Avaliação de mucosite oral em pacientes sob transplante de células-tronco hematopoiéticas submetidos a fotobiomodulação profilática
Introduction: Oral mucositis (OM) is the inflammation of the mucosa due to the cytotoxic effect of some oncological treatments on the oral mucosa. Despite photobiomodulatory therapy (PBMT) being effective in preventing and treating OM, some patients still develop this condition, which has a high imp...
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| Formato: | bachelorThesis |
| Idioma: | pt_BR |
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Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/handle/123456789/55799 |
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| Resumo: | Introduction: Oral mucositis (OM) is the inflammation of the mucosa due to the cytotoxic effect of some oncological treatments on the oral mucosa. Despite photobiomodulatory therapy (PBMT) being effective in preventing and treating OM, some patients still develop this condition, which has a high impact on the treatment of patients undergoing hematopoietic stem cell transplantation (HSCT). Objective: To evaluate the frequency, degree and factors associated with the development of OM in patients undergoing HSCT subjected to prophylactic PBMT. Methodology: Data were collected on sex, age, development time and degree of OM, as well as the conditioning protocol from medical records of 68 patients, who received prophylactic PBMT in a reference hospital in Rio Grande do Norte. Pearson's Chi-square test and Fisher's Exact Test were applied to verify associations between variables. The Kaplan-Meier method was used to calculate OM’s free survival time and the Log-rank test was used to compare survival curves. A significance level of 5% was adopted for all tests. Results: Among the 68 patients analyzed, 54.4% were female with a median age of 40 years. Multiple myeloma was the most common diagnosis (25%). Autologous transplantation was the most performed (54.4%) and MEL200, FluBuMel and FluBuMel and Cy were the most established chemotherapy conditioning protocols (16.2%). OM affected 37 patients, with the majority classified as grade 1 (32.4%) during the aplasia phase (97.3%). There was a statistically significant association between grade 1 and 2 OM in patients up to 40 years old (p = 0.017). The FluBuMel and Cy conditioning protocol was associated with cases of grade 2 OM (p = 0.006), just as the presence of pharyngeal mucositis was associated with grade 1 OM (p < 0.0001). Age group (p = 0.045), pharyngeal mucositis (p < 0.0001) and conditioning protocols LACE (p = 0.008), MEL100 (p < 0.0001), FluCyMel (p < 0.0001), FluBu (p = 0.094) and MEL140 (p < 0.0001) had a significant impact on the disease-free survival rate for the OM event. Patients whose conditioning protocol was MEL100 had a 14.36 times higher risk of developing OM. Conclusions: This research identified important factors associated with the development of OM in patients undergoing HSCT subjected to prophylactic PBMT, reinforcing that additional measures must be established for its prevention and that the dentist must monitor these patients in all phases of treatment. |
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