Avaliação dos fatores de risco para carcinomas de cabeça pescoço e do efeito da terapia de fotobiomodulação no controle de mucosite oral radioinduzida: estudo observacional retrospectivo de caso controle
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Data
2022-09-09
Autores
Rocha, Audrey Foster Lefort [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A fotobiomodulação (FBM) tem sido o tratamento utilizado para prevenção e tratamento de complicações de alguns tratamentos antineoplásicos que podem acometer a cavidade oral, incluindo a mucosite oral (MO) e a hipossalivação. O presente estudo teve como objetivo avaliar o efeito da FBM no controle da MO, levantar os fatores de risco envolvidos e realizar a validação do protocolo de aplicação da FBM. Foi realizado um estudo observacional retrospectivo de caso controle, cujos dados foram obtidos das fichas clínicas dos prontuários de pacientes diagnosticados com carcinoma em região de cabeça e pescoço do Serviço de Medicina Bucal da Faculdade de Odontologia de Araraquara - UNESP. Para o estudo, foi selecionada uma amostra de 208 casos de pacientes com carcinoma de cabeça e pescoço, que foram divididos em 2 grupos, os que foram tratados por meio da FBM e os que não foram tratados com esse método. Para confirmação do diagnóstico foram analisados os laudos histopatológicos contidos nos prontuários. Após coleta dos dados, foram realizadas análises descritivas e foram demonstrados em tabelas e gráficos. Na análise estatística foram realizados teste de qui-quadrado, o teste G de Willians e o teste de regressão logística, sendo que foi utilizado o Software Bioestatic 5.0 ( para todas as análises α=0.05). Como resultado, pacientes que fizeram uso da FBM apresentaram aproximadamente 85% maior probabilidade de apresentar lesões de MO mais leves onde observa-se mais eritema do que ulcerações e, por isso apresentarm risco menor de suspensão do tratamento radioterápico. Concluindo, o perfil do paciente mais presente em nossa amostra era de pacientes da raça branca, com idade entre 50 a 70 anos, com histórico de consumo crônico de tabaco e álcool. A FBM foi considerada eficaz no tratamento e prevenção da MO, com diminuição da sua gravidade, além de ter atuado como analgésico e anti-inflamatório, tendo havido diminuição da sintomatologia dos pacientes e prorrogação do início dos sintomas da hipossalivação (xerostomia).
Photobiomodulation (FBM) has been the treatment used to prevent and treat complications of some antineoplastic treatments that can affect the oral cavity, including oral mucositis (OM) and hyposalivation. The present study aimed to evaluate the effect of FBM in the control of OM, raise the risk factors involved and carry out the validation of the application protocol of FBM. A retrospective observational case-control study was carried out, whose data were obtained from the clinical records of patients diagnosed with carcinoma in the head and neck region of the Oral Medicine Service of the Faculty of Dentistry of Araraquara - UNESP. For the study, a sample of 208 cases of patients with head and neck carcinoma was selected, who were divided into 2 groups, those who were treated using FBM and those who were not treated with this method. To confirm the diagnosis, the histopathological reports contained in the medical records were analyzed. After data collection, descriptive analyzes were performed and demonstrated in tables and graphs. In the statistical analysis, the chi-square test, the Williams G test and the logistic regression test were performed, using the Biostatic Software 5.0 (for all analyses α=0.05). As a result, patients who used FBM were approximately 85% more likely to have milder OM lesions where there is more erythema than ulcerations and, therefore, have a lower risk of discontinuation of radiotherapy treatment. In conclusion, the patient profile most present in our sample was white patients, aged between 50 and 70 years, with a history of chronic consumption of tobacco and alcohol. FBM was considered effective in the treatment and prevention of OM, with a reduction in its severity, in addition to having acted as an analgesic and anti-inflammatory, with a decrease in the patients' symptoms and a delay in the onset of symptoms of hyposalivation (xerostomia).
Photobiomodulation (FBM) has been the treatment used to prevent and treat complications of some antineoplastic treatments that can affect the oral cavity, including oral mucositis (OM) and hyposalivation. The present study aimed to evaluate the effect of FBM in the control of OM, raise the risk factors involved and carry out the validation of the application protocol of FBM. A retrospective observational case-control study was carried out, whose data were obtained from the clinical records of patients diagnosed with carcinoma in the head and neck region of the Oral Medicine Service of the Faculty of Dentistry of Araraquara - UNESP. For the study, a sample of 208 cases of patients with head and neck carcinoma was selected, who were divided into 2 groups, those who were treated using FBM and those who were not treated with this method. To confirm the diagnosis, the histopathological reports contained in the medical records were analyzed. After data collection, descriptive analyzes were performed and demonstrated in tables and graphs. In the statistical analysis, the chi-square test, the Williams G test and the logistic regression test were performed, using the Biostatic Software 5.0 (for all analyses α=0.05). As a result, patients who used FBM were approximately 85% more likely to have milder OM lesions where there is more erythema than ulcerations and, therefore, have a lower risk of discontinuation of radiotherapy treatment. In conclusion, the patient profile most present in our sample was white patients, aged between 50 and 70 years, with a history of chronic consumption of tobacco and alcohol. FBM was considered effective in the treatment and prevention of OM, with a reduction in its severity, in addition to having acted as an analgesic and anti-inflammatory, with a decrease in the patients' symptoms and a delay in the onset of symptoms of hyposalivation (xerostomia).
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Palavras-chave
Neoplasias de cabeça e pescoço, Estomatite, Terapia a laser