Antimicrobial photodynamic therapy for the treatment of oral mucositis-A comparative study

Photodiagnosis Photodyn Ther. 2023 Jun:42:103543. doi: 10.1016/j.pdpdt.2023.103543. Epub 2023 Mar 31.

Abstract

Objectives: The aim was to evaluate the effectiveness of photobiomodulation and antimicrobial photodynamic therapy in the treatment of oral mucositis.

Background: Oral Mucositis is a frequent complication of oral cavity and oropharynx cancer. Considering the OM aggravation by microorganisms contamination, disinfection provide by antimicrobial photodynamic therapy could be an effective approach.

Material and methods: This comparative study included fourteen patients undergoing radiochemotherapy for oral cavity and oropharynx cancer treatment, who developed oral mucositis.

Control group: photobiomodulation. Intervention group: photobiomodulation and antimicrobial photodynamic therapy. The lesion size, duration, pain, and identification of microorganisms were evaluated.

Results: The mean reduction in oral mucositis size in the intervention group was 0.70 cm² (±0.35) and 0.30 cm² (±1.10) for the control group. The mean duration of oral mucositis was 18.37 days (±12.12) for the intervention group and 23 days (±14.78) for the control group. The intervention group had a mean reduction of 3.40 points on the pain scale (±2.44), while the control group had 0.17 (±2.28). In the intervention group, the predominant isolated microbiota was featured as mixed culture (n = 4/ 50%), followed of Gram Positive (n = 3/ 37.50%), and Gram Negative (n = 1/ 12.55%). In the control group, mixed culture was also more frequent (n = 4 / 66%), followed by Gram Positive (n = 2 /34%). Gram Negative was not predominantly isolated in the control group.

Conclusion: No statistical significance was found between PBM-T alone and PBM-T + PDT. However, the better outcomes reached by PBM-T + PDT group would suggest there could be a role for combined treatment in the management of OM lesions.

Keywords: Oral cancer; Oral mucositis; Photobiomodulation; Photodynamic therapy.

MeSH terms

  • Anti-Infective Agents* / therapeutic use
  • Humans
  • Low-Level Light Therapy* / adverse effects
  • Oropharyngeal Neoplasms* / complications
  • Oropharyngeal Neoplasms* / drug therapy
  • Photochemotherapy* / methods
  • Photosensitizing Agents / therapeutic use
  • Stomatitis* / etiology

Substances

  • Photosensitizing Agents
  • Anti-Infective Agents