ЭФФЕКТИВНОСТЬ НИЗКОИНТЕНСИВНОГО ЛАЗЕРНОГО ИЗЛУЧЕНИЯ ДЛЯ ПРОФИЛАКТИКИ И ЛЕЧЕНИЯ РАДИАЦИОННО-ИНДУЦИРОВАННОГО МУКОЗИТА ПОЛОСТИ РТА И ГЛОТКИ

Oral mucositis is the most common and significant complication of chemoradiation therapy for oral and pharyngeal cancer. There are no standard methods for preventing and treating this disease. Patients with severe adverse events need expensive supportive care and unplanned treatment breaks. The objective of the study was to assess and optimize the effectiveness of low level laser therapy (LLLT) for prevention and treatment of chemoradiation-induced oral mucositis in patients with oral and pharyngeal cancer. Material and Methods. Forty-eight patients who received chemoradiation therapy for oral and pharyngeal cancer were enrolled. All patients were randomly divided into two groups. Group I patients (n=28) received standard treatment of chemoradiation-induced complications. Group II patients (n=20) were treated with low level laser therapy (LLLT) at a wavelength of 635 nm, three times a week for three minutes prior to radiation therapy session. Results. In the LLLT group, a statistically significant decrease in the frequency and severity of oral mucositis as well as decrease in pain were observed as compared to the group with standard treatment (χ2 =64,14, р<0,0001). No significant difference in the onset of symptoms and duration of severe mucositis were found. LLLT is an effective method capable of decreasing the frequency and severity of adverse events associated with concurrent chemoradiation therapy. Key words: radiation-induced mucositis, oral and pharyngeal cancer, low level laser therapy, chemoradiation therapy.><0,0001). No significant difference in the onset of symptoms and duration of severe mucositis were found. LLLT is an effective method capable of decreasing the frequency and severity of adverse events associated with concurrent chemoradiation therapy. При проведении лучевой/химиолучевой терапии опухолей полости рта и глотки наиболее частым и клинически значимым побочным эффектом лечения является мукозит – повреждение слизистой оболочки полости рта и глотки. В качестве одного из нефармакологических методов его профилактики и лечения используется низкоэнергетическое лазерное излучение (НИЛИ). Целью исследования было изучение эффективности НИЛИ красного диапазона для профилактики и лечения мукозита слизистой оболочки полости рта и глотки. Материалы и методы. В протокол включены 48 пациентов, получавших лучевую/химиолучевую терапию по поводу злокачественных новообразований полости рта, ротоглотки и носоглотки, которые случайным образом были разделены на две группы. В первой группе (28 пациентов) проводилась коррекция осложнений химиолучевого лечения в соответствии со стандартами клиники. Во второй группе (20 пациентов) дополнительно использовалось воздействие на слизистую оболочку низкоинтенсивным лазерным излучением (длина волны 635 нм, мощность 5 мВт) 3 раза в нед в течение 3 мин перед сеансом облучения, начиная с первого дня лечения. Результаты. В группе воздействия НИЛИ отмечалось статистически значимое снижение частоты и тяжести мукозита, а также снижение выраженности болевого синдрома по сравнению с группой стандартной коррекции мукозита. Статистически значимых различий по критерию появления первых симптомов побочных эффектов и по критерию продолжительности мукозита наиболее тяжелой степени выявлено не было. НИЛИ является эффективным и доступным методом, позволяющим существенно снизить частоту и тяжесть побочных эффектов лучевой и химиолучевой терапии.

The substantiation of the parameters of the rotary-film contactor for extracorporeal processing of large volumes of blood using ozone

Development and improvement of methods of ozone therapy is closely related to the optimization of the technical tools providing solutions to a variety of clinical applications. Aim: The aim of this research is to develop a new method of extracorporeal ozonation and oxygenation of large volumes of blood, as well as the development of a new type of “ozone – blood” contactor. Materials and methods: The kinetics of the interaction of ozone with whole blood was studied by the "stopped flow" method using a continuous-flow cell. The cell was a rectangular tube formed by parallel glass plates. The cell was located strictly horizontally, filled with the whole blood of the volunteer and thermostated at 37 °C. Ozone-oxygen mixture was blown through the slotted hole along the cell at a controlled velocity. The concentration of ozone was measured with a flow-through photometric analyzer. Results: A comparative analysis of ozone therapy techniques has allowed to develop a new method of extracorporeal ozonation and oxygenation of large volumes of blood. The study of the chemical reaction kinetics of whole blood interaction with the ozone-oxygen mixture made it possible to construct a mathematical model describing the process of the heterophase reaction of ozone-blood interaction in a rotor-film contactor. An experimental copy of the plant for extracorporeal treatment of large volumes of blood with ozone was developed based on the model. The experimental results obtained on the developed hardware-software system showed good correspondence with the theoretical model, thereby confirming the possibility of practical application of the proposed method

THE EFFICTIVENESS OF LOW LEVEL LASER THERAPY FOR PROVENTION AND TREATMENT OF RADIATION-INDUCEED MUCO

Oral mucositis is the most common and significant complication of chemoradiation therapy for oral and pharyngeal cancer. There are no standard methods for preventing and treating this disease. Patients with severe adverse events need expensive supportive care and unplanned treatment breaks. The objective of the study was to assess and optimize the effectiveness of low level laser therapy (LLLT) for prevention and treatment of chemoradiation-induced oral mucositis in patients with oral and pharyngeal cancer. Material and Methods. Forty-eight patients who received chemoradiation therapy for oral and pharyngeal cancer were enrolled. All patients were randomly divided into two groups. Group I patients (n=28) received standard treatment of chemoradiation-induced complications. Group II patients (n=20) were treated with low level laser therapy (LLLT) at a wavelength of 635 nm, three times a week for three minutes prior to radiation therapy session. Results. In the LLLT group, a statistically significant decrease in the frequency and severity of oral mucositis as well as decrease in pain were observed as compared to the group with standard treatment (χ2 =64,14, р<0,0001). No significant difference in the onset of symptoms and duration of severe mucositis were found. LLLT is an effective method capable of decreasing the frequency and severity of adverse events associated with concurrent chemoradiation therapy. Key words: radiation-induced mucositis, oral and pharyngeal cancer, low level laser therapy, chemoradiation therapy.><0,0001). No significant difference in the onset of symptoms and duration of severe mucositis were found. LLLT is an effective method capable of decreasing the frequency and severity of adverse events associated with concurrent chemoradiation therapy

ЭФФЕКТИВНОСТЬ НИЗКОИНТЕНСИВНОГО ЛАЗЕРНОГО ИЗЛУЧЕНИЯ КРАСНОГО И ИНФРАКРАСНОГО СПЕКТРА ДЛЯ КОРРЕКЦИИ РАДИАЦИОННОИНДУЦИРОВАННОГО МУКОЗИТА ПОЛОСТИ РТА И ГЛОТКИ

Low-level laser therapy as a method for correcting the mucositis caused by ionizing radiation of the oral mucosa is used in clinical practice for various exposure parameters: radiation power not less than 10 mW, laser doses not less than 2 J/cm2. The purpose of this study was to compare the efficacy of low-level laser therapyred and infrared laser radiation for the correction of mucositis of the oral mucosa in patients receiving radiation and chemoradiotherapy for oral and pharyngeal cancer, with laser doses of less than 1 J/cm2. The study included 106 patients who received radiation and chemoradiotherapy for cancer of the oral cavity and pharynx, which were randomly divided into three groups. In the first (37 patients), mucositis was prevented and corrected in accordance with the standards of the clinic, in the second (36 patients) and the third (33 patients), patients were additionally exposed to the oral cavity with Low-level laser therapy (LLLT) at 635 nm and 780 nm at powers of 5 mW and 20 mW, respectively. The effect of LLLT on the wavelength of 635 nm significantly reduced the frequency and severity of mucositis, increased the time until the appearance of the first symptoms of mucositis of the oral mucosa, shortened the duration of severe mucositis (grade 3), and reduced the need for painkillers, including narcotic analgesics compared with the group who received standard prophylaxis and correction of mucositis.Целью данного исследования было сравнение эффективности низкоинтенсивного лазерного излучения красного и инфракрасного диапазона для коррекции мукозита слизистой оболочки полости рта у пациентов, получающих лучевую и  химиолучевую терапию по  поводу рака полости рта и  глотки при плотности энергии менее 1 Дж/см2. В исследование были включены 106 пациентов, которым проводилась лучевая и химиолучевая терапия по поводу рака полости рта и глотки, которые случайным образом были разделены на три группы. В 1-й группе (37 пациентов) проводилась профилактика и коррекция мукозита в соответствии со стандартами клиники, во 2-й (36 пациентов) и 3-й группе (33 пациента) пациенты дополнительно получали воздействие на полость рта низкоинтенсивным лазерным излучением (НИЛИ) на длине волны 635 нм в дозе 0,3 Дж/см2 (профилактический режим) и  0,45  Дж/см2 (лечебный режим). При воздействии на  длине волны 780  нм доза составляла 0,6  Дж/см2 при профилактическом режиме и  0,8  Дж/см2 при лечебном воздействии, соответственно. Воздействие НИЛИ на  длине волны 635  нм статистически значимо уменьшило частоту и  тяжесть лучевого мукозита, увеличило время до  момента появления его первых симптомов, сократило длительность тяжелого мукозита (3-й степени) и снизило потребность пациентов в обезболивающих препаратах, в том числе и наркотических анальгетиках, по сравнению с группой, получавшей стандартную профилактику и коррекцию мукозита. НИЛИ на длине волны 780 нм по сравнению с группой стандартной коррекции статистически значимо увеличило время до появления первых симптомов мукозита и уменьшило выраженность болевого синдрома