回顾性评估低水平激光治疗/光生物调节对头/颈部癌症患者的安全性。

Retrospective evaluation of the safety of low-level laser therapy/photobiomodulation in patients with head/neck cancer.

机构信息

Laser Therapy Unit, Institut Jules Bordet, Université Libre de Bruxelles Centre des Tumeurs de l'ULB, Rue Héger-Bordet, 1, 1000, Brussels, Belgium.

Data Centre, Institut Jules Bordet, Université Libre de Bruxelles Centre des Tumeurs de l'ULB, Rue Héger-Bordet, 1, 1000, Brussels, Belgium.

出版信息

Support Care Cancer. 2020 Jul;28(7):3015-3022. doi: 10.1007/s00520-019-05041-3. Epub 2019 Sep 9.

Abstract

BACKGROUND

The standard therapeutic approach for locally advanced head and neck cancer is optimal use of radiation therapy with or without concomitant chemotherapy. The most common and distressing acute complication of such therapies is oral/pharyngeal mucositis that may be associated with severe morbidity and can interfere with the planned administration of therapy.

METHODS

We have identified all patients diagnosed with head/neck cancer between 2005 and 2009, having received radiotherapy with or without cisplatin-based chemotherapy. Radiotherapy consisted of intensity-modulated radiation therapy (IMRT) in all patients. In patients with grade > 2 mucositis, photobiomodulation (PBM) consisted of three sessions of low-level laser irradiation weekly, in accordance with recently published recommendations for PBM. Patients who did not receive PBM were those for whom that approach was not requested by the radiotherapists and those who declined it.

RESULTS

Two hundred twenty-two patients (62%) received PBM and 139 did not (39%). The patient's characteristics were equally distributed between the two groups. For overall survival, time to local recurrence, and progression-free survival, there was no statistical evidence for a difference in prognosis between patients with and without PBM. In a multivariate analysis, after adjusting for known prognostic factors, we found no statistical evidence that PBM was related to overall survival, progression-free survival, or local recurrence.

CONCLUSIONS

Our results show evidence of no effect of PBM upon overall survival, time to local recurrences, and disease-free survival of patients with head and neck cancer treated with radiotherapy with/without chemotherapy.

摘要

背景

局部晚期头颈部癌症的标准治疗方法是最佳使用放射治疗联合或不联合同期化疗。此类治疗最常见且令人痛苦的急性并发症是口腔/咽黏膜炎,可能与严重发病率相关,并会干扰计划的治疗。

方法

我们已经确定了 2005 年至 2009 年间所有被诊断为头颈部癌症的患者,这些患者接受了放射治疗联合或不联合顺铂为基础的化疗。所有患者均接受调强放疗(IMRT)。对于 2 级以上黏膜炎患者,光生物调节(PBM)包括每周三次低水平激光照射,根据最近发布的 PBM 建议进行。未接受 PBM 的患者是指放射治疗师未要求或拒绝该治疗的患者。

结果

222 名患者(62%)接受了 PBM,139 名患者未接受(38%)。两组患者的特征分布均匀。对于总生存、局部复发时间和无进展生存,接受和未接受 PBM 的患者的预后无统计学差异。在多变量分析中,在调整已知预后因素后,我们发现 PBM 与总生存、无进展生存或局部复发无统计学关联。

结论

我们的结果表明,PBM 对接受放射治疗联合或不联合化疗的头颈部癌症患者的总生存、局部复发时间和无病生存没有影响。

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