Oliveira de Lima Talita, Freitas Karina Alexandra Batista da Silva, Batista da Silva Karen Aline, Rodrigues Maria Fernanda Setúbal Destro, Dos Santos Thais Barbosa, Shimozato Illora Aswinkumar Darbar, Pavani Christiane, Cecatto Rebeca Boltes
Biophotonics-Medicine Post-Graduate Program / Universidade Nove de Julho UNINOVE, Rua Vergueiro 235, São Paulo, 01504-001, Brazil.
Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista (HCFMB-UNESP), São Paulo, 18618-687, Brazil.
EXCLI J. 2024 Oct 18;23:1276-1286. doi: 10.17179/excli2024-7749. eCollection 2024.
The main treatments for cancer are radiotherapy and chemotherapy, but they can generate side effects such as fatigue, myelosuppression, and radiodermatitis. The Multinational Association of Supportive Care in Cancer already recommends the use of laser for radiodermatitis in breast cancer patients. However, in relation to head and neck cancer patients, there is a lack of studies clearly demonstrating clinical effects and identifying the best light parameters for the treatment of radiodermatitis. This study reports on three oncological patients with radiodermatitis treated with light-based therapies to show clinical improvements in lesion grades and to discuss the effects of laser and its parameters. A retrospective report of three head and neck cancer patients with radiodermatitis, treated with photobiomodulation and photodynamic therapy at an outpatient health clinical facility. The Visual Analog Scale, Toxicity Criteria of the Radiation Therapy Oncology Group (RTOG) Scale, and the clinical characteristics of lesions were evaluated before and after a photobiomodulation plus photodynamic therapy protocol. Improvements were observed in cases with RTOG grade III with just 4 treatment sessions required for complete healing of the lesions. The patient with RTOG grade IV required antibiotic therapy, temporary suspension of radiotherapy, and more than 4 light sessions to achieve improvements. None of the patients showed worsening of the lesions, necrosis, or infection after treatment with no adverse effects. Head and neck cancer patients with radiodermatitis treated with phototherapy obtained good results in wound healing and pain relief in a short period. These case reports embody the easy-to-apply implementation of a light protocol in a health facility based on previous scientific evidence with positive results and no short-term side effects. In light of the negative impact on quality of life caused by radiodermatitis, health teams should be encouraged to design research study protocols involving light-based therapies.
癌症的主要治疗方法是放疗和化疗，但它们会产生诸如疲劳、骨髓抑制和放射性皮炎等副作用。癌症支持治疗多国协会已经建议对乳腺癌患者的放射性皮炎使用激光治疗。然而，对于头颈癌患者，缺乏明确证明临床效果和确定治疗放射性皮炎最佳光参数的研究。本研究报告了3例接受光基治疗的放射性皮炎肿瘤患者，以显示病变等级的临床改善情况，并讨论激光及其参数的效果。这是一份对3例头颈癌放射性皮炎患者的回顾性报告，这些患者在门诊健康临床机构接受了光生物调节和光动力治疗。在光生物调节加光动力治疗方案前后，评估了视觉模拟量表、放射治疗肿瘤学组（RTOG）毒性标准以及病变的临床特征。观察到RTOG III级的病例有改善，病变完全愈合仅需4次治疗。RTOG IV级的患者需要抗生素治疗、暂时中止放疗，且需要超过4次光治疗才能取得改善。治疗后，所有患者均未出现病变恶化、坏死或感染，也没有不良反应。接受光疗的头颈癌放射性皮炎患者在伤口愈合和短期内缓解疼痛方面取得了良好效果。这些病例报告体现了基于先前科学证据且结果积极且无短期副作用的光治疗方案在健康机构中易于应用的实施情况。鉴于放射性皮炎对生活质量造成的负面影响，应鼓励医疗团队设计涉及光基治疗的研究方案。
