Patterns of oral mucositis in advanced oral squamous cell carcinoma patients managed with prophylactic photobiomodulation therapy-insights for future protocol development

Author(s):Show less -

Paglioni, Mariana de Pauli ^[1] ; Faria, Karina Morais ^[2] ; Palmier, Natalia Rangel ^[1] ; Prado-Ribeiro, Ana Carolina ^{[2, 1]} ; Brito e Dias, Reinaldo ^[3] ; da Graca Pinto, Henrique ^[3] ; Treister, Nathaniel Simon ^{[4, 5]} ; Epstein, Joel B. ^{[6, 7]} ; Migliorati, Cesar Augusto ^[8] ; Santos-Silva, Alan Roger ^[1] ; Brandao, Thais Bianca ^{[2, 1]}

Affiliation

^[1] Univ Estadual Campinas, Piracicaba Dent Sch, Oral Diag Dept, UNICAMP, Piracicaba, SP - Brazil

^[2] Sao Paulo State Canc Inst ICESP FMUSP, Dent Oncol Serv, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Dept Bucomaxillofacial Prosthesis, Dent Sch, Sao Paulo - Brazil

^[4] Dana Farber Canc Inst, Boston, MA 02115 - USA

^[5] Brigham & Womens Hosp, Div Oral Med & Dent, 75 Francis St, Boston, MA 02115 - USA

^[6] Cedars Sinai Hosp Syst, Samuel Oschin Comprehens Canc Inst, Los Angeles, CA - USA

^[7] City Hope Natl Med Ctr, 1500 E Duarte Rd, Duarte, CA 91010 - USA

^[8] Univ Florida, Coll Dent, Gainesville, FL - USA

• Document type: Journal article
• Source: Lasers in Medical Science; v. 36, n. 2 JUL 2020.
• Web of Science Citations: 0

Abstract

To characterize oral sites affected by radiation-induced oral mucositis (OM) and related clinical outcomes in oral cancer patients subjected to prophylactic photobiomodulation therapy (PBMT). This study included advanced oral squamous cell carcinoma (OSCC) patients treated with prophylactic PBMT for OM. The site distribution of OM, OM grading (CTCAE NCI, Version 4.0, 2010), OM-related pain (VAS), analgesic protocol (WHO Analgesic Ladder), and use of enteral nutrition were evaluated weekly during treatment. Data analysis was performed using descriptive statistics expressed as median values and percentages. A total of 145 OSCC patients were included. OM most frequently affected the lateral border of the tongue (44.1%), buccal mucosa (37.2%), and labial mucosa (33.8%). Keratinized oral mucosa sites, including the tongue dorsum (6.21%), retromolar trigone (8.3%), and hard palate (2.76%), were less frequently affected. Peak OM scores were observed at weeks 5, 6, and 7, with severe OM (NCI grades 3 and 4) rates of 11%, 20%, and 25%, respectively. The cumulative occurrence of severe OM was 23%, which developed as early as week 3 and as late as week 7. The highest mean value of OM-related pain (2.7) was observed at the sixth week, and 13.8% of the patients required feeding support. This study showed, compared with studies that did not provide PBMT, reduced severity of mucositis, reduced pain and analgesic use, and reduced tube feeding in patients treated with PBMT. OM involving keratinized and non-keratinized surfaces should be included in the prophylactic PBMT to reduce severe OM in future studies. (AU)

• FAPESP's process: 12/06138-1 - A prospective study of radiation-induced trismus in patients with oral squamous cell carcinoma
• Grantee: Ana Carolina Prado Ribeiro e Silva
• Support type: Regular Research Grants
• FAPESP's process: 13/18402-8 - Evaluation of the direct effects of radiation on the enamel, dentin and dental pulp of head and neck cancer patients
• Grantee: Alan Roger dos Santos Silva
• Support type: Regular Research Grants
• FAPESP's process: 18/04657-8 - Salivary protein markers of radiation-related oral toxicites
• Grantee: Natália Rangel Palmier
• Support type: Scholarships in Brazil - Doctorate
• FAPESP's process: 18/02233-6 - Oncological safety of the use of intraoral and extraoral photobiomodulation in patients with oral cavity and oropharyngeal squamous cell carcinoma
• Grantee: Alan Roger dos Santos Silva
• Support type: Regular Research Grants