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Patterns of oral mucositis in advanced oral squamous cell carcinoma patients managed with prophylactic photobiomodulation therapy—insights for future protocol development
- Source :
- Lasers in Medical Science. 36:429-436
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
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.
- Subjects :
- medicine.medical_specialty
business.industry
medicine.medical_treatment
Analgesic
030206 dentistry
Dermatology
medicine.disease
Gastroenterology
Radiation therapy
stomatognathic diseases
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
Parenteral nutrition
Tongue
Internal medicine
Mucositis
Medicine
Surgery
Basal cell
Hard palate
Oral mucosa
business
Subjects
Details
- ISSN :
- 1435604X and 02688921
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Lasers in Medical Science
- Accession number :
- edsair.doi...........e5fb34732325b3fd6f492e8d3a83dedd