Extraoral photobiomodulation for prevention of oral and oropharyngeal mucositis in head and neck cancer patients: interim analysis of a randomized, double-blind, clinical trial

Author(s):Show less -

Kauark-Fontes, Elisa ^[1] ; Migliorati, Cesar Augusto ^[2] ; Epstein, Joel B. ^{[3, 4]} ; Treister, Nathaniel Simon ^{[5, 6]} ; Bonfim Alves, Carolina Guimaraes ^{[1, 7]} ; Faria, Karina Morais ^[7] ; Palmier, Natalia Rangel ^{[1, 7]} ; Rodrigues-Oliveira, Leticia ^[1] ; Paglioni, Mariana de Pauli ^[1] ; Monteiro Gueiros, Luiz Alcino ^[8] ; da Conceicao Vasconcelos, Karina G. M. ^{[9, 10]} ; de Castro Jr, Gilberto ; Paes Leme, Adriana Franco ^[11] ; Lopes, Marcio Ajudarte ^[1] ; Prado-Ribeiro, Ana Carolina ^[7] ; Brandao, Thais Bianca ^[7] ; Santos-Silva, Alan Roger ^[1]

Affiliation:Show less -

^[1] Univ Campinas UNICAMP, Piracicaba Dent Sch, Oral Diag Dept, Av Limeira 901, BR-13414903 Piracicaba, SP - Brazil

^[2] Univ Florida, Coll Dent, Gainesville, FL - USA

^[3] City Hope Comprehens Canc Ctr, Duarte, CA - USA

^[4] Samuel Oschin Comprehens Canc Ctr, Cedars Sinai Hlth Syst, Los Angeles, CA - USA

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

^[6] Harvard Sch Dent Med, Dept Oral Med Infect & Immun, Boston, MA - USA

^[7] Inst Canc Estado Sao Paulo ICESP FMUSP, Dent Oncol Serv, Sao Paulo, SP - Brazil

^[8] Univ Fed Pernambuco, Clin & Prevent Dent Dept, Recife, SP - Brazil

^[9] Univ Sao Paulo FMUSP, Inst Canc Estado Sao Paulo ICESP, Serv Radiat Oncol, Fac Med, Sao Paulo, SP - Brazil

^[10] Radiotherapy DOr, Sao Paulo, SP - Brazil

^[11] Brazilian Ctr Res Energy & Mat CNPEM, Brazilian Biosci Natl Lab LNBio, Campinas, SP - Brazil

• Document type: Journal article
• Source: SUPPORTIVE CARE IN CANCER; v. 30, n. 3 OCT 2021.
• Web of Science Citations: 0

Abstract

Purpose To assess the safety and efficacy of prophylactic extraoral photobiomodulation (PBM) for the prevention of oral and oropharyngeal mucositis (OM) on clinical outcomes and survival in patients with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC). Methods OOPSCC patients who received radiotherapy (RT) were prospectively randomized to two groups: prophylactic extraoral PBM and placebo. OM grade (NCI), pain (VAS), analgesia, and anti-inflammatory prescriptions were assessed weekly. Quality of life questionnaires (QoL) were performed at the first and last day of RT. Following RT, participants were evaluated quarterly for oncological outcomes follow-up. Results Fifty-five patients met the inclusion criteria. The first occurrence of OM was observed at week 1, for the placebo group (p = 0.014). Later, OM onset and severity was observed for the PBM group, with first occurrence at week 2 (p = 0.009). No difference in severe OM incidence was observed (p > 0.05). Lower mean pain score was noted at week 7 for the PBM group (2.1) compared to placebo group (4.5) (p = 0.009). Less analgesics (week 3; p = 0.009/week 7; p = 0.02) and anti-inflammatory prescription (week 5; p = 0.0346) were observed for the PBM group. Better QoL scores were observed for the PBM group at last day of RT (p = 0.0034). No difference in overall survival among groups was observed in 1 year of follow-up (p = 0.889). Conclusion Prophylactic extraoral PBM can delay OM onset, reduce pain, and reduce analgesic and anti-inflammatory prescription requirements. Extraoral PBM was associated with better QoL. There was no evidence of PBM impact on oncological outcomes. (AU)

• 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 Opportunities: Regular Research Grants
• FAPESP's process: 18/23479-3 - Oncological safety of extraoral photobiomodulation in patients with oral and oropharyngeal squamous cell carcinoma
• Grantee: Elisa Kauark Fontes
• Support Opportunities: Scholarships in Brazil - Master