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预防性光生物调节疗法使用 660nm 二极管激光治疗化疗患儿的口腔黏膜炎:来自巴西转诊服务的 5 年经验。

Prophylactic photobiomodulation therapy using 660 nm diode laser for oral mucositis in paediatric patients under chemotherapy: 5-year experience from a Brazilian referral service.

机构信息

Dental Surgeon Residency, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Room 3204, Belo Horizonte, MG, 31270-910, Brazil.

出版信息

Lasers Med Sci. 2020 Oct;35(8):1857-1866. doi: 10.1007/s10103-020-03060-9. Epub 2020 Jun 13.

Abstract

The use of photobiomodulation therapy (PBMT) in the prevention of oral mucositis (OM) in paediatric care has increased. In this article, we report data of paediatric oncology/haematopoietic stem cell transplantation (HSCT) patients treated with PBMT to prevent chemotherapy-induced OM. A retrospective study was conducted at a Brazilian referral service. Prophylactic PBMT was used in children and adolescents (≤ 17 years) following the protocol: InGaAIP, 660 nm, 100 mW, 2 J, 3.33 W/cm, and 20 s per point. Demographic data and OM severity scores were assessed. A regression model tested the association between OM with prophylactic PBMT and antineoplastic therapy. A total of 148 individuals who had undergone 358 chemotherapy cycles were analysed. A higher occurrence of OM was observed in HSCT and osteosarcoma (OS) patients. Except for HSCT, OM was associated with methotrexate (MTX) use in all disease groups. PBMT significantly reduced OM severity in acute lymphoblastic leukaemia (ALL) and OS patients. OM grade was 3.16 and 5.45 times higher among individuals with ALL and OS, who had not undergone prophylactic PBMT compared with those who had undergone prophylactic PBMT (p < 0.001). PBMT prevented chemotherapy-induced OM. Individuals who used MTX and did not undergo prophylactic PBMT were at increased risk of OM.

摘要

光生物调节疗法 (PBMT) 在儿科护理中预防口腔黏膜炎 (OM) 的应用有所增加。本文报告了在巴西转诊服务中心接受 PBMT 预防化疗引起的 OM 的儿科肿瘤/造血干细胞移植 (HSCT) 患者的数据。进行了一项回顾性研究。根据方案,对儿童和青少年(≤ 17 岁)进行预防性 PBMT:InGaAIP、660nm、100mW、2J、3.33W/cm 和每个点 20s。评估了人口统计学数据和 OM 严重程度评分。回归模型测试了 OM 与预防性 PBMT 和抗肿瘤治疗之间的关联。共分析了 148 名接受了 358 个化疗周期的个体。HSCT 和骨肉瘤(OS)患者的 OM 发生率更高。除了 HSCT 外,所有疾病组中,MTX 用药与 OM 均相关。PBMT 显著降低了 ALL 和 OS 患者的 OM 严重程度。与接受预防性 PBMT 的个体相比,未接受预防性 PBMT 的 ALL 和 OS 患者的 OM 分级分别高出 3.16 倍和 5.45 倍(p<0.001)。PBMT 预防了化疗引起的 OM。使用 MTX 且未接受预防性 PBMT 的个体发生 OM 的风险增加。

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