Radiotherapy‐Induced Oral Mucositis...Photobiomodulation on Nitrite and Inflammatory Activity

The Effect of Photobiomodulation on Nitrite and Inflammatory Activity in Radiotherapy‐Induced Oral Mucositis: A Randomized Clinical Trial:

Background and Objectives

To investigate pro‐ and anti‐inflammatory cytokines and nitrite salivary levels in patients with head and neck cancer receiving photobiomodulation therapy (PBMT) associated with a Preventive Oral Care Program (POCP), for prevention and control of oral mucositis (OM) during radiotherapy (RT) associated or not with chemotherapy protocol.

Study Design/Materials and Methods

In this randomized double‐blinded clinical trial, 48 patients were randomly assigned to two groups: PBMT (n = 25) and Control (n = 23). In the PBMT group, patients were submitted to PBMT associated with the POCP. In the Control group, patients were submitted only to the POCP. Saliva samples were collected in the 1st (baseline), 7th, 14th, 21st, and 30th sessions of RT, and the levels of interleukin‐6 (IL‐6), IL‐8, IL‐10, IL‐12p70, IL‐1β, and tumoral necrosis factor‐α (TNF‐α) were measured using the cytometric bead array. Nitrite levels were measured by colorimetric method. OM was assessed using the World Health Organization and the National Cancer Institute scales.

Results

Patients in the PBMT group presented less severe OM. PBMT tended to stabilize nitrite concentration levels during the RT regimen. The IL‐1β concentration was associated with higher OM scores. PBMT promoted an increase in IL‐12p70, TNF‐α, and IL‐10 concentration.

Conclusion

PBMT was effective in the prevention and control of severe OM, and its mechanism of action may be related to a better balance of inflammatory response that may favor injury control. Lasers Surg. Med. © 2020 Wiley Periodicals LLC