Intravascular Laser Irradiation of Blood, Photodynamic Therapy and Photobiomodulation Therapy for prevention and treatment of oral mucositis in patients with cancer

Autor: Silva, Lucas Augusto da
Přispěvatelé: Pinheiro, S?rgio Luiz, Mendes, Fausto Medeiros, Villalpando, Karina Teixeira
Jazyk: portugalština
Rok vydání: 2021
Předmět:
Zdroj: Biblioteca Digital de Teses e Dissertações da PUC_CAMPINAS
Pontifícia Universidade Católica de Campinas (PUC-CAMPINAS)
instacron:PUC_CAMP
Popis: Submitted by SBI Biblioteca Digital (sbi.bibliotecadigital@puc-campinas.edu.br) on 2021-06-08T18:33:01Z No. of bitstreams: 1 LUCAS AUGUSTO DA SILVA.pdf: 4271933 bytes, checksum: ab885c90fe167ef9f8796fd0fc0a06c4 (MD5) Made available in DSpace on 2021-06-08T18:33:01Z (GMT). No. of bitstreams: 1 LUCAS AUGUSTO DA SILVA.pdf: 4271933 bytes, checksum: ab885c90fe167ef9f8796fd0fc0a06c4 (MD5) Previous issue date: 2021-02-26 Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES Oral mucositis (OM) is the most frequent and debilitating side effect associated with cancer treatment. The objective of this study was to evaluate the preventive and therapeutic clinical application of intravascular laser blood irradiation (ILIB), photodynamic therapy (PDT) and photobiomodulation therapy (PBM-T) in OM in patients with cancer undergoing chemotherapy and/or radiation therapy. Thirty-six cancer patients, with and without mucositis lesion, were divided by convenience into 3 groups, according to the established therapeutic protocol: PP (n = 10): PDT and PBM-T; PPI (n = 10): PDT, PBM-T and ILIB and I (n = 16): exclusively the ILIB technique. The PDT was performed with the photosensitizer curcumin (mouthwash with 20 mL of the solution for 5 min) and irradiation of the oral cavity with blue LED (1200 mW of power and wavelength of 468 nm, for 5 min). PBM-T was performed using a low intensity laser (100 mW of power, 660 nm wavelength, in continuous mode and 1 J of energy) at 26 points of the oral cavity, weekly for 5 weeks. The ILIB technique was performed with a bracelet on the radial artery and was applied using a low intensity laser (100 mW of power, 660 nm wavelength and 30 J of total irradiation energy, for 5 min), weekly, with a 5-session protocol. In patients without mucositis, the appearance or not of OM lesions after therapies was measured. In patients with mucositis, before and after their performance, the degree of OM was assessed according to the criteria established by the WHO. The results were analyzed using Biostat 5.3 Program. The Kruskal-Wallis non-parametric test was applied to assess types of cancer treatments and tumor staging and Wilcoxon's test to assess degrees of OM. The ANOVA parametric test was applied to evaluate parameters of oxygen saturation and heart rate. The level of significance in all tests was 5%. There was no significant difference between the types of cancer treatments (p=0.9602) and the tumor staging (p>0.05) between the sample groups. There was a significant reduction in the degrees of OM after treatment with PP (p=0.0117), PPI (p=0.0277) and I (p=0.0277). All groups were effective in preventing OM. The average follow-up time was 5 ? months. There was no significant change in oxygen saturation and heart rate when applying the laser in the PPI and I groups (p>0.05). It can be concluded that ILIB, PDT and PBM-T can be alternatives for prevention and treatment of OM lesions. A mucosite oral (MO) ? o efeito colateral mais frequente e debilitante associado ao tratamento oncol?gico. O objetivo deste trabalho foi avaliar a aplica??o cl?nica preventiva e terap?utica da irradia??o intravascular do sangue com laser (ILIB), terapia fotodin?mica (PDT) e terapia de fotobiomodula??o (PBM-T) na MO em pacientes oncol?gicos submetidos a tratamentos de quimioterapia e/ou radioterapia. Trinta e seis pacientes com c?ncer, sem e com les?o de mucosite, foram divididos por conveni?ncia em 3 grupos, de acordo com o protocolo terap?utico estabelecido: PP (n = 10): PDT e PBM-T; PPI (n = 10): PDT, PBM-T e ILIB e I (n = 16): exclusivamente a t?cnica da ILIB. A PDT foi realizada com o fotossensibilizante curcumina (bochechos com 20 mL da solu??o por 5 min) e irradia??o da cavidade oral com LED azul (1200 mW de pot?ncia e comprimento de onda de 468 nm, durante 5 min). A PBM-T foi realizada utilizando o laser de baixa intensidade (100 mW de pot?ncia, comprimento de onda de 660 nm, em modo cont?nuo e 1 J de energia) em 26 pontos da cavidade oral, semanalmente por 5 semanas. A t?cnica da ILIB foi executada com uma pulseira na art?ria radial e foi aplicada utilizando o laser de baixa intensidade (100 mW de pot?ncia, comprimento de onda de 660 nm e 30 J de energia total de irradia??o, durante 5 min), semanalmente, com um protocolo de 5 sess?es. Nos pacientes sem mucosite, o aparecimento ou n?o das les?es de MO ap?s as terapias foram mensurados. Nos pacientes com mucosite, antes e ap?s a sua realiza??o, o grau de MO dos pacientes foi avaliado de acordo com os crit?rios estabelecidos pela OMS. Os resultados foram analisados no Programa Biostat 5.3. Foi aplicado o teste n?o param?trico de Kruskal-Wallis para avaliar os tipos de tratamentos do c?ncer e estadiamento do tumor e o de Wilcoxon para avaliar os graus de MO. Foi aplicado o teste param?trico de ANOVA para avaliar os par?metros da satura??o de oxig?nio e frequ?ncia card?aca. O n?vel de signific?ncia em todos os testes foi de 5%. N?o houve diferen?a significante entre os tipos de tratamentos do c?ncer (p=0.9602) e no estadiamento do tumor (p>0.05) entre os grupos amostrais. Houve redu??o significante dos graus de MO ap?s o tratamento com PP (p=0.0117), PPI (p=0.0277) e I (p=0.0277). Todos os grupos foram efetivos na preven??o da MO. O tempo m?dio de acompanhamento foi de 5 meses e meio. N?o houve altera??o significante na satura??o de oxig?nio e frequ?ncia card?aca na aplica??o do laser nos grupos PPI e I (p>0.05). Pode-se concluir que a ILIB, PDT e PBM-T podem ser alternativas na preven??o e no tratamento das les?es de MO.
Databáze: OpenAIRE
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