Corti Luigi, Chiarion-Sileni Vanna, Aversa Savina, Ponzoni Alberto, D'Arcais Raimondo, Pagnutti Stefano, Fiore Davide, Sotti Guido
Radiotherapy Department, Istituto Oncologico Veneto, University of Padua, Italy.
Photomed Laser Surg. 2006 Apr;24(2):207-13. doi: 10.1089/pho.2006.24.207.
The aim of this study was to assess the clinical effectiveness of phototherapy with noncoherent light in the alleviation of chemotherapy-induced mucositis in patients with metastatic cancer.
Mucositis occurs in more than 40% of chemotherapy-treated patients, significantly reducing the quality of their lives. Many different interventions have been evaluated to reduce oral mucositis. Recently, good results have been achieved by phototherapy with photoradiation, a technique which has virtually no side effects. Some clinical results seem to indicate that also phototherapy through noncoherent light emissions which can be produced by less expensive light sources such as light-emitting diodes (LEDs) may be effective. However, until now, no studies have been available on this subject.
Twelve patients, aged from 34 to 82, selected on the basis of a diagnosis of chemotherapy-induced oral mucositis, were treated intra-orally through a noncoherent LED emission, wavelength 645 +/- 15 nm, 7.8 mW, fluence 0.99 J/cm(2), three times a day for 1 week. Mucositis was scored daily using the Daily Mucositis Index (DMI), a scale that evaluates the disease evolution through 16 different items. The primary end-point assessed was the time to recovery, from the start of LED treatment, compared to a nonrandomized control group of 12 patients with comparable stomatitis.
The median healing time, expressed as the DMI decrease, was 1.7 (range 1-2.8) and, in seven LED-treated patients, was shorter than in the control group. The healing rate (measured as the ratio of the DMIs) increased from 117% to 164%.
This pilot study shows that LED treatment is safe and capable of reducing the duration of chemotherapy-induced mucositis. This result needs to be confirmed in an adequate phase III study.
本研究旨在评估非相干光光疗在缓解转移性癌症患者化疗引起的口腔黏膜炎方面的临床疗效。
超过40%接受化疗的患者会发生口腔黏膜炎,这显著降低了他们的生活质量。人们已经评估了许多不同的干预措施来减少口腔黏膜炎。最近,光辐射光疗取得了良好效果,该技术几乎没有副作用。一些临床结果似乎表明,通过非相干光发射进行光疗(这种光可由发光二极管等较便宜的光源产生)也可能有效。然而,迄今为止,尚未有关于该主题的研究。
选取12例年龄在34至82岁之间、诊断为化疗引起的口腔黏膜炎的患者,通过波长为645±15nm、功率为7.8mW、能量密度为0.99J/cm²的非相干发光二极管进行口腔内治疗,每天3次,持续1周。每天使用每日口腔黏膜炎指数(DMI)对口腔黏膜炎进行评分,该量表通过16个不同项目评估疾病进展。评估的主要终点是从开始发光二极管治疗起至恢复的时间,并与12例患有类似口腔炎的非随机对照组患者进行比较。
以DMI降低表示的中位愈合时间为1.7(范围1 - 2.8),7例接受发光二极管治疗的患者的愈合时间短于对照组。愈合率(以DMI的比值衡量)从117%提高到164%。
这项初步研究表明,发光二极管治疗是安全的,并且能够缩短化疗引起的口腔黏膜炎的持续时间。这一结果需要在充分的III期研究中得到证实。