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

• Published in: Supportive care in cancer Vol. 30; no. 9; pp. 7365 - 7371
• Main Authors: de Cássia Dias Viana Andrade, Rita, Azevedo Reis, Thaís, Rosa, Luciano Pereira, de Oliveira Santos, Gabriel Pinto, da CristinaSilva, Francine
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2022; Springer; Springer Nature B.V
• Subjects: Antifungal agents; Antimicrobial agents; Cancer; Chemotherapy; Clinical trials; Comparative analysis; Drug therapy; Lasers in surgery; Light therapy; Light-emitting diodes; Medicine; Medicine & Public Health; Mucositis; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Photochemotherapy; Photodynamic therapy; Radiation therapy; Rehabilitation Medicine; Side effects; Stomatitis; Curcumin; Oral mucositis; Photodynamic therapy; Photobiomodulation; Cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-022-07127-x

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.