Oliveira Lopes, Carlos de

Ortega Lopez, Ana

Rigau, Josepa

Zangaro, Renato A.

English

Engineering Conferences International

Page 1 of 2   11/23/2004 Light Activated Tissue Regeneration and Therapy August 22-27, 2004 Notes by Joan B. Martin MD  Please contact me with any corrections drjoanbmartin@yahoo.com or joan.b.martin@kp.org   LOW LEVEL LASER REDUCES THE SEVERITY OF RADIOTHERAPY INDUCED ORAL MUCOSITIS AND XEROSTOMIA Ana Ortega Lopez MD, Univ. of Hawaii Pathology Residency Program, originally from Spain • Studies directed by Dr. Josepha Rigau • Mucositis and xerostomia are common reasons to have to halt radiotherapy or decrease the dose • Many topical drugs, oral drugs have been tried • Soft laser therapy (InGaAIP laser) 685 nm, 50 mW, output power mw, application size 2J/cm2 • 3 application points on jaw, 2 buccal mucosa each side, 3 pharynx, 4 on tongue • No application points over the tumor, did not want to activate • 60 patients • Radiotherapy daily 1.8-2.0 Gy, total dose 45-72 GY • Many received cisplatinum weekly therapy • Done in Brazil, randomized • Most had squamous cell cancer • Used a grading o oral mucositis, done weekly (NCI scores) o 0=none o 4=life-threatening • Used a pain score, 1-10 • Salivary flow rate was measures at day 1 (basal, day 15, at end of treatment, and 15 and 30 days after TX was completed • Statistical analysis Results: • NCI scores: baseline approx 0.3, without laser was 2, and less than one with laser • Pain scores 2 without laser, 07-0.9 with laser throughout the treatment • Salivation: without laser had significant decreased saliva production, treated with laser maintained their salivary flow rate • Stimulated salivary flow rate: same results Pathology slides:  • See more atrophy of salivary gland cells and larger loss of acini if no laser therapy is given • Radiotherapy alone: pathology shows more chronic inflammation than those who received laser treatment • Less fibrosis, more serous cells with laser One-year follow-up:  • Radiotherapy alone: loss of salivary flow has been permanent • With laser therapy: have been able to maintain their salivary flow Page 2 of 2   11/23/2004 • Plan to follow these patients for six years Conclusions: • The incidence of xerostomia is significantly reduced in patients treated with radiotherapy with laser • The use of laser in combination with radiotherapy decreases the severity of oral mucositis • The pain associated the oral mucositis is also reduced significantly in patients treated with radiotherapy with laser Discussion: • Did you try to treat the cancer? No, because clinical experience suggests that the laser activates the cancer. • Work in rats: can use ankophorin (sp?) to restore salivation knocked out by radiotherapy • How did you choose the target spots?  Followed the same pattern of previous studies.  It is the idea of the vascular areas that supply the glands. • Would this work after the radiotherapy is complete?  Harry Wayland has not a similar study with children, use a light box externally on the outside of the cheek, use in pt. with any kind of cancer but who develop xerostomia after radiation, they have had very good results • Paul Bradley: many groups are working on this, but this study shows treating the salivary glands directly.  The French have treated the patient before the radiotherapy begins and have found a protective effect.  In this study the principal investigator is a radiotherapist so he does not see them before. • Paul Bradley: Russian Skibelkin has done animal studies: laser can treat cancer.  Mikilov: cancer of esophagus: radiotherapy, no TX, LLLT; the LLLT group did the best but were creative in watching and treating the immune system, would irradiate the spleen etc.  

Low Level Laser Reduces the Severity of Radiotherapy Induced Oral Mucositis and Xerostomia

https://dc.engconfintl.org/cgi/viewcontent.cgi?filename=0&article=1018&context=tissue_regen&type=additional

Low Level Laser Reduces the Severity of Radiotherapy Induced Oral Mucositis and Xerostomia

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