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最常用于预处理造血干细胞移植后治疗口腔黏膜炎的光生物调节剂量学参数:系统评价和荟萃分析。

Most used photobiomodulation dosimetry parameters to treat oral mucositis after preconditioning for hematopoietic stem cell transplantation: systematic review and meta-analysis.

机构信息

Department of Stomatology, Federal University of Paraná, Curitiba, Paraná, Brazil.

Department of Medicine of the Pontifical Catholic University, Curitiba, Paraná, Brazil.

出版信息

Support Care Cancer. 2022 May;30(5):3721-3732. doi: 10.1007/s00520-022-06817-w. Epub 2022 Jan 10.

Abstract

Parameter reproducibility in photobiomodulation therapy (PBMT) is still scarce in literature for the management of oral mucositis (OM). This study aimed to identify the most used PBMT dosimetry parameters (DP) and their efficacy in OM management after preconditioning for hematopoietic stem cell transplantation (HSCT). This research was conducted according to the PRISMA guidelines. The search for primary studies was in PubMed/MEDLINE, Web of Science, Embase, BVS, and Cochrane Library. Gray literature was verified on BDTD-Ibict and Open Gray. A total of 1044 studies were identified. Nine met the eligibility criteria for qualitative assessment and 7 for meta-analysis. The studies involved 396 patients submitted to preconditioning for HSCT, 211 with PBMT and 185 without PBMT in the OM management. The WHO scale was the most used to assess OM degree. The most used parameters were 660-nm wavelength, 40-mw power, 0.16-J energy, 1-W/cm power density, 4-J/cm energy density, and 0.04-cm spot size. The meta-analysis demonstrated that PBMT decreased the severity of OM, with a protection factor 20% higher than the control group (without PBMT), and when the parameters are similar to the DP mentioned, the protection factor increases to 94%. These most used DP with similarity seem to be a therapeutic strategy for the management of OM in this population.

摘要

光生物调节疗法(PBMT)在口腔黏膜炎(OM)管理中的参数重现性在文献中仍然很少。本研究旨在确定在造血干细胞移植(HSCT)预处理后,用于 OM 管理的最常用 PBMT 剂量参数(DP)及其疗效。这项研究是根据 PRISMA 指南进行的。对初级研究的搜索是在 PubMed/MEDLINE、Web of Science、Embase、BVS 和 Cochrane Library 中进行的。灰色文献在 BDTD-Ibict 和 Open Gray 上进行了验证。共确定了 1044 项研究。有 9 项符合定性评估的标准,有 7 项符合荟萃分析的标准。这些研究涉及 396 名接受 HSCT 预处理的患者,211 名接受 PBMT,185 名在 OM 管理中未接受 PBMT。世界卫生组织(WHO)量表是评估 OM 程度最常用的量表。最常用的参数是 660nm 波长、40mw 功率、0.16J 能量、1W/cm 功率密度、4J/cm 能量密度和 0.04cm 光斑尺寸。荟萃分析表明,PBMT 降低了 OM 的严重程度,保护因子比对照组(未接受 PBMT)高 20%,当参数与上述 DP 相似时,保护因子增加到 94%。这些最常用的 DP 似乎具有相似性,是该人群 OM 管理的一种治疗策略。

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