Department of Physiological Science, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil.
Biotechnology Post-Graduation Program, Health Sciences Center, Federal University of Espirito Santo, Vitoria, ES, Brazil.
Asian Pac J Cancer Prev. 2021 Oct 1;22(10):3211-3217. doi: 10.31557/APJCP.2021.22.10.3211.
Oral mucositis is a painful condition that occurs in patients who undergo chemotherapy. Due to the worsening of oral mucositis, the patient may progress to a worse clinical condition and interrupt antineoplastic treatment. There is little literature on low-power laser therapy in chemotherapy for other solid tumors. The purpose of this study was to investigate whether low-level laser therapy (LLLT) applied before chemotherapy could prevent oral mucositis in patients with solid tumors.
Laser therapy was applied at a frequency of 630nm, with a dose of 2J / cm2, for the prevention of oral mucositis induced by chemotherapy specifically for non-hematological tumors. Epidemiological data, total neutrophils, general side effects, development of oral mucositis and degree, and the performance of low-power laser therapy to prevent oral mucositis were collected. The involvement of oxidative stress was evaluated by the enzyme superoxide dismutase (SOD) through blood samples, before and after chemotherapy treatments.
LLLT in the proposed protocol is efficient in reducing the development of oral mucositis (only at grade I/II) in patients under chemotherapy and able to reduce the severity of oral mucosal lesions, in patients who developed mucositis after the use of the laser for prevention. All individuals who underwent LLLT protocol did not show a significant reduction of SOD activity after the last chemotherapy cycle.
The prophylactic laser therapy protocol proposed by the study, defined at a frequency of 630nm, a dose of 2J / cm2, demonstrated the ability to decrease the occurrence of oral mucositis in patients undergoing chemotherapy protocols to solid tumors. This effect could be related to preserved SOD activity, as it was observed that oral mucositis is related to leukopenia and reduced SOD activity and LLLT protocol prevented the decrease of SOD activity.
口腔黏膜炎是一种在接受化疗的患者中发生的疼痛性疾病。由于口腔黏膜炎的恶化，患者可能会出现更糟糕的临床状况并中断抗肿瘤治疗。关于低功率激光疗法在其他实体瘤化疗中的应用，文献报道较少。本研究旨在探讨化疗前应用低水平激光疗法（LLLT）是否可以预防实体瘤患者的口腔黏膜炎。
针对非血液系统肿瘤，应用波长为 630nm、剂量为 2J/cm2 的激光疗法预防化疗引起的口腔黏膜炎。收集流行病学数据、总中性粒细胞计数、一般副作用、口腔黏膜炎的发生和程度，以及低功率激光疗法预防口腔黏膜炎的疗效。通过血液样本评估氧化应激的酶超氧化物歧化酶（SOD）的参与。
所提出方案中的 LLLT 可有效降低化疗患者口腔黏膜炎的发生（仅为 I/II 级），并能降低口腔黏膜病变的严重程度，对于使用激光预防后发生黏膜炎的患者。所有接受 LLLT 方案的患者在最后一个化疗周期后 SOD 活性均无明显降低。
本研究提出的、定义为 630nm 波长、2J/cm2 剂量的预防性激光治疗方案，能够降低接受实体瘤化疗方案患者口腔黏膜炎的发生率。这种作用可能与 SOD 活性的保存有关，因为观察到口腔黏膜炎与白细胞减少症和 SOD 活性降低有关，而 LLLT 方案可预防 SOD 活性的降低。
