Effect of low-level laser therapy on chemoradiotherapy-induced oral mucositis and salivary inflammatory mediators in head and neck cancer patients

Background and Objective Oral mucositis (OM) is considered a painful and debilitating side effect in patients receiving head and neck cancer treatment. Low‐level laser therapy (LLLT) proved to be effective to prevent and treat chemoradiotherapy‐induced OM. The aim of this study was to evaluate the e...

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Published in:	Lasers in surgery and medicine Vol. 47; no. 4; pp. 296 - 305
Main Authors:	Oton-Leite, Angélica F., Silva, Geisa Badauy L., Morais, Marília O., Silva, Tarcília A., Leles, Cláudio R., Valadares, Marize Campos, Pinezi, Juliana Castro D., Batista, Aline C., Mendonça, Elismauro F.
Format:	Journal Article
Language:	English
Published:	United States Blackwell Publishing Ltd 01-04-2015 Wiley Subscription Services, Inc
Subjects:	Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - radiotherapy Chemoradiotherapy - adverse effects cytokines Cytokines - metabolism Double-Blind Method Epidermal Growth Factor - metabolism Female growth factors head and neck cancer Head and Neck Neoplasms - drug therapy Head and Neck Neoplasms - radiotherapy Humans laser therapy Low-Level Light Therapy Male matrix metalloproteinases Metalloproteases - metabolism Middle Aged Saliva - metabolism Severity of Illness Index Stomatitis - radiotherapy Vascular Endothelial Growth Factor A - metabolism cytokines growth factors head and neck cancer matrix metalloproteinases laser therapy
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Summary:	Background and Objective Oral mucositis (OM) is considered a painful and debilitating side effect in patients receiving head and neck cancer treatment. Low‐level laser therapy (LLLT) proved to be effective to prevent and treat chemoradiotherapy‐induced OM. The aim of this study was to evaluate the effect of LLLT in the severity of OM in patients with head and neck cancer and on the release of salivary inflammatory mediators. Clinical (score of OM severity) and biochemical parameters (concentration of inflammatory mediators, growth factors, and enzymes in saliva) were used. Materials and Methods Thirty patients were randomized into two groups: control and laser. LLLT was performed three times a week in the laser group, while control group received sham irradiation. OM severity was assessed according to the World Health Organization (WHO) and National Cancer Institute (NCI) scales. Pro‐inflammatory and anti‐inflammatory cytokines (TNF‐α, IL‐6, IL‐1β, IL‐10, TGF‐β), growth factors (EGF, FGF, VEGF), and metalloproteinases (MMP2/TIMP2, MMP9/TIMP2) concentrations were assessed using ELISA test. Saliva samples were collected on admission, and at the 7th, 21st, and 35th sessions of radiotherapy. Results The laser group showed a reduction in the severity of OM, which coursed with significantly diminished salivary concentration of EGF and VEGF in the 7th radiotherapy session and of IL‐6 and FGF in the 35th. There was a trend for reduced levels of IL‐1β, TNF‐α, IL‐10, TGF‐β, MMP2/TIMP2, MMP9/TIMP2 in the laser group compared to the control, however, no statistically significant differences were found. Conclusions These findings demonstrated that LLLT was effective in reducing the severity of chemoradiotherapy‐induced OM and was associated with the reduction of inflammation and repair. Lasers Surg. Med. 47:296–305, 2015. © 2015 Wiley Periodicals, Inc.
Bibliography:	istex:C89B26B149ACA3E138578CC7BCE3471C8889CCC4 National Council for Scientific and Technological Development - No. 479587/2010-8 ark:/67375/WNG-G1T2J371-D ArticleID:LSM22349 Foundation for Research Support in the State of Goiás - No. 2010102670007 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0196-8092 1096-9101
DOI:	10.1002/lsm.22349