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低强度激光疗法治疗化疗所致口腔黏膜炎的效果

Effect of Low-Level Laser Therapy in Treatment of Chemotherapy Induced Oral Mucositis.

作者信息

Rezk-Allah Soheir Shehata, Abd Elshaf Heba Mohamed, Farid Reem Jan, Hassan Mohamed Abd Elrahman, Alsirafy Samy A

机构信息

Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.

Chemical and Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

出版信息

J Lasers Med Sci. 2019 Spring;10(2):125-130. doi: 10.15171/jlms.2019.20. Epub 2019 Feb 25.

Abstract

Oral mucositis (OM) is an unavoidable condition of the oral cavity that accompanies chemotherapy for various malignant cases. Chemotherapy-induced oral Mucositis (COM) is a frequent complication due to mucotoxic drugs and is known to deteriorate the general health significantly, while negatively affecting the quality of life (QOL). Studies have reported that low-level laser therapy (LLLT) promotes the tissue healing. The objective of the present study was to explore the efficacy of gallium-arsenide (GaAs) laser in treating COM and its impact on inflammatory cytokine levels in patients receiving chemotherapy for various malignancies. A total of 80 patients with COM received LLLT 6 days/week. OM was graded according to the World Health Organization (WHO) grading scale. The outcome parameters were the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) measured before, during and after administration of LLLT. After LLLT, a significant decrease was found in the mean values of mucositis grade from 2.35 ± 0.695 to 1.13 ± 0.333 after ( < 0.001). A significant reduction in the level of TNF-α was found after LLLT among breast cancer patients ( = 0.0045), but not in head and neck cancer and lymphoma patients. A significant reduction was also found in IL-6 level after treatment among head and neck and breast cancer patients ( = 0.0307 and 0.019, respectively). The use of GaAs LLLT in treating COM in patients with various malignancies is well tolerated by patients, it results in improvement of mucositis, however; mechanism of action does not seem to be completely linked to the change of pro or anti-inflammatory cytokines.

摘要

口腔黏膜炎(OM)是各种恶性疾病化疗过程中口腔不可避免出现的状况。化疗引起的口腔黏膜炎(COM)是使用具有黏膜毒性的药物后常见的并发症,已知其会显著损害整体健康,同时对生活质量(QOL)产生负面影响。研究报告称,低强度激光疗法(LLLT)可促进组织愈合。本研究的目的是探讨砷化镓(GaAs)激光治疗COM的疗效及其对接受各种恶性肿瘤化疗患者炎症细胞因子水平的影响。共有80例COM患者接受每周6天的LLLT治疗。根据世界卫生组织(WHO)分级量表对OM进行分级。观察指标为在LLLT治疗前、治疗期间和治疗后测量的血清肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平。LLLT治疗后,黏膜炎分级的平均值从2.35±0.695显著降至1.13±0.333(<0.001)。乳腺癌患者在LLLT治疗后TNF-α水平显著降低(P = 0.0045),但头颈癌和淋巴瘤患者未出现此情况。头颈癌和乳腺癌患者在治疗后IL-6水平也显著降低(分别为P = 0.0307和0.019)。患者对使用GaAs LLLT治疗各种恶性肿瘤患者的COM耐受性良好,该治疗可改善黏膜炎;然而,其作用机制似乎与促炎或抗炎细胞因子的变化并不完全相关。

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