Barasch A, Peterson D E, Tanzer J M, D'Ambrosio J A, Nuki K, Schubert M M, Franquin J C, Clive J, Tutschka P
Department of Oral Diagnosis, University of Connecticut School of Dental Medicine, Farmington, USA.
Cancer. 1995 Dec 15;76(12):2550-6. doi: 10.1002/1097-0142(19951215)76:12<2550::aid-cncr2820761222>3.0.co;2-x.
Oral mucositis is a common complication of bone marrow transplantation (BMT) conditioning therapy. Sequelae consist of increased risk for infection, moderate to severe pain, compromised oral function, and bleeding. This study investigated helium-neon laser treatment for prevention of conditioning-induced oral mucositis in BMT patients. Patterns and severity of mucositis for specific conditioning drug regimens also were analyzed.
Twenty patients received laser radiation to their oral mucosa, either left or right of midline. The contralateral side was sham-treated and served as a control. Mucositis severity was scored independently by two modified versions of the Oral Mucositis Index Scale (OMI-A and OMI-B) and the Eastern Cooperative Oncology Group (ECOG) Oral Toxicity Scale; pain severity was scored by subjects on a visual analogue scale (VAS). Cumulative scores were analyzed for differences between the laser-treated and sham-treated sides.
Oral mucositis and pain scores were significantly lower for the treated versus the untreated side by OMI-A and B (P < 0.005) and VAS (P = 0.027) criteria, respectively. Ulcerative lesions occurred in all patients bilaterally; severity increased until Day +6, and lesions resolved by Day +21. Mucositis was more severe for patients conditioned with busulfan/carboplatin/thiotepa than for patients conditioned with busulfan/cyclophosphamide/etoposide.
Helium-neon laser treatment was well-tolerated and reduced the severity of conditioning-induced oral mucositis in BMT patients.
口腔黏膜炎是骨髓移植（BMT）预处理疗法的常见并发症。其后遗症包括感染风险增加、中度至重度疼痛、口腔功能受损和出血。本研究调查了氦氖激光治疗对预防BMT患者预处理引起的口腔黏膜炎的效果。还分析了特定预处理药物方案导致的黏膜炎模式和严重程度。
20名患者接受口腔黏膜激光照射，照射部位为中线左侧或右侧。对侧进行假治疗作为对照。由两个改良版的口腔黏膜炎指数量表（OMI - A和OMI - B）以及东部肿瘤协作组（ECOG）口腔毒性量表独立对黏膜炎严重程度进行评分；疼痛严重程度由受试者通过视觉模拟量表（VAS）评分。分析激光治疗侧和假治疗侧的累积评分差异。
根据OMI - A和B标准（P < 0.005）以及VAS标准（P = 0.027），治疗侧的口腔黏膜炎和疼痛评分分别显著低于未治疗侧。所有患者双侧均出现溃疡性病变；严重程度在第 +6天前增加，病变在第 +21天消退。接受白消安/卡铂/噻替派预处理的患者比接受白消安/环磷酰胺/依托泊苷预处理的患者黏膜炎更严重。
氦氖激光治疗耐受性良好，可降低BMT患者预处理引起的口腔黏膜炎的严重程度。
