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低能量激光治疗放化疗相关性口腔黏膜炎的疗效观察:A.C. 卡梅戈医院的初步结果。

Management of chemo- and radiotherapy induced oral mucositis with low-energy laser: initial results of A.C. Camargo Hospital.

机构信息

Department of Stomatology, A.C. Camargo Hospital.

出版信息

J Appl Oral Sci. 2003 Dec;11(4):337-41. doi: 10.1590/s1678-77572003000400012.

DOI:10.1590/s1678-77572003000400012
PMID:21394411
Abstract

Background. Oral mucositis is a common complication of some malignancies treatment, causing therapeutic modifications due to patient's debilitation, which often interferes with the prognosis of the disease. Many attempts have been made to find an optimal treatment or preventive method to minimize the severity of oral mucositis. Several studies have shown good results with the use of low-energy laser, with the aim of accelerating the process of wound healing and promoting pain relief. Methods. Patients (n=18) who developed oral mucositis during chemotherapy and/or radiotherapy were submitted to low-energy laser applications until cessation of symptoms. Mucositis severity was scored by an oral mucositis scale based on clinical features and by an oral toxicity scale from the National Cancer Institute based on the ability to swallow; pain severity was scored by subjects on a visual analogue scale before and after the applications. Results. Immediate pain relief was achieved in 66.6% of the patients after the first application. Based on the functional scale, mucositis grade III (not capable to eat solids) was reduced in 42.85% of the cases. According to the scale based on the clinical features, mucositis grade IV (ulcerative lesions) was reduced in 75% of the patients that presented this grade of mucositis at the beginning of laser therapy. Conclusions. Low-energy laser was well-tolerated and showed beneficial effects on the management of oral mucositis, improving the quality of life during the oncologic treatment.

摘要

背景

口腔黏膜炎是某些恶性肿瘤治疗的常见并发症,导致因患者虚弱而进行治疗调整,这往往会影响疾病的预后。人们已经尝试了许多方法来寻找最佳的治疗或预防方法,以尽量减少口腔黏膜炎的严重程度。多项研究表明,低能量激光的使用效果良好,其目的是加速伤口愈合过程并促进疼痛缓解。

方法

在化疗和/或放疗期间发生口腔黏膜炎的患者(n=18)接受低能量激光治疗,直至症状消失。根据基于临床特征的口腔黏膜炎量表和基于吞咽能力的国家癌症研究所口腔毒性量表对黏膜炎严重程度进行评分;在应用前后,患者通过视觉模拟量表对疼痛严重程度进行评分。

结果

首次应用后,66.6%的患者立即缓解疼痛。根据功能量表,3 级(无法进食固体食物)黏膜炎的病例中有 42.85%得到缓解。根据开始激光治疗时处于 4 级(溃疡性病变)的患者的临床特征量表,75%的患者口腔黏膜炎得到缓解。

结论

低能量激光耐受性良好,对口腔黏膜炎的管理有有益效果,可提高肿瘤治疗期间的生活质量。

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