Rozza-de-Menezes Rafaela, Souza Paulo H C, Westphalen Fernando H, Ignácio Sérgio A, Moysés Simone T, Sarmento Viviane A
Oral Health Prev Dent. 2018;16(6):549-555. doi: 10.3290/j.ohpd.a41659.
This study evaluated the efficacy of four methods to prevent chemotherapy-induced oral mucositis (OM) in patients with solid tumors (ST). In addition, the behaviour of OM was investigated in these oncological patients.
Forty-eight patients, aged 27-84, were randomly allocated to different groups from the first day of chemotherapy (CT), in the following sequence: group 1: intensive oral care programme (IOCP); group 2: 0.12% chlorhexidine mouthrinse; group 3: 0.03% triclosan mouthrinse; group 4: low-level laser therapy (LLLT). Oral mucositis was evaluated on the 7th and 14th days by means of the Oral Mucositis Assessment Scale (OMAS).
Thirty-one (64.5%) patients developed OM in the first cycle of CT and the pain was significantly associated with OM severity (p < 0.0001). The statistically significantly worst OMAS score was found for the lips and buccal mucosa (p < 0.0001). Despite a lack of statistical significance, IOCP and LLLT notably demonstrated potential effects to prevent OM in patients who presented with only oral erythema (75%) and lower peak of severity during the follow up, respectively.
Improved oral care awareness is needed in patients undergoing 5'fluorouracil and doxorubicin, mainly to avoid pain caused by oral mucositis. Oral mucositis was more prevalent and aggressive in oral sites exposed to chronic trauma. The IOCP and LLLT approaches showed positive results to prevent oral mucositis and should be further investigated in similar and larger samples.
本研究评估了四种方法预防实体瘤（ST）患者化疗引起的口腔黏膜炎（OM）的疗效。此外，还对这些肿瘤患者口腔黏膜炎的表现进行了研究。
48例年龄在27 - 84岁的患者从化疗（CT）第一天起被随机分配到不同组，分组如下：第1组：强化口腔护理方案（IOCP）；第2组：0.12%氯己定漱口水；第3组：0.03%三氯生漱口水；第4组：低强度激光治疗（LLLT）。在第7天和第14天通过口腔黏膜炎评估量表（OMAS）评估口腔黏膜炎。
31例（64.5%）患者在CT的第一个周期出现OM，疼痛与OM严重程度显著相关（p < 0.0001）。嘴唇和颊黏膜的OMAS评分在统计学上显著最差（p < 0.0001）。尽管缺乏统计学意义，但IOCP和LLLT分别在仅出现口腔红斑的患者（75%）以及随访期间严重程度峰值较低的患者中，明显显示出预防OM的潜在效果。
接受5-氟尿嘧啶和阿霉素治疗的患者需要提高口腔护理意识，主要是为了避免口腔黏膜炎引起的疼痛。口腔黏膜炎在暴露于慢性创伤的口腔部位更普遍且更具侵袭性。IOCP和LLLT方法在预防口腔黏膜炎方面显示出积极结果，应在类似的更大样本中进一步研究。
