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Papel da fotobiomodulação no tratamento das toxicidades orais em pacientes tratados por carcinoma da cabeça e pescoço
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Resumo(s)
Os doentes tratados por Carcinoma da Cabeça e Pescoço (CCP) apresentam frequentemente toxicidades orais induzidas pelos tratamentos oncológicos, tais como mucosite oral (MO), xerostomia, dor, disgeusia, trismo, linfedema e disfagia. Estas complicações afetam significativamente a Qualidade de Vida (QdV) e podem comprometer a continuidade terapêutica. A Fotobiomodulação (PBM) surge como uma ferramenta adjuvante com um mecanismo de ação baseia na absorção de energia luminosa por cromóforos intracelulares, ativando vias biológicas envolvidas na produção de adenosina trifosfato (ATP), na modulação da inflamação e na regeneração tecidular.
Objetivo: O objetivo desta revisão foi analisar o papel da PBM na prevenção e no tratamento das toxicidades orais em doentes com CCP com base na literatura e nas recomendações internacionais da Multinational Association of Supportive Care in Cancer/ International Society of Oral Oncology (MASCC/ISOO) e da World Association for Photobiomodulation Therapy (WALT).
Materiais e Métodos: Foi realizada uma pesquisa bibliográfica estruturada nas bases de dados PubMed e Cochrane Library. Os estudos foram selecionados, analisados e sintetizados de forma descritiva.
Resultados: Os resultados demonstram que a PBM constitui o tratamento com maior nível de evidência para a MO. Para a xerostomia, dados são promissores, mas sem recomendações oficiais. Para a dor orofacial, a disgeusia, o trismo, o linfedema e a disfagia, a evidência é preliminar e heterogénea.
Conclusão: A PBM apresenta-se como uma abordagem terapêutica versátil, não invasiva, bem tolerada e promissora na abordagem das toxicidades orais. No entanto, a padronização dos protocolos e a realização de ensaios clínicos de grande dimensão continuam a ser necessárias para reforçar a evidência e promover a sua integração na prática clínica.
Patients treated for head and neck cancer (CCP) frequently present with oral toxicities induced by oncological treatments, such as Oral Mucositis (MO), xerostomia, pain, dysgeusia, trismus, lymphedema, and dysphagia. These complications significantly impair quality of life (QdV) and may compromise treatment continuity. Photobiomodulation (PBM) has emerged as an adjuvant therapeutic tool whose mechanism of action is based on the absorption of light energy by intracellular chromophores, activating biological pathways involved in adenosine triphosphate (ATP) production, modulation of inflammation, and tissue regeneration. Objective: The aim of this review was to analyse the role of PBM in the prevention and treatment of oral toxicities in patients with HNC based on literature and international recommendations from Multinational Association of Supportive Care in Cancer/ International Society of Oral Oncology (MASCC/ISOO) e da World Association for Photobiomodulation Therapy (WALT). Materials and Methods: A structured literature search was conducted in the PubMed and Cochrane Library databases. The studies were selected, analysed, and synthesized descriptively. Results: The findings demonstrate that PBM constitutes the treatment with the highest level of evidence for MO. For xerostomia, the data are promising but official recommendations are still lacking. Regarding orofacial pain, dysgeusia, trismus, lymphedema, and dysphagia, the available evidence remains preliminary and heterogeneous. Conclusion: PBM appears to be a versatile, non-invasive, well-tolerated, and promising therapeutic approach for the management of oral toxicities. However, the standardization of protocols and the implementation of large-scale clinical trials remain necessary to strengthen the evidence base and support its integration into clinical practice.
Patients treated for head and neck cancer (CCP) frequently present with oral toxicities induced by oncological treatments, such as Oral Mucositis (MO), xerostomia, pain, dysgeusia, trismus, lymphedema, and dysphagia. These complications significantly impair quality of life (QdV) and may compromise treatment continuity. Photobiomodulation (PBM) has emerged as an adjuvant therapeutic tool whose mechanism of action is based on the absorption of light energy by intracellular chromophores, activating biological pathways involved in adenosine triphosphate (ATP) production, modulation of inflammation, and tissue regeneration. Objective: The aim of this review was to analyse the role of PBM in the prevention and treatment of oral toxicities in patients with HNC based on literature and international recommendations from Multinational Association of Supportive Care in Cancer/ International Society of Oral Oncology (MASCC/ISOO) e da World Association for Photobiomodulation Therapy (WALT). Materials and Methods: A structured literature search was conducted in the PubMed and Cochrane Library databases. The studies were selected, analysed, and synthesized descriptively. Results: The findings demonstrate that PBM constitutes the treatment with the highest level of evidence for MO. For xerostomia, the data are promising but official recommendations are still lacking. Regarding orofacial pain, dysgeusia, trismus, lymphedema, and dysphagia, the available evidence remains preliminary and heterogeneous. Conclusion: PBM appears to be a versatile, non-invasive, well-tolerated, and promising therapeutic approach for the management of oral toxicities. However, the standardization of protocols and the implementation of large-scale clinical trials remain necessary to strengthen the evidence base and support its integration into clinical practice.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Fotobiomodulação Toxicidades orais Carcinoma da cabeça e do pescoço Mucosite