Orientador: Alan Roger dos Santos SilvaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Objetivo: Descrever os padrões de resposta ao tratamento e sobrevida em pacientes com carcinoma espinocelular (CEC) de cavidade oral submetidos à fotobiomodulação (FBM) profilática para mucosite oral (MO). Material e métodos: Estudo clínico longitudinal retrospectivo realizado entre os anos de 2009 e 2014, baseado em pacientes diagnosticados com CEC de cavidade oral (C02; C03; C04; C05; C06) que concluíram protocolos curativos de radioterapia (RT) adjuvante à cirurgia ou quimiorradioterapia (QRT), bem como protocolos profiláticos de FBM para MO (InGaAlP; 660 nm, 40 mW, densidade de energia 10 J/cm2; 10 s/ponto; spot size 4mm2). Os prontuários digitais dos pacientes incluídos no estudo foram avaliados para coleta e análise de dados clínicos referentes ao grau de MO (Common Terminology Criteria for Adverse Events, National Cancer Institute, Version 4.0, 2010). Adicionalmente, foram coletadas informações relacionadas aos padrões clínicos de resposta tumoral ao tratamento oncológico e sobrevida. Resultados: Cento e cinquenta e dois pacientes com doença avançada ao diagnóstico foram incluídos no estudo, 88 (57,9%) foram submetidos à cirurgia, 152 (100%) à radioterapia e 100 (65.8%) à quimioterapia. Após um período médio de 40,84 (±11,71) meses de acompanhamento pós-tratamento, as taxas de sobrevida global e sobrevida livre de doenças foram de 46,7% e 51,8%, respectivamente. Quarenta e cinco pacientes (29.6%) desenvolveram recorrência locorregional, 10 (6,57%) pacientes desenvolveram metástase à distância e 19 (12,5%) pacientes desenvolveram segundos tumores primários. Conclusão: Os resultados de resposta ao tratamento multimodal e de sobrevida descritos no presente estudo foram similares aos encontrados em estudos clínicos previamente publicados na literatura pertinente a pacientes com CEC de boca em estágios avançados. Em suma, protocolos contemporâneos de FMB profiláticos para a MO não parecem gerar impacto negativo na sobrevida de pacientes com CEC de bocaAbstract: Aim: To describe the patterns of treatment response and overall survival in patients with oral squamous cell carcinoma (OSCC) which were submitted to prophylactic photobiomodulation (PBM) for oral mucositis (OM). Material and Methods: This was a retrospective longitudinal clinical study carried out in the period between the years 2009 and 2014, based on patients diagnosed with OSCC (C02; C03; C05; C06) that have concluded curative protocols of radiotherapy (RT) adjuvant to surgery or chemoradiotherapy (CRT), as well as prophylactic protocols of PBM for OM (InGaAlP; 660nm, 40Mw, density of energy 10J/cm2; 10 s/spot; spot size 4mm2). Digital medical records of the patients included in the study were assessed for data collection and analysis of clinical data referent to the OM grade (Common Terminology Criteria for Adverse Events, National Cancer Institute, Version 4.0, 2010). Additionally, data related to clinical patterns of tumor response to oncological treatment and overall survival were collected. Results: One hundred and fifty-two patients with advanced disease at the diagnosis were included in the study, 88 (57.9%) were submitted to surgery, 152 (100%) to RT and 100 (65.8%) to chemotherapy (QT). After a mean time of 40.84 (±11,71) months of post-treatment follow-up the overall survival and disease-free survival rates were 46.7% and 51.8%, respectively. Forty-five patients (29.6%) developed locoregional recurrence, 10 (6.57%) patients developed distant metastasis and 19 (12.5%) patients developed second primary tumors. Conclusion: The results of the response to multimodality treatment and of overall survival described in the present study were similar to the results found in clinical trials previously published in the literature regarding patients with OSCC in advanced stages. In conclusion, contemporary protocols of prophylactic PBM for OM do not seem to cause a negative impact on the overall survival of patients with OSCCDoutoradoEstomatologiaDoutora em Estomatopatologi
