Title: The low-level laser therapy in the prevention of oral mucositis in pediatric cancer patients at Hospital da Crianca de Brasilia Jose Alencar
The oral mucositis (OM) manifests in more than 60% of patients undergoing chemotherapy, impacting their quality of life, increasing morbidity and mortality rate. Therefore, it is important establishing a suitable protocol for the treatment and also the prevention of OM. Low-level laser therapy (LLLT) is an effective method of prevention, but there is no consensus regarding an appropriate dosimetry. This research objective was to verify effectiveness of preventive laser in children undergoing treatment for acute lymphoblastic leukemia (ALL) at the Hospital da Criança de Brasilia José Alencar (HCB). While in hospital care, patients who use Methotrexate (>1g/m2), will receive application of LLLT in order to prevent OM, starting at a day after the beginning of the cycle, with at least three consecutive applications in the same week. They were selected and distributed in two groups of 22 patients. G1: It was applied an energy density of 2J/point at an approximate distance of 1 cm, touching the tissue during 2s. G2: It was applied an energy density of 2J/point at a distance of 2 cm between points, touching the tissue during 2s. Patients returned on the 8th day to evaluate their oral cavity. Statistical analysis was performed by using SSPS Statistics. During years 2012- 2014 patients diagnosed with ALL, 37.68% had OM manifestation of varying degrees during chemotherapy. Yet in 2015 and 2016 patients allocated in G1, 88.5% showed no signs of OM and G2 92.9% also showed no signs of OM. It was concluded that the preventive use of LBP has been beneficial, and that irradiated patients in less points (G2) had better answer. And those who showed predisposition an OM, had less severe form. The adoption of an appropriate protocol of the preventive use of LBP, and motivation of oral hygiene and early search for a dental treatment led to a scenario of nonexistence of severe OM manifestations in pediatric patients treated at HCB.
The study draws attention to the importance of technological advances, the new treatment resources in the use of laser therapy in hospitalized patients, as well as the multiprofessional and humanized care that welcomes the individualities of each patient, helping him to live more and better. The dental intervention evidences an optimization of the antineoplastic treatment, avoiding interruptions and contributing to a better quality of life of the individuals.