Genot-Klastersky M T, Klastersky J, Awada F, Awada A, Crombez P, Martinez M D, Jaivenois M F, Delmelle M, Vogt G, Meuleman N, Paesmans M
Department of Medicine, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, Rue Héger-Bordet, 1, Brussels, 1000, Belgium.
Support Care Cancer. 2008 Dec;16(12):1381-7. doi: 10.1007/s00520-008-0439-8. Epub 2008 May 6.
Low-energy laser (LEL) treatment has been suggested as an effective and safe method to prevent and/or treat oral mucositis induced by chemotherapy and/or radiotherapy; however, it has not gained wide acceptance so far.
We conducted two clinical trials testing the LEL technique: firstly, as a secondary prevention in patients with various solid tumors treated with chemotherapy who all developed severe mucositis after a previous identical chemotherapy and, secondly, as therapeutic intervention (compared to sham illumination in a randomized way) in patients with hematological tumors receiving intensive chemotherapy and having developed low-grade oral mucositis.
We entered 26 eligible patients in the first study and 36 were randomized in the second study. The success rate was 81% (95%CI = 61-93%) when LEL was given as a preventive treatment. In the second study, in patients with existing lesions, the therapeutic success rate was 83% (95%CI = 59-96%), which was significantly different from the success rate reached in the sham-treated patients (11%; 95%CI = 1-35%); the time to development of grade 3 mucositis was also significantly shorter in the sham-treated patients (p < 0.001).
Our results strongly support the already available literature, suggesting that LEL is an effective and safe approach to prevent or treat oral mucositis resulting from cancer chemotherapy.
低能量激光(LEL)治疗已被认为是预防和/或治疗化疗和/或放疗引起的口腔黏膜炎的一种有效且安全的方法;然而,到目前为止它尚未得到广泛认可。
我们进行了两项测试LEL技术的临床试验:首先,对接受化疗的各种实体瘤患者进行二级预防,这些患者在之前相同的化疗后均出现了严重的黏膜炎;其次,对接受强化化疗并已发展为低度口腔黏膜炎的血液系统肿瘤患者进行治疗干预(与假照射进行随机对照)。
第一项研究纳入了26例符合条件的患者,第二项研究中有36例患者被随机分组。当LEL作为预防性治疗时,成功率为81%(95%CI = 61 - 93%)。在第二项研究中,对于已有病变的患者,治疗成功率为83%(95%CI = 59 - 96%),这与假治疗患者的成功率(11%;95%CI = 1 - 35%)有显著差异;假治疗患者发生3级黏膜炎的时间也明显更短(p < 0.001)。
我们的结果有力地支持了现有文献,表明LEL是预防或治疗癌症化疗引起的口腔黏膜炎的一种有效且安全的方法。