Ensaio clínico cego e randomizado para avaliação de dois protocolos de fotobiomodulação para a prevenção das complicações orais em pacientes transplantados de medula óssea

Abstract

Bone marrow transplantation (BMT) or hematopoietic cell transplantation requires high doses of chemotherapy in patients who will undergo HSCT (Hematopoietic Stem Cell Transplantation), this chemotherapy regimen causes the destruction of cells with a high mitotic index leading to damage to the oral and gastric mucosa called Mucositis. The aim of this study was to investigate the efficacy of Photobiomodulation (PBM) in the prevention of oral complications in hematopoietic transplant patients applying PBM daily and comparing it to the application every other day, totalizing 4 weekly applications from the beginning of conditioning to neutrophilic engraftment (bone marrow engraftment) in gender-independent, halogen and/or haploidentical transplant recipients. The volunteers were randomly divided into 2 groups: Daily Laser Group (DLG) P=13; LG4 (4x a week) P=17. All groups were evaluated daily by a trained nursing staff., from the beginning of conditioning D-7 to D+21, the results were cataloged and analyzed in a blind, longitudinal study, according to the WHO scale for evaluation of oral mucositis and pain degree (VAS scale). The groups were submitted to low power laser treatment (Therapy XT-DMC, São Carlos, Brazil) with a wavelength of 660nm, Power of 100mW, exposure time of 20 s delivering 2J per point throughout the oral cavity. Data related to xerostomia, odynophagia and degree of mucositis were analyzed over 21 days and the data were compared statistically using the Mann-Whitney test. The statistical comparison results for xerostomia (D+8 p=0.4434), odynophagia (D+8 p=0.8560) and mucositis (D+8 p=0.7285) showed no significant differences at any time during the study. According to the results, the PBM protocol on alternate days is as efficient as the daily application for the prevention of oral complications in patients who underwent HSCT.