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Comparative randomized trial study about the efficacy of photobiomodulation and curcumin antimicrobial photodynamic therapy as a coadjuvant treatment of oral mucositis in oncologic patients: antimicrobial, analgesic, and degree alteration effect

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Abstract

Introduction

As conventional treatments currently available for mucositis are not considerably effective, there is a need to implement an adjuvant protocol for the treatment of oral mucositis in patients undergoing radiotherapy and chemotherapy.

Purpose

To evaluate the effect of photobiomodulation (PBM) and antimicrobial photodynamic therapy (aPDT) mediated by curcumin and blue LED as an adjunct treatment of oral mucositis for oncology patients using chemotherapy and/or radiotherapy.

Methods

Clinical, randomized study, in a single location, in an oncology service of a general hospital, with a total of 30 patients (over 18 years old) with stable oral mucosa lesions in the process of chemotherapy and/or radiotherapy. The patients were divided into 3 groups: control group (treated with nystatin), PBM group (treated with low-level laser therapy), and the aPDT group (treated with 450-nm blue LED and curcumin photosensitizer).

Results

The results showed, by means of intra-group comparisons, that the two experimental treatments promoted yeast reduction of the genus Candida in the last two evaluations (21 days and 30 days), but not in the first two evaluations (7 days and 14 days). The intra-group comparisons showed that the control and aPDT group showed a significant difference in the degree of mucositis over the four evaluations performed, with the results pointing out that the mucositis worsened in the control group from the 14th day, while reduced in the aPDT group from the 21st day of treatment.

Conclusion

A reduction in the degree of mucositis and pain score was observed in the PBM and aPDT groups, with the aPDT group standing out when presenting early clinical improvement in relation to the PBM group and the control group, thus emphasizing its effectiveness within the desired aspects. Regarding the antimicrobial effect, aPDT showed a greater reduction of yeasts of the genus Candida in the tested parameters.

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Acknowledgements

We would like to thank Prof. Dr. Walter João Genovese (in memoriam) for his immense contribution in the area of laser therapy. His work, especially in Dentistry, has always been and will be a source of inspiration for many researchers and clinicians.

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Authors and Affiliations

  1. Cruzeiro Do Sul University, Paulista Avenue, 1415 Centro, São Paulo, São Paulo, 01311-925, Brazil

    Rita de Cássia Dias Viana Andrade

  2. Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Rio de Contas Street, 58 Candeias, Bahia, 450029-094, Brazil

    Thaís Azevedo Reis, Luciano Pereira Rosa, Gabriel Pinto de Oliveira Santos & Francine da CristinaSilva

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  1. Rita de Cássia Dias Viana Andrade
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  2. Thaís Azevedo Reis
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  3. Luciano Pereira Rosa
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  5. Francine da CristinaSilva
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Rita de Cássia Dias Viana Andrade, Thaís Azevedo Reis, and Francine Cristina da Silva. The first draft of the manuscript was written by Rita de Cássia Dias Viana Andrade and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Thaís Azevedo Reis.

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Ethics approval and study location

The study was approved by the Human Research Ethics Committee of the Multidisciplinary Health Institute of the Federal University of Bahia, under number CAAE 83784618.4.0000.5556. The study was carried out at the High Complexity Assistance Unit in Oncology of the General Hospital of Vitória da Conquista (HGVC) in the city of Vitória da Conquista, Bahia, Brazil.

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de Cássia Dias Viana Andrade, R., Azevedo Reis, T., Rosa, L.P. et al. Comparative randomized trial study about the efficacy of photobiomodulation and curcumin antimicrobial photodynamic therapy as a coadjuvant treatment of oral mucositis in oncologic patients: antimicrobial, analgesic, and degree alteration effect. Support Care Cancer 30, 7365–7371 (2022). https://doi.org/10.1007/s00520-022-07127-x

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