Abstract
Purpose
To retrospectively evaluate the role of class IV laser therapy in the amelioration of nutritional status of patients affected by oral mucositis due to radiotherapy of the head and neck region during oncological treatment.
Methods
Sixty-three oncological patients were included in this study. All patients were affected by tumors in the head and neck region and had developed oral mucositis during radiotherapy. Forty-two patients had been treated by high-power laser therapy whereas 21 patients had been managed with traditional medications. Data collection included weight measurement (kilogram) and body mass index (BMI) calculation (mass (kilogram)/(height) (square meter)) on the first and last day of radiotherapy. In addition, gender, age, pathology, and the kind of oncological treatment have been considered.
Results
Laser-treated patients decreased less in BMI during radiotherapy (p = 0.000). Patients treated by combined oncological treatments (radiotherapy and/or chemotherapy and/or surgery) had a higher weight loss during radiotherapy (p = 0.015). According to a multivariate regression analysis, the only variable which significantly influenced the reduction of BMI was laser treatment (p = 0.000).
Conclusions
Laser therapy is actually considered one of the recommended remedies for the healing of oral mucositis due to cancer treatments. Healing of mucositis can deeply influence the feeding capacity of patients, through reduction of pain and improvement of chewing and swallowing capacities. It also allows lowering the costs for hospitalization and supportive care. Laser therapy should become part of nutritional interventions in oncological patients affected by oral mucositis.
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References
Ren JS, Masuyer E, Ferlay J (2013) Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer 132(5):1133–1145
Jonsson EL, Nylander K, Hallén L, Laurell G (2012) Effect of radiotherapy on expression of hyaluronan and EGFR Bray Fand presence of mast cells in squamous cell carcinoma of the head and neck. Oncol Lett 4(6):1177–1182
Amit M, Yen TC, Liao CT, Chaturvedi P, Agarwal JP, Kowalski LP, Ebrahimi A, Clark JR, Kreppel M, Zöller J, Fridman E, Bolzoni VA, Shah JP, Binenbaum Y, Patel SG, Gil Z (2013) The International Consortium for Outcome Research (ICOR) in head and neck cancer. Improvement in survival of patients with oral cavity squamous cell carcinoma: An International Collaborative Study. Cancer
Mesía R, Pastor M, Grau JJ, Del Barco E (2013) SEOM clinical guidelines for the treatment of head and neck cancer (OSCC) 2013. Clin Transl Oncol
Elting LS, Keefe DM, Sonis ST, Garden AS, Spijkervet FK, Barasch A, Tishler RB, Canty TP, Kudrimoti MK, Vera-Llonch M (2008) Burden of Illness Head and Neck Writing Committee. Patient-reported measurements of oral mucositis in head and neck cancer patients treated with radiotherapy with or without chemotherapy: demonstration of increased frequency, severity, resistance to palliation, and impact on quality of life. Cancer 113(10):2704–2713
Turner L, Mupparapu M, Akintoye SO (2013) Review of the complications associated with treatment of oropharyngeal cancer: a guide for the dental practitioner. Quintessence Int 44(3):267–279
Rose-PED AM, Bellm LA, Epstein JB, Trotti A, Gwede C, Fuchs H (2002) Complications of radiation therapy for head and neck cancers: the patient’s perspective. Cancer nurse 25:461–467
Chandu A, Smith AC, Rogers SN (2006) Health-related quality of life in oral cancer: a review. J Oral Maxillofac Surg 64(3):495–502
Shah JP, Gil Z (2009) Current concepts in management of oral cancer—surgery. Oral Oncol Apr-May 45(4–5):394–401
Cheng KK, Leung SF, Liang RH, Tai JW, Yeung RM, Thompson DR (2010) Severe oral mucositis associated with cancer therapy: impact on oral functional status and quality of life. Support Care Cancer 18(11):1477–1485
Ehrsson YT, Langius-Eklöf A, Laurell G (2012) Nutritional surveillance and weight loss in head and neck cancer patients. Support Care Cancer 20(4):757–765
McRackan TR, Watkins JM, Herrin AE, Garrett-Mayer EM, Sharma AK, Day TA, Gillespie MB (2008) Effect of body mass index on chemoradiation outcomes in head and neck cancer. Laryngoscope 118(7):1180–1185
Nugent B, Lewis S, O’Sullivan JM (2010) Enteral feeding methods for nutritional management in patients with head and neck cancers being treated with radiotherapy and/or chemotherapy. Cochrane Database Syst Rev. (3):CD007904
Gautam AP, Fernandes DJ, Vidyasagar MS, Maiya AG, Nigudgi S (2012) Effect of low-level laser therapy on patient reported measures of oral mucositis and quality of life in head and neck cancer patients receiving chemoradiotherapy-a randomized controlled trial. Support Care Cancer
Gobbo M, Ottaviani G, Bussani R, Pozzato G, Biasotto M (2013) Methotrexate-induced oral mucositis in rheumatoid arthritis disease: therapeutic strategy in a case report. Photon Lasers Med; aop
Garcia VG, de Lima MA, Okamoto T, Milanezi LA, Júnior EC, Fernandes LA, de Almeida JM, Theodoro LH (2010) Effect of photodynamic therapy on the healing of cutaneous third-degree-burn: histological study in rats. Lasers Med Sci 25(2):221–228
Corazza AV, Jorge J, Kurachi C, Bagnato VS (2007) Photobiomodulation on the angiogenesis of skin wounds in rats using different light sources. Photomed Laser Surg 25(2):102–106
Ottaviani G, Gobbo M, Sturnega M, Martinelli V, Mano M, Zanconati F, Bussani R, Perinetti G, Long CS, Di Lenarda R, Giacca M, Biasotto M, Zaccchigna S (2013) Effect of class IV laser therapy on chemotherapy-induced oral mucositis: a clinical and experimental study. Am J Pathol
Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR (2012) The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng 40(2):516–533
Perinetti G, Baccetti T, Di Leonardo B, Di Lenarda R, Contardo L (2011) Dentition phase and chronological age in relation to gingival crevicular fluid alkaline phosphatase activity in growing subjects. Prog Orthod 12:100–106
Cohen J (1992) A power primer. Psychol Bull 112:155–159
Koom WS, Ahn SD, Song SY, Lee CG, Moon SH, Chie EK, Jang HS, Oh YT, Lee HS, Keum KC (2012) Nutritional status of patients treated with radiotherapy as determined by subjective global assessment. Radiat Oncol J 30(3):132–139
Valentini V, Marazzi F, Bossola M, Miccichè F, Nardone L, Balducci M, Dinapoli N, Bonomo P, Autorino R, Silipigni S, Giuliani F, Tamanti C, Mele MC, Martorana GE (2012) Nutritional counselling and oral nutritional supplements in head and neck cancer patients undergoing chemoradiotherapy. J Hum Nutr Diet 25(3):201–208
Ottosson S, Zackrisson B, Kjellén E, Nilsson P, Laurell G (2012) Weight loss in patients with head and neck cancer during and after conventional and accelerated radiotherapy. Acta Oncol
Nakahara S, Yoshino K, Fujii T, Uemura H, Suzuki M, Nishiyama K, Inohara H (2012) Nutritional surveillance in head and neck cancer patients during radiotherapy—the difference between concurrent chemoradiotherapy using high-dose cisplatin and radiotherapy alone. Nihon Jibiinkoka Gakkai Kaiho 115(10):902–909
Büntzel J, Krauß T, Büntzel H, Küttner K, Fröhlich D, Oehler W, Glatzel M, Wackes M, Putziger J, Micke O, Kisters K, Mücke R (2012) Nutritional parameters for patients with head and neck cancer. Anticancer Res 32(5):2119–2123
Koom WS, Ahn SD, Song SY, Lee CG, Moon SH, Chie EK, Jang HS, Oh YT, Lee HS, Keum KC (2012) Nutritional status of patients treated with radiotherapy as determined by subjective global assessment. Radiat Oncol J 30(3):132–139
Isenring E, Bauer J, Capra S (2010) The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 57:305–309
Kubrak C, Olson K, Jha N et al (2010) Nutrition impact symptoms: key determinants of reduced dietary intake, weight loss, and reduced functional capacity of patients with head and neck cancer before treatment. Head Neck 32:290–300
Caillot E, Denis F (2012) Radio-induced oral and pharyngeal mucositis: management updates. Cancer Radiother 16(5–6):358–363
Bjordal JM, Bensadoun RJ, Tuner J, Frigo L, Gjerde K, Lopes-Martins RA (2011) A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis. Support Care Cancer 19:1069–1077
Migliorati C, Hewson I, Lalla RV, Antunes HS, Estilo CL, Hodgson B, Lopes NN, Schubert MM, Bowen J, Elad S; For the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (2013) Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Support Care Cancer 21:333-341
Fan TY, Xing J, Lu J, Liu TH, Xu M, Zhang YJ, Shao Q, Li JB, Yu JM (2013) Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer. Oncol Lett 5(3):889–895
Ehrsson YT, Langius-Eklöf A, Laurell G (2012) Nutritional surveillance and weight loss in head and neck cancer patients. Support Care Cancer 20:757–765
Dymkovets VP, Ezhov VV, Manykin AA, Belov SV, Danileiko YK, Osiko VV, Salyuk VA (2011) Evaluation of human papillomavirus elimination from cervix uteri by infrared laser exposure. Bull Exp Biol Med 152(2):228–230
Manevitch Z, Lev D, Hochberg M, Palhan M, Lewis A, Enk CD (2010) Direct antifungal effect of femtosecond laser on Trichophyton rubrum onychomycosis. Photochem Photobiol 86(2):476–479
Mârţu S, Amălinei C, Tatarciuc M, Rotaru M, Potârnichie O, Liliac L, Căruntu ID (2012) Healing process and laser therapy in the superficial periodontium: a histological study. Rom J Morphol Embryol 53(1):111–116
Gobbo M, Ottaviani G, Mustacchi G, Di Lenarda R, Biasotto M (2012) Acneiform rash due to epidermal growth factor receptor inhibitors: high-level laser therapy as an innovative approach. Lasers Med Sci 27(5):1085–1090
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Gobbo, M., Ottaviani, G., Perinetti, G. et al. Evaluation of nutritional status in head and neck radio-treated patients affected by oral mucositis: efficacy of class IV laser therapy. Support Care Cancer 22, 1851–1856 (2014). https://doi.org/10.1007/s00520-014-2155-x
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DOI: https://doi.org/10.1007/s00520-014-2155-x