemotherapy at risk of developing OM.
Highlights
Oral mucositis (OM) is an inflammatory condition induced by chemotherapy (CT) and radiotherapy (RT) that consists of inflammation of the oral mucosa which can cause pain and ulcerations, interfere with quality of life, and can facilitate opportunistic infections.[1,2]
blood flow (BF) variations during CT The average BF values [F (%)] determined during CT are presented. (Figure 1) Evaluation of the average BF variation in the analyzed time points compared to T0 [(F (%) = 100)] indicated that there was an increase in flow at T1, T2, and T3
There was a positive correlation between the Oral Mucositis Assessment Scale (OMAS) (p=0.009), World Health Organization (WHO) (p= 0.031), and flujo sanguíneo microvascular (FS) [F(AU)] scales; namely, the more BF increased, the more OM evolved with proportional severity
Summary
Oral mucositis (OM) is an inflammatory condition induced by chemotherapy (CT) and radiotherapy (RT) that consists of inflammation of the oral mucosa which can cause pain and ulcerations, interfere with quality of life, and can facilitate opportunistic infections.[1,2] Alterations in oral microcirculation (MC) can develop immediately following CT. LDF is based on BF measurement by laser radiation interaction, which is generated by a helium-neon laser with a wavelength of 632.8nm, or by diode lasers releasing waves between 780 and 820nm, with power outputs between 1 and 3 mW.[6-10] This technique has been used previously to assess oral MC in patients subjected to CT that underwent low power laser therapy (LPL) for the treatment of OM, showing no significant changes in oral blood perfusion observed as a result of the LPL effect over the OM lesions repair.[11]. Purpose: Develop a method to evaluate BF in the genian region cheek in patients undergoing chemotherapy by LDF and compare the degrees of OM and pain with evaluation of BF. Conclusion: The method developed in this pilot study is effective, reliable, and reproducible, and allows the evaluation of BF dynamics in the genian region using LDF of patients undergoing chemotherapy at risk of developing OM
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