Prophylactic photobiomodulation therapy using 660 nm diode laser for oral mucositis in paediatric patients under chemoth
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ORIGINAL ARTICLE
Prophylactic photobiomodulation therapy using 660 nm diode laser for oral mucositis in paediatric patients under chemotherapy: 5-year experience from a Brazilian referral service Laiz Fernandes Mendes Nunes 1 & José Alcides Almeida de Arruda 2 & Alessandra Figueiredo Souza 2 & Raíssa Cristina Costa Silva 1 & Célia Regina Moreira Lanza 2 & Fabiana Maria Kakehasi 3 & Ricardo Alves Mesquita 2 & Lucas Guimarães Abreu 4 & Denise Vieira Travassos 5 & Tarcília Aparecida Silva 2 Received: 23 March 2020 / Accepted: 1 June 2020 # Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract The use of photobiomodulation therapy (PBMT) in the prevention of oral mucositis (OM) in paediatric care has increased. In this article, we report data of paediatric oncology/haematopoietic stem cell transplantation (HSCT) patients treated with PBMT to prevent chemotherapy-induced OM. A retrospective study was conducted at a Brazilian referral service. Prophylactic PBMT was used in children and adolescents (≤ 17 years) following the protocol: InGaAIP, 660 nm, 100 mW, 2 J, 3.33 W/cm2, and 20 s per point. Demographic data and OM severity scores were assessed. A regression model tested the association between OM with prophylactic PBMT and antineoplastic therapy. A total of 148 individuals who had undergone 358 chemotherapy cycles were analysed. A higher occurrence of OM was observed in HSCT and osteosarcoma (OS) patients. Except for HSCT, OM was associated with methotrexate (MTX) use in all disease groups. PBMT significantly reduced OM severity in acute lymphoblastic leukaemia (ALL) and OS patients. OM grade was 3.16 and 5.45 times higher among individuals with ALL and OS, who had not undergone prophylactic PBMT compared with those who had undergone prophylactic PBMT (p < 0.001). PBMT prevented chemotherapy-induced OM. Individuals who used MTX and did not undergo prophylactic PBMT were at increased risk of OM. Keywords Cancer . Chemotherapy . Haematopoietic stem cell transplantation . Methotrexate . Oral mucositis . Paediatric oncology
Introduction Paediatric cancers are a significant cause of the global burden of disease, even when compared with other disorders of youth
or with adult cancers [1]. Despite the differences of the global epidemiological aspects across countries, childhood cancer is the sixth leading cause of total cancer burden and the ninth leading cause of childhood disease burden worldwide [1],
Laiz Fernandes Mendes Nunes, José Alcides Almeida de Arruda and Alessandra Figueiredo Souza contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10103-020-03060-9) contains supplementary material, which is available to authorized users. * Tarcília Aparecida Silva [email protected]; [email protected] 1
Dental Surgeon Residency, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
2
Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Mina
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