Oliveira Susyane Vieira, Batista João Victor Falcão, Gutierres Gabriela Godinho, Silva Nicole Pantojo, Lino-Dos-Santos-Franco Adriana, Rodrigues Maria Fernanda Setúbal Destro, Cecatto Rebeca Boltes
Biophotonics-Medicine Post-Graduate Program, Universidade Nove de Julho/UNINOVE, 249 Vergueiro Street, Liberdade, São Paulo, SP, 01504-001, Brazil.
School of Medicine of Universidade Nove de Julho UNINOVE, 249 Vergueiro Street, Liberdade, São Paulo, SP, 01504-001, Brazil.
Eur Arch Otorhinolaryngol. 2024 Jun;281(6):2793-2805. doi: 10.1007/s00405-023-08425-8. Epub 2024 Jan 8.
Radiotherapy is one of the main strategies used in the treatment of cancer patients and it can cause early or late xerostomia and/or hyposalivation. Therapeutic management of xerostomia includes oral hygiene, sialogenic agents among others.
This study reviews the use of extra-oral salivary glands photobiomodulation in treating xerostomia and/or hyposalivation after radiotherapy and performs a meta-analysis of this data.
After a broad search of the literature, eight clinical studies were selected.
In a safe way, the studies found that extra-oral stimulation of the salivary glands has benefits in the hyposalivation and changes in salivary flow resulting from lesions by radiotherapy. A meta-analysis found significant values in pain comparing the pre- and post-treatment moments (MD - 3.02, I2 95%, IC - 5.56; - 0.48) and for stimulated salivary flow at 30 days after the end of radiotherapy (MD 2.90, I2 95%, IC 1.96; 3.84).
The most promising parameters comprise wavelengths between 630 and 830 nm, radiant exposure from 2 to 10 J/cm, two-to-three times a week, before the radiotherapy damage, and homogeneously in the glands. Therefore, Light-Emitting Diode (LED) stimulation of larger areas than the punctual stimulation of small millimeters of the Low-Level Laser Therapy (LLLT) appears to be promising.
放射治疗是癌症患者治疗的主要策略之一，可导致早发性或迟发性口干症和/或唾液分泌减少。口干症的治疗管理包括口腔卫生、唾液生成剂等。
本研究回顾了口外唾液腺光生物调节在放疗后口干症和/或唾液分泌减少治疗中的应用，并对该数据进行了荟萃分析。
在广泛检索文献后，选择了八项临床研究。
研究发现，以安全的方式对口外唾液腺进行刺激，对放疗所致唾液分泌减少及唾液流量变化有益。一项荟萃分析发现，治疗前后疼痛有显著差异（MD - 3.02，I² 95%，IC - 5.56；- 0.48），放疗结束30天后刺激唾液流量也有显著差异（MD 2.90，I² 95%，IC 1.96；3.84）。
最有前景的参数包括波长在630至830纳米之间，辐射暴露为2至10焦耳/平方厘米，每周两到三次，在放疗损伤之前，且在腺体中均匀照射。因此，与低强度激光疗法（LLLT）对几毫米小区域的点状刺激相比，发光二极管（LED）对更大区域的刺激似乎更有前景。
