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Locally advanced oral squamous cell carcinoma patients treated with photobiomodulation for prevention of oral mucositis: retrospective outcomes and safety analyses

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Abstract

Purpose

The well-established clinical efficacy of photobiomodulation (PBM) therapy in management of oral mucositis (OM) is leading to increasing use in oncology care. This protection and enhanced repair of damage to mucosal tissue have led to the question of the potential effects of PBM therapy on pre-malignant and malignant cells. The purpose of this study was to examine the outcome of cancer therapy and incidence of tumor recurrence in locally advanced oral squamous cell carcinoma (OSCC) patients treated with PBM therapy for OM.

Methods

A retrospective clinical analysis of 152 advanced OSCC patients treated with prophylactic PBM therapy for radiotherapy-induced OM from January 2009 to December 2014 was conducted.

Results

Of the 152 OSCC patients treated with PBM therapy in this study, 19 (12.5%) had stage III and 133 (87.5%) had stage IV tumors. Of these, 52 (34.2%) received initial treatment with surgery followed by adjuvant radiotherapy, 94 (61.8%) with exclusive chemoradiation, and 6 (4%) with induction chemotherapy followed by surgery and radiotherapy. After a mean follow-up of 40.84 (± 11.71) months, the overall survival and disease-free survival rates were 46.7 and 51.8%, respectively. Forty-five (29.6%) patients developed local-regional recurrence, 10 (6.57%) patients developed distant relapse, and 19 (12.5%) developed new (second) primary tumors.

Conclusions

Clinicopathological features and survival outcomes in the PBM-treated patients were similar to previously published data for conventional treatments in patients with advanced OSCC. In this study, prophylactic use of PBM therapy did not impact treatment outcomes of the primary cancer, recurrence or new primary tumors, or survival in advanced OSCC patients.

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Acknowledgments

The authors would like to gratefully acknowledge the financial support of the São Paulo Research Foundation (FAPESP) (process numbers 2013/00429-7; 2013/18402-8 and 2012/06138-1) as well as the National Council for Scientific and Technological Development—CNPq.

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Authors and Affiliations

  1. Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Thaís Bianca Brandão, Karina Morais-Faria, Ana Carolina Prado Ribeiro & Alan Roger Santos-Silva

  2. Oral Diagnosis Department, Piracicaba Dental School, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areão, Piracicaba, São Paulo, CEP 13414-903, Brazil

    Thaís Bianca Brandão, Karina Morais-Faria, Ana Carolina Prado Ribeiro, César Rivera, Marcio Ajudarte Lopes & Alan Roger Santos-Silva

  3. Universidade Brasil, Fernandópolis, São Paulo, Brazil

    Ana Carolina Prado Ribeiro

  4. Radiotherapy Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    João Victor Salvajoli

  5. Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Hospital System, Los Angeles, CA, USA

    Joel B. Epstein

  6. Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA, USA

    Joel B. Epstein

  7. Departments of Oral Biology and Biomedical Engineering, Schools of Dental Medicine, Engineering and Applied Sciences, State University of New York at Buffalo, Buffalo, NY, USA

    Praveen R. Arany

  8. Clinical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Gilberto de Castro Jr

  9. College of Dentistry, University of Florida, Gainesville, FL, USA

    Cesar Augusto Migliorati

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  1. Thaís Bianca Brandão
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  7. Joel B. Epstein
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Correspondence to Alan Roger Santos-Silva.

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The authors declare that they have no conflict of interest.

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Thaís Bianca Brandão, Cesar Augusto Migliorati and Alan Roger Santos-Silva are shared senior authors

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Brandão, T.B., Morais-Faria, K., Ribeiro, A.C.P. et al. Locally advanced oral squamous cell carcinoma patients treated with photobiomodulation for prevention of oral mucositis: retrospective outcomes and safety analyses. Support Care Cancer 26, 2417–2423 (2018). https://doi.org/10.1007/s00520-018-4046-z

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