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2. Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2: proposed applications and treatment protocols

Author

Zecha, Judith A. E. M., Raber-Durlacher, Judith E., Nair, Raj G., Epstein, Joel B., Elad, Sharon, Hamblin, Michael R., Barasch, Andrei, Migliorati, Cesar A., Milstein, Dan M. J., Genot, Marie-Thérèse, Lansaat, Liset, van der Brink, Ron, Arnabat-Dominguez, Josep, van der Molen, Lisette, Jacobi, Irene, van Diessen, Judi, de Lange, Jan, Smeele, Ludi E., Schubert, Mark M., and Bensadoun, René-Jean

Published
2016
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3. Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations

Author

Zecha, Judith A. E. M., Raber-Durlacher, Judith E., Nair, Raj G., Epstein, Joel B., Sonis, Stephen T., Elad, Sharon, Hamblin, Michael R., Barasch, Andrei, Migliorati, Cesar A., Milstein, Dan M. J., Genot, Marie-Thérèse, Lansaat, Liset, van der Brink, Ron, Arnabat-Dominguez, Josep, van der Molen, Lisette, Jacobi, Irene, van Diessen, Judi, de Lange, Jan, Smeele, Ludi E., Schubert, Mark M., and Bensadoun, René-Jean

Published
2016
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7. Ex vivo humidifying capacity and patient acceptability of stoma cloths in laryngectomized individuals

Author

Lansaat, Liset, van den Boer, Cindy, Muller, Sara H., van der Noort, Vincent, van den Brekel, Michiel W. M., Hilgers, Frans J. M., Graduate School, and Other departments

Abstract

Heat and moisture exchangers (HMEs) improve respiratory function after laryngectomy, but there is virtually no information on the benefit of traditional stoma cloths or other covers. Two sequential studies were performed: (1) an ex vivo test was used to compare the humidifying capacity of stoma cloths to other coverings; and (2) a 4-week randomized trial was then performed to assess patient acceptability of cloths both alone and with an HME (N = 18). The humidifying capacity of the coverings tested varied widely. For stoma cloths, a humidifying capacity of 13.7 mg/L was found to decrease to 8.5 mg/L if air-leaks around the cloth occurred. Patients who used HMEs disliked stoma cloths because they interfered with voicing, they became soiled more easily, and were less effective at reducing coughing and mucus production. Although less acceptable to patients who use an HME, stoma cloths do provide significant humidifying capacity and should be encouraged when HMEs are unavailable or inappropriate. © 2017 Wiley Periodicals, Inc. Head Neck 39: 921-931, 2017

Published
2017

9. Solving periprosthetic leakage with a novel prosthetic device.

Author

Petersen, Japke F., Lansaat, Liset, Hilgers, Frans, Brekel, Michiel, and van den Brekel, Michiel

Abstract

After placement of the PVX, patients and physicians were asked to fill in a study-specific questionnaire regarding the satisfaction of (placement of) the PVX with regard to the handling of the insertion device and the procedure. Five patients received multiple PVXs during FU, with a maximum of seven PVXs in one patient (see Table). The patient was free from periprosthetic leakage since insertion of the first PVX; the first two PVXs lasted 79 and 62 days, respectively. Of the five remaining patients, two still had a PVX in situ at last date of FU; two died; and the TEP-tract was closed in one patient. [Extracted from the article]

Published
2019
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10. Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations

Author

Institute for Medical Engineering and Science, Harvard University--MIT Division of Health Sciences and Technology, Hamblin, Michael R, Elad, Sharon, Barasch, Andrei, Genot, Marie-Thérèse, Lansaat, Liset, van der Brink, Ron, Arnabat-Dominguez, Josep, van der Molen, Lisette, Jacobi, Irene, van Diessen, Judi, de Lange, Jan, Bensadoun, René-Jean, Zecha, Judith A. E. M., Raber-Durlacher, Judith E., Nair, Raj G., Epstein, Joel B., Sonis, Stephen T., Migliorati, Cesar A., Milstein, Dan M. J., Smeele, Ludi E., Schubert, Mark M., Institute for Medical Engineering and Science, Harvard University--MIT Division of Health Sciences and Technology, Hamblin, Michael R, Elad, Sharon, Barasch, Andrei, Genot, Marie-Thérèse, Lansaat, Liset, van der Brink, Ron, Arnabat-Dominguez, Josep, van der Molen, Lisette, Jacobi, Irene, van Diessen, Judi, de Lange, Jan, Bensadoun, René-Jean, Zecha, Judith A. E. M., Raber-Durlacher, Judith E., Nair, Raj G., Epstein, Joel B., Sonis, Stephen T., Migliorati, Cesar A., Milstein, Dan M. J., Smeele, Ludi E., and Schubert, Mark M.

Abstract

Purpose: There is a large body of evidence supporting the efficacy of low level laser therapy (LLLT), more recently termed photobiomodulation (PBM), for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved, may expand the applications for PBM in the management of other complications associated with HNC treatment. This article (part 1) describes PBM mechanisms of action, dosimetry, and safety aspects and, in doing so, provides a basis for a companion paper (part 2) which describes the potential breadth of potential applications of PBM in the management of side-effects of (chemo)radiation therapy in patients being treated for HNC and proposes PBM parameters. Methods: This study is a narrative non-systematic review. Results: We review PBM mechanisms of action and dosimetric considerations. Virtually, all conditions modulated by PBM (e.g., ulceration, inflammation, lymphedema, pain, fibrosis, neurological and muscular injury) are thought to be involved in the pathogenesis of (chemo)radiation therapy-induced complications in patients treated for HNC. The impact of PBM on tumor behavior and tumor response to treatment has been insufficiently studied. In vitro studies assessing the effect of PBM on tumor cells report conflicting results, perhaps attributable to inconsistencies of PBM power and dose. Nonetheless, the biological bases for the broad clinical activities ascribed to PBM have also been noted to be similar to those activities and pathways associated with negative tumor behaviors and impeded response to treatment. While there are no anecdotal descriptions of poor tumor outcomes in patients treated with PBM, confirming its neutrality with respect to cancer responsiveness is a critical priority. Conclusion: Based on its therapeutic effects, PBM may have utility in a broad range of oral, oropharyngeal, facial, and neck co, National Institutes of Health (U.S.) (grant R01AI050875)

Published
2016

11. Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2: proposed applications and treatment protocols

Author

Harvard University--MIT Division of Health Sciences and Technology, Hamblin, Michael R, Elad, Sharon, Barasch, Andrei, Genot, Marie-Thérèse, Lansaat, Liset, van der Brink, Ron, Arnabat-Dominguez, Josep, van der Molen, Lisette, Jacobi, Irene, van Diessen, Judi, de Lange, Jan, Bensadoun, René-Jean, Zecha, Judith A. E. M., Raber-Durlacher, Judith E., Nair, Raj G., Epstein, Joel B., Migliorati, Cesar A., Milstein, Dan M. J., Smeele, Ludi E., Schubert, Mark M., Harvard University--MIT Division of Health Sciences and Technology, Hamblin, Michael R, Elad, Sharon, Barasch, Andrei, Genot, Marie-Thérèse, Lansaat, Liset, van der Brink, Ron, Arnabat-Dominguez, Josep, van der Molen, Lisette, Jacobi, Irene, van Diessen, Judi, de Lange, Jan, Bensadoun, René-Jean, Zecha, Judith A. E. M., Raber-Durlacher, Judith E., Nair, Raj G., Epstein, Joel B., Migliorati, Cesar A., Milstein, Dan M. J., Smeele, Ludi E., and Schubert, Mark M.

Abstract

Purpose: There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photobiomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved and dosimetric parameters may lead to the management of a broader range of complications associated with HNC treatment. This could enhance patient adherence to cancer therapy, and improve quality of life and treatment outcomes. The mechanisms of action, dosimetric, and safety considerations for PBM have been reviewed in part 1. Part 2 discusses the head and neck treatment side effects for which PBM may prove to be effective. In addition, PBM parameters for each of these complications are suggested and future research directions are discussed. Methods: Narrative review and presentation of PBM parameters are based on current evidence and expert opinion. Results: PBM may have potential applications in the management of a broad range of side effects of (chemo)radiation therapy (CRT) in patients being treated for HNC. For OM management, optimal PBM parameters identified were as follows: wavelength, typically between 633 and 685 nm or 780–830 nm; energy density, laser or light-emitting diode (LED) output between 10 and 150 mW; dose, 2–3 J (J/cm2), and no more than 6 J/cm2 on the tissue surface treated; treatment schedule, two to three times a week up to daily; emission type, pulsed (<100 Hz); and route of delivery, intraorally and/or transcutaneously. To facilitate further studies, we propose potentially effective PBM parameters for prophylactic and therapeutic use in supportive care for dermatitis, dysphagia, dry mouth, dysgeusia, trismus, necrosis, lymphedema, and voice/speech alterations. Conclusion: PBM may have a role in supportive care for a broad range of complications associated with the treatment of HNC with CRT. The, National Institutes of Health (U.S.) (NIH grant R01AI050875)

Published
2016

12. Comparative Study Between Peristomal Patches in Patients with Definitive Tracheostomy.

Author

Lansaat, Liset, de Kleijn, Bertram, Hilgers, Frans, van der Laan, Bernard, and den Brekel, Michiel van

Subjects
*HYDROCOLLOID surgical dressings, *TRACHEOTOMY patients, *LARYNGECTOMY
Abstract

Introduction To prevent or diminish pulmonary problems in laryngectomized patients, continuous use of a heat and moisture exchanger (HME) is recommended. Therefore, automatic speaking valves are also often combined with an HME to enable hands-free speech. In order to keep these devices in place, most commonly, peristomal patches are used. Objective This prospective clinical 2 x 2 crossover study aims at assessing the added value of a new patch for HME application, the Provox StabiliBase OptiDerm (SBO). The device combines the stable and conical base of the Provox StabiliBase with the skinfriendlier hydrocolloid Provox OptiDerm (OD) patch. Methods Thirty-two laryngectomized patients were included in this multicenter study. Participants were asked to compare SBO to OD, and to the patch they normally use. The primary outcome measure was patient preference. Results Overall, 60% of the participants had preference for their normally used patch, 23% preferred the SBO and 17% indicated no preference. When comparing the SBO to the OD, 43% preferred the SBO, 40% the OD and 17% had no preference. Conclusion Most patients preferred their normally used patch and SBO was favored by a subgroup. Provox StabiliBase OptiDerm seems to be a valuable addition to the existing patches and further increases patients' options for HME application. [ABSTRACT FROM AUTHOR]

Published
2018
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15. Ex vivo humidifying capacity and patient acceptability of stoma cloths in laryngectomized individuals.

Author

Lansaat L, van den Boer C, Muller SH, van der Noort V, van den Brekel MW, and Hilgers FJ

Subjects
Female, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome, Humidity, Laryngeal Neoplasms surgery, Laryngectomy, Patient Preference, Surgical Stomas
Abstract

Background: Heat and moisture exchangers (HMEs) improve respiratory function after laryngectomy, but there is virtually no information on the benefit of traditional stoma cloths or other covers., Methods: Two sequential studies were performed: (1) an ex vivo test was used to compare the humidifying capacity of stoma cloths to other coverings; and (2) a 4-week randomized trial was then performed to assess patient acceptability of cloths both alone and with an HME (N = 18)., Results: The humidifying capacity of the coverings tested varied widely. For stoma cloths, a humidifying capacity of 13.7 mg/L was found to decrease to 8.5 mg/L if air-leaks around the cloth occurred. Patients who used HMEs disliked stoma cloths because they interfered with voicing, they became soiled more easily, and were less effective at reducing coughing and mucus production., Conclusion: Although less acceptable to patients who use an HME, stoma cloths do provide significant humidifying capacity and should be encouraged when HMEs are unavailable or inappropriate. © 2017 Wiley Periodicals, Inc. Head Neck 39: 921-931, 2017., (© 2017 Wiley Periodicals, Inc.)

Published
2017
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