Low power laser photobiomodulation therapy in radiotherapy-induced oral complications: a case report
DOI:
https://doi.org/10.20453/reh.v34i4.5967Keywords:
laser therapy, dentistry, oral mucositis, case reportAbstract
Oropharyngeal cancer is one of the most common malignant tumors in the head and neck, and among its most frequent complications is oral mucositis, a common result of radiotherapy treatments in this region. Despite its high incidence, no consensus has yet been reached on its therapeutic management. In this context, photobiomodulation with low power laser is presented as a promising alternative, since it does not produce significant adverse effects and facilitates both healing and analgesia in the affected areas, thus improving the patient's quality of life. During the clinical examination of this case report, ulcers were observed on the jugal mucosa on both sides, as well as a lesion with fibrinoleukocytic coating on the posterior right lateral border, which, together with the patient's clinical record, allowed establishing the diagnosis of oral mucositis. For the management of this condition, low power laser photobiomodulation was applied in a total of five sessions, aimed at reducing pain, favoring ulcer healing and treating hyposalivation. At the end of the therapeutic cycle, the patient no longer had ulcers in the oral cavity, the patient reported having recovered his/her sense of taste and there was evidence of an improvement in salivary production. These results highlight the efficacy of photobiomodulation, since it not only relieves the symptoms almost immediately, but also, being a minimally invasive procedure with no known adverse effects, it becomes a valuable tool for the management of oral complications in oncologic patients.
Downloads
References
Klastersky JA, Fontaine C. Editorial: Supportive care in cancer patients: a constantly evolving field. Curr Opin Oncol [Internet]. 2019; 31(4): 257-258. Disponible en: https://doi.org/10.1097/cco.0000000000000542
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin [Internet]. 2021; 71(3): 209-249. Disponible en: https://doi.org/10.3322/caac.21660
Bagan J, Sarrion G, Jimenez Y. Oral cancer: clinical features. Oral Oncol [Internet]. 2010; 46(6): 414-417. Disponible en: https://doi.org/10.1016/j.oraloncology.2010.03.009
Speight PM, Farthing PM. The pathology of oral cancer. Br Dent J [Internet]. 2018; 225(9): 841-847. Disponible en: https://doi.org/10.1038/sj.bdj.2018.926
De Virgilio A, Costantino A, Mercante G, Petruzzi G, Sebastiani D, Franzese C, et al. Present and future of de-intensification strategies in the treatment of orophargyngeal carcinoma. Curr Oncol Rep [Internet]. 2020; 22(9): 91. Disponible en: https://doi.org/10.1007/s11912-020-00948-1
Wang D, Duan X, Zhang Y, Meng Z, Wang J. Traditional Chinese medicine for oral squamous cell carcinoma: a Bayesian network meta-analysis protocol. Medicine (Baltimore) [Internet]. 2020; 99(43): e22955. Disponible en: https://doi.org/10.1097/md.0000000000022955
Zadick Y, Arany PR, Fregnani ER, Bossi P, Antunes HS, Bensadoun RJ, et al. Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer [Internet]. 2019; 27(10): 3936-3983. Disponible en: https://doi.org/10.1007/s00520-019-04890-2
Anders JJ, Arany PR, Baxter GD, Lanzafame RJ. Ligth-emitting diode therapy and low-level light therapy are photobiomodulation therapy. Photobiomodul Photomed Laser Surg [Internet]. 2019, 37(2): 63-65. Disponible en: https://doi.org/10.1089/photob.2018.4600
Gamarra-Insfrán JM, Ruiz MC, Giménez-Leguizamón MC, González MC, Espínola MD, Cantero-Viñarro MF. Láser de baja potencia como alternativa terapéutica al eritema multiforme idiopático. Informe de caso. Mem Inst Investig Cienc Salud [Internet]. 2023; 21(1): e21132301. Disponible en: https://doi.org/10.18004/mem.iics/1812-9528/2023.e21132301
Carneiro-Neto JN, De Menezes JD, Moura LB, Massucato EM, De Andrade CR. Protocols for management of oral complications of chemotherapy and/or radiotherapy for oral cancer: systematic review and meta-analysis current. Med Oral Patol Oral Cir Bucal [Internet]. 2017; 22(1): e15-e23. Disponible en: https://doi.org/10.4317/medoral.21314
Mosel DD, Bauer RL, Lynch DP, Hwang ST. Oral complications in the treatment of cancer patients. Oral Dis [Internet]. 2011; 17(6): 550-559. Disponible en: https://doi.org/10.1111/j.1601-0825.2011.01788.x
Robijns J, Nair RG, Lodewijckx J, Arany P, Barasch A, Bjordal JM, et al. Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022. Front Oncol [Internet]. 2022; 12: 927685. Disponible en: https://doi.org/10.3389/fonc.2022.927685
Walinski CJ, Mellusi SM, Brodeur AE, Marchick E, Katz D, Putten MV. Review of oral mucositis treatment guidelines with an emphasis on laser therapy. Gen Dent [Internet]. 2022; 70(2): 22-26. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35225799/
Rubenstein EB, Peterson DE, Schubert M, Keefe D, McGuire D, Epstein J, et al. Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer [Internet]. 2004; 100(S9): 2026-2046. Disponible en: https://doi.org/10.1002/cncr.20163
Khouri VY, Stracieri AB, Rodrigues MC, Moraes DA, Pieroni F, Simões BP, et al. Use of therapeutic laser for prevention and treatment of oral mucositis. Braz Dent J [Internet]. 2009; 20(3): 215-220. Disponible en: https://doi.org/10.1590/s0103-64402009000300008
Legouté F, Bensadoun RJ, Seegers V, Pointreau Y, Caron D, Lang P, et al. Low-level laser therapy in treatment of chemoradiotherapy-induced mucositis in head and neck cancer: results of a randomised, triple blind, multicentre phase III trial. Radiat Oncol [Internet]. 2019; 14(1): 83. Disponible en: https://doi.org/10.1186/s13014-019-1292-2
Ferreira AS, Macedo C, Silva AM, Delerue-Matos C, Costa P, Rodrigues F. Natural products for the prevention and treatment of oral mucositis-A review. Int J Mol Sci [Internet]. 2022; 23(8): 4385. Disponible en: https://doi.org/10.3390/ijms23084385
Lu Y, Zhu X, Ma Q, Wang J, Jiang P, Teng S, et al. Oral cryotherapy for oral mucositis management in patients receiving allogeneic hematopoietic stem cell transplantation: a prospective randomized study. Support Care Cancer [Internet]. 2020; 28(4): 1747-1754. Disponible en: https://doi.org/10.1007/s00520-019-04966-z
Kamsvåg T, Svanberg A, Legert KG, Arvidson J, Von Essen L, Mellgren K, et al. Prevention of oral mucositis with cryotherapy in children undergoing hematopoietic stem cell transplantations-a feasibility study and randomized controlled trial. Support Care Cancer [Internet]. 2020; 28(10): 4869-4879. Disponible en: https://doi.org/10.1007/s00520-019-05258-2
Kusiak A, Jereczek-Fossa BA, Cichońska D, Alterio D. Oncological-therapy related oral mucositis as an interdisciplinary problem-Literature review. Int J Environ Res Public Health [Internet]. 2020; 17(7): 2464. Disponible en: https://doi.org/10.3390/ijerph17072464
Migliorati C, Hewson I, Lalla RV, Antunes HS, Estilo CL, Hodgson B, et al. Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Support Care Cancer [Internet]. 2013; 21(1): 333-341. Disponible en: https://doi.org/10.1007/s00520-012-1605-6
He M, Zhang B, Shen N, Wu N, Sun J. A systematic review and meta-analysis of the effect of low-level laser therapy (LLLT) on chemotherapy-induced oral mucositis in pediatric and young patients. Eur J Pediatr [Internet]. 2018; 177(1): 7-17. Disponible en: https://doi.org/10.1007/s00431-017-3043-4
Daugėlaitė G, Užkuraitytė K, Jagelavičienė E, Filipauskas A. Prevention and treatment of chemotherapy and radiotherapy induced oral mucositis. Medicina [Internet]. 2019; 55(2): 25. Disponible en: https://doi.org/10.3390/medicina55020025
Theodoro LH, Marcantonio RA, Wainwright M, Garcia VG. LASER in periodontal treatment: is it an effective treatment or science fiction? Braz Oral Res [Internet]. 2021; 35(Supp 2): e099. Disponible en: https://doi.org/10.1590/1807-3107bor-2021.vol35.0099
Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophys [Internet]. 2017; 4(3): 337-361. Disponible en: https://doi.org/10.3934/biophy.2017.3.337
Petrović MS, Kannosh IY, Milašin JM, Mihailović DS, Obradović RR, Bubanj SR, et al. Clinical, microbiological and cytomorphometric evaluation of low-level laser therapy as an adjunct to periodontal therapy in patients with chronic periodontitis. Int J Dent Hyg [Internet]. 2018; 16(2): e120-e127. Disponible en: https://doi.org/10.1111/idh.12328
Cuevas-González MV, Echevarría-y-Pérez E, Díaz-Aguirre CM, Cuevas-González JC. Tratamiento de la mucositis oral en pacientes oncológicos: revisión de la literatura y experiencia en el Hospital General de México. Int J Odontostomatol [Internet]. 2015; 9(2): 289-294. Disponible en: http://dx.doi.org/10.4067/S0718-381X2015000200016
Oltra-Arimon D, España-Tost AJ, Berini-Aylés L, Gay-Escoda C. Aplicaciones del láser de baja potencia en odontología. RCOE [Internet]. 2004; 9(5): 517-524. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S1138-123X2004000500003
Revilla H, Valiente Y. Efectividad del láser de baja potencia como terapia adyuvante en pacientes con herpes zóster. MEDISAN [Internet]. 2022; 26(1): 36-46. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192022000100036
Silveira AC, Castro FL, Leão JC, Cruz AF, Lacerda JC, Resende RG. Aplicação do laser de baixa intensidade no tratamento do eritema multiforme: relato de caso. Arq Odontol [Internet]. 2022; 58: 57-62. Disponible en: https://doi.org/10.35699/2178-1990.2022.37226
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Dylan Casco, María del Carmen González, José Miguel Gamarra, Célica Said, Mirtha Espínola
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain the copyright and cede to the journal the right of first publication, with the work registered with the Creative Commons License, which allows third parties to use what is published as long as they mention the authorship of the work, and to the first publication in this journal.