Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients

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• 作者：Cesar Migliorati (1)
  Ian Hewson (2)
  Rajesh V. Lalla (3)
  Heliton Spindola Antunes (4) (5)
  Cherry L. Estilo (6)
  Brian Hodgson (7)
  Nilza Nelly Fontana Lopes (8)
  Mark M. Schubert (9)
  Joanne Bowen (10)
  Sharon Elad (11)
  
• 关键词：Oral mucositis ; Stomatitis ; Laser therapy ; LLLT ; LED ; Oral complications of cancer therapy ; Mucositis prevention ; Mucositis treatment
• 刊名：Supportive Care in Cancer
• 出版年：2013
• 出版时间：January 2013
• 年：2013
• 卷：21
• 期：1
• 页码：333-341
• 全文大小：183KB
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• 作者单位：Cesar Migliorati (1)
  Ian Hewson (2)
  Rajesh V. Lalla (3)
  Heliton Spindola Antunes (4) (5)
  Cherry L. Estilo (6)
  Brian Hodgson (7)
  Nilza Nelly Fontana Lopes (8)
  Mark M. Schubert (9)
  Joanne Bowen (10)
  Sharon Elad (11)
  
  1. Department of Diagnostic Sciences and Oral Medicine, College of Dentistry, University of Tennessee Health Sciences Center, 875 Union Avenue, suite N231, Memphis, TN, 38163, USA
  2. Dental Unit Royal Melbourne Hospital, Grattan Street, Parkville, Melbourne, 3050, Victoria, Australia
  3. Section of Oral Medicine, University of Connecticut Health Center, 263, Farmington Avenue, Farmington, CT, 06030-1605, USA
  4. Department of Oral Diagnosis, School of Dentistry, Universidade do Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
  5. Instituto Nacional de Cancer (INCA), Rua André Cavalcante, no 37, 2o andar, Rio de Janeiro, CEP-20231-050, Brazil
  6. Dental Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
  7. Pediatric Dentistry, Department of Developmental Sciences, Marquette University School of Dentistry, 1801 W. Wisconsin Ave., Milwaukee, WI, 53233, USA
  8. Rua Padre Priuli 11, S?o Paulo, S?o Paulo, Brazil
  9. Oral Medicine, UW School of Dentistry, Seattle Cancer Care Alliance, 825 Eastlake Avenue E, Seattle, WA, 98109, USA
  10. School of Medical Sciences, The University of Adelaide, Frome Road, Adelaide, South Australia, 5005, Australia
  11. Division of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave., Rochester, NY, 14620, USA
  
• ISSN：1433-7339

文摘

Background The aim of this study was to review the available literature and define clinical practice guidelines for the use of laser and other light therapies for the prevention and treatment of oral mucositis. Methods A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, and no guideline possible. Results A new recommendation was made for low-level laser (wavelength at 650?nm, power of 40?mW, and each square centimeter treated with the required time to a tissue energy dose of 2?J/cm2 (2?s/point)) for the prevention of oral mucositis in adult patients receiving hematopoietic stem cell transplantation conditioned with high-dose chemotherapy, with or without total body irradiation. A new suggestion was made for low-level laser (wavelength around 632.8?nm) for the prevention of oral mucositis in patients undergoing radiotherapy, without concomitant chemotherapy, for head and neck cancer. No guideline was possible in other populations and for other light sources due to insufficient evidence. Conclusions The increasing evidence in favor of low-level laser therapy allowed for the development of two new guidelines supporting this modality in the populations listed above. Evidence for other populations was also generally encouraging over a range of wavelengths and intensities. However, additional well-designed research is needed to evaluate the efficacy of laser and other light therapies in various cancer treatment settings.