ABSTRACT
PURPOSE: Oral mucositis (OM) is a frequent side effect resulting from antineoplastic treatment and is described as an acute alteration characterized by ulcerative lesions, with the presence of a persistent chronic inflammatory infiltrate, erythema, and pain. AIMS: The purpose of the study was to evaluate the presence of the herpes simplex virus (HSV-1/2) in patients with squamous cell carcinoma of the head and neck region (SCC) and its influence on the aggravation of oral mucositis after radiotherapy or radio/chemotherapy treatment. METHODS: In this prospective cohort study, 91 patients were evaluated with regard to their serological status for IgG before treatment (initial time interval--TI) and for IgM before treatment (T1) and on the 30th day after the first day of radiotherapy application/radiation therapy (final time interval--TF), using immunoenzymatic assay (ELISA), and the results were correlated with the intensity of OM. RESULTS: The seroprevalence for IgG was 97.8 %. IgM (TI) was positive in 18.7% and IgM (TF) in 20.9% of patients. All the patients developed some degree of oral mucositis; however, there was statistically significant correlation between positivity for IgM and degree of severity of OM, irrespective of the type of treatment to which the patient was submitted. CONCLUSION: The reactivation of HSV-1/2 was shown to be relatively infrequent and there was no correlation between presence of the virus and aggravation of oral mucositis resulting from antineoplastic treatment.
Subject(s)
Carcinoma, Squamous Cell/virology , Head and Neck Neoplasms/virology , Herpesvirus 1, Human/isolation & purification , Herpesvirus 2, Human/isolation & purification , Stomatitis/virology , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/immunology , Carcinoma, Squamous Cell/radiotherapy , Cohort Studies , Enzyme-Linked Immunosorbent Assay , Female , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/immunology , Head and Neck Neoplasms/radiotherapy , Herpesvirus 1, Human/immunology , Herpesvirus 2, Human/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Immunoglobulin M/blood , Immunoglobulin M/immunology , Male , Middle Aged , Prospective Studies , Seroepidemiologic Studies , Squamous Cell Carcinoma of Head and Neck , Stomatitis/etiology , Stomatitis/immunology , Young AdultABSTRACT
OBJECTIVE: The aim of this study was to evaluate the influence of low-level laser therapy (LLLT) on the prevention and treatment of oral mucositis (OM) in pediatric cancer patients taking methotrexate. BACKGROUND DATA: OM is a very common, potentially severe side effect, caused by treatment with radiotherapy and chemotherapy for cancer. METHODS: Forty patients with acute lymphoblastic leukemia, who received high doses of methotrexate, were distributed into two groups. Group A (Preventive Group) was composed of patients who received preventive laser (red-subgroup A1 or infrared-subgroup A2) for 5 days, beginning on the 1st day of infusion. Group B (Treatment Group) was composed of patients who received laser treatment only if they developed post-chemotherapy mucositis (red-subgroup B1 or infrared-subgroup B2). Laser was used at wavelengths of 660 or 830 nm with output 100 mW, power density 3.57 W/cm(2), spot size 0.028 cm(2), energy of 1 J, resulting in an energy density of 35 J/cm(2) for 10 sec in the prophylactic group, and energy of 2 J, resulting in energy density of 70 J/cm(2) for 20 sec in the therapeutic group. RESULTS: The percentage of patients who did not develop OM was higher in Group A (60% vs. 25%). In Group B, 3/20 patients developed grade IV OM (15%), and a significant difference was found between the two subgroups at the end of treatment (p=0.019). CONCLUSIONS: Prophylactic laser produced a better outcome than when patients did not receive any preventive intervention, and red laser (660 nm) was better than infrared (830 nm) in the prevention and treatment of OM.
