Fotobiomodulação com led no manejo da mucosite oral: uma revisão integrativa
Palavras-chave:
mucosite oral, estomatite, diodo emissor de luz, fototerapia, luzes de cura dentária.Resumo
RESUMO
Introdução: A mucosite oral é um efeito colateral comum no tratamento oncológico com radio/quimioterapia, podendo causar dor, dificuldade de alimentação e perda de peso. Recomenda-se a fotobiomodulação para o manejo dessas lesões, sendo o diodo emissor de luz (LED) uma terapia recente. Objetivo: Compilar os dados existentes acerca do uso da fotobiomodulação com LED para a prevenção e tratamento da mucosite oral em pacientes sob tratamento oncológico. Método: Criou-se uma chave de busca com os termos inscritos no Descritores em Ciências da Saúde e no Medical Subject Headings. Em seguida, uma pesquisa na Biblioteca Virtual em Saúde e no Medical Literature Analysis and Retrieval System Online via PubMed foi feita. Filtrou-se os artigos encontrados pelas publicações realizadas nos últimos dez anos, em inglês ou português, selecionando-se produções que avaliassem a prevenção e/ou tratamento da mucosite oral com fotobiomodulação com LED em pacientes oncológicos, excluindo-se opiniões, revisões e estudos em animais. Resultados: Após análise dos trabalhos, incluíram-se 6 artigos para compor esta revisão. Observou-se uma variedade de protocolos, com comprimento de onda entre 630 nm e 850 nm, potência entre 5 mW/cm² e 80 mW/cm², tempo de aplicação entre 3 segundos e 286 segundos, além de dosagem entre 3 J/cm² e 6,6 J/cm². Todos os estudos relataram alguma satisfação com o manejo empregado, seja em relação à segurança, custo-benefício, efetividade, entre outros. Conclusão: Depreende-se que a terapia com LED é eficaz na cicatrização das lesões oral e redução da dor, promovendo melhoria na saúde e qualidade de vida dos pacientes.
Referências
Kauark-Fontes E, Migliorati CA, Epstein JB et al. Extraoral photobiomodulation for prevention of oral and oropharyngeal mucositis in head and neck cancer patients: interim analysis of a randomized, double-blind, clinical trial. Support Care Cancer. 2022 Mar;30(3):2225-2236. doi: 10.1007/s00520-021-06625-8
Scully C, Sonis S, Diz PD. Oral mucositis. Oral Dis. 2006 May;12(3):229-241. doi: 10.1111/j.1601-0825.2006.01258.x
Trotti A, Bellm LA, Epstein JB et al. Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol. 2003 Mar;66(3):253-262. doi: 10.1016/s0167-8140(02)00404-8
Elting LS, Cooksley CD, Chambers MS et al. Risk, outcomes, and costs of radiation-induced oral mucositis among patients with head-and-neck malignancies. Int J Radiat Oncol Biol Phys. 2007 Jul;68(4):1110-1120. doi: 10.1016/j.ijrobp.2007.01.053
Murphy BA, Beaumont JL, Isitt J et al. Mucositis-related morbidity and resource utilization in head and neck cancer patients receiving radiation therapy with or without chemotherapy. J Pain Symptom Manage. 2009 Oct;38(4):522-532. doi: 10.1016/j.jpainsymman.2008.12.004
Papadopoulou A, Williams MD, Darbyshire PJ et al. Nutritional support in children undergoing bone marrow transplantation. Clin Nutr. 1998 Apr;17(2):57-63. doi: 10.1016/S0261-5614(98)80306-3
Al-Dasooqi N, Sonis ST, Bowen JM et al. Emerging evidence on the pathobiology of mucositis. Support Care Cancer. 2013 Jul;21(7):2070-2083. doi: 10.1007/s00520-013-1900-x
Maria OM, Eliopoulos N, Muanza T. Radiation-induced oral mucositis. Front Oncol. 2017;7:1-23. doi: 10.3389%2Ffonc.2017.00089
Lalla RV, Pilbeam CC, Walsh SJ et al. Role of the cyclooxygenase pathway in chemotherapy-induced oral mucositis: a pilot study. 2010 Jan;18(1):95-103. doi: 10.1007/s00520-009-0635-1
Cawley MM, Benson LM. Current trends in managing oral mucositis. Clin J Oncol Nurs. 2005 Oct;9(5):584-592. doi: 10.1188/05.CJON.584-592.
Vissink A, Jansma J, Spijkervet FKL et al. Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003;14(3):199-212. doi: 10.1177/154411130301400305.
Zadik Y, Arany PR, Fregnani ER et al. Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer. 2019 Oct;27(10):3969-3983. doi: 10.1007/s00520-019-04890-2.
Hamblin MR, Sousa MVP, Agawal T. Handbook of low-level laser therapy. 1st ed. Singapore: Jenny Stanford Publishing. 1170 p.
Huang YY, Sharma SK, Carroll J et al. Biphasic dose response in low level light therapy – an update. Dose Response. 2011;9(4):602-18. doi: 10.2203/dose-response.11-009.Hamblin.
Courtois E, Bouleftour W. Guy JB et al. Mechanisms of PhotoBioModulation (PBM) focused on oral mucositis prevention and treatment: a scoping review. BMC Oral Health. 2021 Apr 29;21(1):220. doi: 10.1186/s12903-021-01574-4.
Karu T. Mitochondrial mechanisms of photobiomodulation in context of new data about multiple roles of ATP. Photomed Laser Surg. 2010 Apr;28(2):159-60. doi: 10.1089/pho.2010.2789.
Freitas PM, Simões A. Laser in dentistry: guide for clinical practice. 1st ed. Iowa: Wiley-Blackwell. 376 p.
Hesikanen V, Hamblin MR. Photobiomodulation: lasers vs. light emitting diodes? Photochem Photobiol Sci. 2018 Aug 8;17(8):1003-1017. doi: 10.1039/c8pp90049c.
Whelan HT, Smits Junior RL, Buchman EV et al. Effect of NASA light-emitting diode irradiation on wound healing. J Clin Laser Med Surg. 2001 Dec;19(6):305-14. doi: 10.1089/104454701753342758.
Silveira RCCP, Galvão CM. O cuidado de enfermagem e o cateter de Hickman: a busca de evidências. Acta Paul Enferm. 2005;18(3):276-284. doi: 10.1590/S0103-21002005000300008.
Phillips B, Ball C, Sackett D et al. Oxford Centre for Evidence-Based Medicine: Levels of Evidence (March 2009) [Internet]. Oxford (UK): University of Oxford, Nuffield Department of Primary Care Health Sciences; 1998 Nov [updated 2009 Mar]. Available from: https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009.
WHO Handbook for reporting results of cancer treatment. Geneva: World Health Organization; 1979. 45 p.
Commom Terminology Criteria for Adverse Events v3.0. Bethesda: National Cancer Institute; 2006. 71 p.
Commom Terminology Criteria for Adverse Events v4.0. Bethesda: National Cancer Institute; 2010.
Sonis ST, Eilers JP, Epstein JB et al. Validation of a new scoring system for the assessment of clinical trial research of oral mucositis induced by radiation or chemotherapy. Mucositis Study Group. Cancer. 1999 May 15;85(10):2103-13. doi: 10.1002/(sici)1097-0142(19990515)85:10<2103::aid-cncr2>3.0.co;2-0.
Jacobs S, Baggott C, Agarwal R et al. Validation of the Children's International Mucositis Evaluation Scale (ChIMES) in paediatric cancer and SCT. Br J Cancer. 2013 Nov 12; 109(10): 2515–2522. doi: 10.1038/bjc.2013.618.
Delgado DA, Lambert BS, Boutris N et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. J Am Acad Orthop Surg Glob Res Rev. 2018 Mar; 2(3): e088. doi: 10.5435/JAAOSGlobal-D-17-00088.
Wong-Baker FACES® Pain Rating Scale. Oklahoma: Wong-Baker Faces Foundation; 2016.
Hodgson BD, Margolis DM, Salzman DE et al. Amelioration of oral mucositis pain by NASA near-infrared light-emitting diodes in bone marrow transplant patients. Support Care Cancer. 2012 Jul;20(7):1405-15. doi: 10.1007/s00520-011-1223-8.
Freire MRS, Freitas R, Colombo F et al. LED and laser photobiomodulation in the prevention and treatment of oral mucositis: experimental study in hamsters. Clin Oral Investig. 2014 Apr;18(3):1005-13. doi: 10.1007/s00784-013-1058-4.
Ash C, Dubec M, Donne K et al. Effect of wavelength and beam width on penetration in light-tissue interaction using computational methods. Lasers Med Sci. 2017 Nov;32(8):1909-1918. doi: 10.1007/s10103-017-2317-4.
Freitas ACC, Campos L, Brandão TB et al. Chemotherapy-induced oral mucositis: effect of led and laser
phototherapy treatment protocols. Photomed Laser Surg. 2014 Feb;32(2):81-7. doi: 10.1089/pho.2013.3576.
Guimaraes DM, Ota TMN, Silva DAC et al. Low-level laser or LED photobiomodulation on oral mucositis in pediatric patients under high doses of methotrexate: prospective, randomized, controlled trial. Support Care Cancer. 2021 Nov;29(11):6441-6447. doi: 10.1007/s00520-021-06206-9.
Treister NS, London WB, Guo D et al. A feasibility study evaluating extraoral photobiomodulation therapy for prevention of mucositis in pediatric hematopoietic cell transplantation. Photomed Laser Surg. 2016 Apr;34(4):178-84. doi: 10.1089/pho.2015.4021.
Bensadoun RJ, Bollet MA, Liem X et al. New photobiomodulation device for prevention and cure of radiotherapy-induced oral mucositis and dermatitis: results of the prospective safe PBM study. Support Care Cancer. 2022 Feb;30(2):1569-1577. doi: 10.1007/s00520-021-06574-2.
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