RESUMO
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.
Assuntos
Carcinoma de Células Escamosas/virologia , Neoplasias de Cabeça e Pescoço/virologia , Herpesvirus Humano 1/isolamento & purificação , Herpesvirus Humano 2/isolamento & purificação , Estomatite/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/imunologia , Carcinoma de Células Escamosas/radioterapia , Estudos de Coortes , Ensaio de Imunoadsorção Enzimática , Feminino , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/imunologia , Neoplasias de Cabeça e Pescoço/radioterapia , Herpesvirus Humano 1/imunologia , Herpesvirus Humano 2/imunologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Imunoglobulina M/sangue , Imunoglobulina M/imunologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Soroepidemiológicos , Carcinoma de Células Escamosas de Cabeça e Pescoço , Estomatite/etiologia , Estomatite/imunologia , Adulto JovemRESUMO
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.