Laser de baixa intensidade na prevenção de mucosite oral quimioinduzida em pacientes pediátricos com leucemia aguda, HC/UFMG 2012-2013

Abstract

Oral mucositis is the non-hematologic toxicity most prevalent and of morbidity resulting from the antineoplasic treatment, which besides suffering, can affect the longevity of the patient. The purpose of this study is to evaluate the clinical efficacy of the low-level laser protocol for the prevention of chemo induced oral mucositis, comparing cycles of prophylactic irradiation of diode laser InGaAl ( = 660 nm; P= 40mW, dose 4 J/cm2) with no radiation cycles. Information about the demographic and clinical profile, which are risk factors for the oral mucositis and the course of the disease were collected from the medical and dental records of 53 children and teenagers who had acute leukemia, submitted to 222 cycles of chemotherapy, at Hospital das Clínicas of UFMG, from 2012 to 2013. Connections of the following topics were analyzed: the correlations about the buccal health conditions, chemotherapy cycles, neutropenia standards, infectious events, nutritional state on the clinical outcome of the mucositis. The mucositis occurred in 41.9% of the chemotherapy cycles. The change for the development of oral mucositis in the final cycles (7 to 10)was 7.34 times bigger than in the initial cycles (1 to 6); in the febrile neutropenia, it is 4.19 times bigger than in the functional neutropenia, when the antimicrobial therapy is used, it was 2.08 times bigger. And, in case of gingivitis, the chance was 2.12 times bigger. As regards the severity of the oral mucositis, only the standard ofneutropenia (p= 0.035), the use of antimicrobial therapy (p=0.006) and the presence of bacterial, fungal and/or multiple infection (p=0.004) presented evidence of connections. After checking the similarity among the groups related to the variables studied, we concluded that the use of prophylactic laser did not reduce the frequency of chemo induced oral mucositis, but it showed effectiveness in the reduction of its severity, not presenting adverse effects, thus, justifying its recommendation as a preventive procedure for children and teenagers under risk.