Krc Rebecca F, Singh Sarah A, Fang Wei, Weir Joshua S
Department of Radiation Oncology, University of Maryland, Baltimore, Maryland.
Department of Radiation Oncology, West Virginia University, Morgantown, West Virginia.
Adv Radiat Oncol. 2023 Mar 10;8(4):101216. doi: 10.1016/j.adro.2023.101216. eCollection 2023 Jul-Aug.
The standard therapeutic approach in head and neck cancer (HNC) involves multimodality therapy, including surgery, radiation therapy (RT), or chemoradiation therapy (CRT). Treatment complications (mucositis, weight loss, and feeding tube dependence [FTD]) can result in treatment delays, incomplete treatment, and decreased quality of life. Studies on photobiomodulation (PBM) have shown promising reductions in mucositis severity but with little quantitative supporting data. We compared complications for patients with HNC receiving PBM with those in patients who did not, hypothesizing that PBM improves mucositis severity, weight loss, and FTD.
Medical records of 44 patients with HNC treated with CRT or RT from 2015 to 2021 were reviewed (22 PBM, 22 controls; median age, 63.5 years; range, 45-83 years). Between-group outcomes of interest included maximum mucositis grade, weight loss, and FTD 100 days after initiation of treatment.
Median RT doses were 60 Gy (PBM) and 66 Gy (control). Eleven patients treated with PBM received CRT; 11 received RT alone (median of 22 PBM sessions [range, 6-32]). Sixteen control group patients received CRT; 6 received RT alone. Median maximal mucositis grades were 1 in the PBM group and 3 in the control group ( < .0001). The adjusted odds of higher mucositis grade were only 0.024% ( < .0001; 95% confidence interval, 0.004-0.135) in PBM compared with the control group.
PBM may have a role in decreasing complications related to RT and CRT for HNC, mainly mucositis severity.
头颈部癌（HNC）的标准治疗方法包括多模式治疗，如手术、放射治疗（RT）或放化疗（CRT）。治疗并发症（黏膜炎、体重减轻和依赖饲管[FTD]）可导致治疗延迟、治疗不完整以及生活质量下降。光生物调节（PBM）研究显示，黏膜炎严重程度有望降低，但定量支持数据较少。我们比较了接受PBM的HNC患者与未接受PBM的患者的并发症情况，假设PBM可改善黏膜炎严重程度、体重减轻和FTD。
回顾了2015年至2021年接受CRT或RT治疗的44例HNC患者的病历（22例接受PBM，22例为对照组；中位年龄63.5岁；范围45 - 83岁）。组间感兴趣的结果包括治疗开始后100天的最大黏膜炎分级、体重减轻和FTD。
PBM组的中位放疗剂量为60 Gy，对照组为66 Gy。11例接受PBM治疗的患者接受了CRT；11例仅接受RT（PBM治疗的中位次数为22次[范围6 - 32次]）。16例对照组患者接受了CRT；6例仅接受RT。PBM组的中位最大黏膜炎分级为1级，对照组为3级（P <.0001）。与对照组相比，PBM组黏膜炎分级较高的调整后几率仅为0.024%（P <.0001；95%置信区间，0.004 - 0.135）。
PBM可能在降低HNC患者RT和CRT相关并发症方面发挥作用，主要是降低黏膜炎严重程度。
