Chermetz Maddalena, Gobbo Margherita, Ronfani Luca, Ottaviani Giulia, Zanazzo Giulio A, Verzegnassi Federico, Treister Nathaniel S, Di Lenarda Roberto, Biasotto Matteo, Zacchigna Serena
Division of Oral Medicine and Pathology, Department of Dental Science, University of Trieste, Trieste, Italy.
Int J Paediatr Dent. 2014 Nov;24(6):441-9. doi: 10.1111/ipd.12090. Epub 2013 Dec 25.
Oral mucositis is a debilitating side effect of chemotherapy. Laser therapy has recently demonstrated efficacy in the management of oral mucositis (OM).
This prospective study was conducted to evaluate the efficacy of class IV laser therapy in patients affected by OM.
Eighteen onco-haematological paediatric patients receiving chemotherapy and/or haematopoietic stem cell transplantation, prior to total body irradiation, affected by OM, were enrolled in this study. Patients were treated with class IV laser therapy for four consecutive days; the assessment of OM was performed through WHO Oral Mucositis Grading Objective Scale, and pain was evaluated through visual analogue scale. Patients completed a validated questionnaire, and photographs of lesions were taken during each session. Patients were re-evaluated 11 days after the first day of laser therapy.
All patients demonstrated improvement in pain sensation, and all mucositis was fully resolved at the 11-day follow-up visit, with no apparent side effects. Laser therapy was well tolerated with remarkable reduction in pain associated with oral mucositis after 1-2 days of laser therapy.
Given class IV laser therapy appears to be safe, non-invasive, and potentially effective, prospective, randomized, controlled trials are necessary to further assess efficacy and to determine optimal treatment parameters.
口腔黏膜炎是化疗的一种使人衰弱的副作用。激光疗法最近已证明在口腔黏膜炎(OM)的治疗中具有疗效。
进行这项前瞻性研究以评估IV类激光疗法对受OM影响患者的疗效。
18名接受化疗和/或造血干细胞移植、在全身照射前受OM影响的儿科肿瘤血液学患者被纳入本研究。患者连续四天接受IV类激光疗法治疗;通过世界卫生组织口腔黏膜炎分级客观量表对OM进行评估,并通过视觉模拟量表评估疼痛。患者完成一份经过验证的问卷,并在每次治疗期间拍摄病变照片。在激光治疗第一天后的11天对患者进行重新评估。
所有患者的疼痛感均有改善,在11天的随访中所有黏膜炎均完全消退,且无明显副作用。激光疗法耐受性良好,在激光治疗1 - 2天后与口腔黏膜炎相关的疼痛显著减轻。
鉴于IV类激光疗法似乎安全、无创且可能有效,有必要进行前瞻性、随机、对照试验以进一步评估疗效并确定最佳治疗参数。