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A phaseⅡprospective trial of photobiomodulation therapy in limiting oral mucositis in the treatment of locally advanced head and neck.cancer patients

引用

World Journal of Otorhinolaryngology-Head and Neck.Surgery 2022年第4期8卷 345-354页

作者： janielle k.-a.taylor Leila J.Mady k.alil Baddour Uzoma k.Iheagwara Shuyan Zhai James P.Ohr Daniel P.Zandber Vik.am C.Gorantla Robert L.Ferris Seungwon k.m Umamaheswar Duvvuri Mark.W.k.bik.Shaum Sridharan Jonas T.Johnson k.ren D.Holeva Annette E.Quinn David A.Clump School of Medicine University of PittsburghPittsburghPennsylvaniaUSA Department of Otorhinolaryngology—Head and Neck.Surgery University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Otolaryngology—Head and Neck.Surgery UPMCPittsburghPennsylvaniaUSA UPMC Department of Radiation Oncology UPMCPittsburghPennsylvaniaUSA Biostatistics UPMC Hillman Cancer CenterPittsburghPennsylvaniaUSA Department of Medicine Division of Hematology/OncologyUPMC Hillman Cancer CenterPittsburghPennsylvaniaUSA Department of Immunology UPMCPittsburghPennsylvaniaUSA Department of Plastic and Reconstructive Surgery University of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA

Objective:This study aimed to compare the historical incidence rate of severe oral mucositis(OM)in head and neck.cancer patients undergoing definitive concurrent chemoradiation therapy(CRT)versus a prospective cohort of patients with locally advanced head and neck.squamous cell carcinoma(HNSCC)treated with prophylactic photobiomodulation therapy(PBMT).Methods:This US-based,institutional,single-arm,phaseⅡprospective clinical trial was initiated in 50 patients(age≥18 years,k.rnofsk. Performance Scale Index>60,with locally advanced HNSCC(excluding oral cavity)receiving definitive or adjuvant radiation therapy(RT)with concurrent platinum-based chemotherapy(CT).PBMT was delivered three times per week.throughout RT utilizing both an intraoral as well extraoral delivery *** outcome measure was incidence of severe OM utilizing both the National Cancer Institute Common Toxicity Criteria,version 4.0(NCI-CTCAE)Grade≥3 and the World Health Organization Mucositis Grading Scale(WHO)Grade≥3 versus historical controls;secondary outcome measures included time to onset of severe OM following therapy ***:At baseline,all patients included in final analysis(N=47)had OM Grade *** RT and CT dose was(66.3±5.1)Gy and(486.1±106.8)mg/m ^(2),*** OM was observed in 11 of 47 patients(23%,confidence interval:12,38).OM toxicity grade trended upward during treatment,reaching a maximum at 7 week.(WHO:1.8 ***-CTCAE:1.7).Subsequently,OM grade returned to baseline 3 months following completion of *** mean time to onset of severe OM was(35±12)*** mean time to resolution of severe OM was(37±37)***:Compared to historical outcomes,PBMT aides in decreasing severe OM in patients with locally advanced *** represents a minimally invasive,prophylactic intervention to decrease OM as a major treatment-related side effect.

关键词： chemoradiotherapy oral mucositis photobiomodulation therapy squamous cell carcinoma of head and neck

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