Phase III Trial of Low-level Laser Therapy to Prevent Induced Oral Mucositis in Head and Neck Cancer Patients Submitted to Concurrent Chemoradiation
Overview
- Phase
- Phase 3
- Intervention
- Not specified
- Conditions
- Squamous Cell Carcinoma of Nasopharynx
- Sponsor
- Instituto Nacional de Cancer, Brazil
- Enrollment
- 94
- Locations
- 1
- Primary Endpoint
- Incidence and / or Severity of Oral Mucositis
- Status
- Completed
- Last Updated
- 12 years ago
Overview
Brief Summary
Oral mucositis remains a limiting factor in in head and neck squamous cell carcinomas patients treated with chemoradiation leading to pain, dysphagia, and weight loss. Low-level laser therapy emerges as a promising, preventive therapy of chemoradiation-induced OM. This study was designed to assess the efficacy of Low Level Laser Therapy (LLLT) in reducing the incidence and/or severity of oral mucositis.
Detailed Description
Assuming oral mucositis grade 3 for placebo 0.4 (P0); laser group 0.15 (P1) ; β=0.2; α=0.05, sample size was 94 pts. From Jun 2007 to Dec 2010, 47 laser group and 47 placebo patients bearer of head and neck squamous cell carcinomas of nasopharynx, oropharynx and hypopharynx entered a prospective, randomized, double blind, placebo-controlled, phase III trial. chemoradiotherapy consisted of conventional radiotherapy 70.2 Gray (Gy) (1.8Gy/d, 5 times/wk) + concurrent cisplatin 100 mg/m2 every 3 weeks. The primary end point was the incidence of grade 3-4 oral mucositis. The Low-level laser therapy used daily, was a diode indium phosphide, gallium and aluminum (InGaAlP), 660nm-100 milliwatts (mW)-4 Joules (J)/cm²(DMC, São Carlos, São Paulo, Brazil). Oral mucositis evaluation was done by WHO and Oral Mucositis Assessment Scale (OMAS) scale.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age ≥ 18 years
- •Histological diagnosis of squamous cell carcinoma (nasopharynx, oropharynx and hypopharynx)
- •Candidates for surgery or treatment for organ preservation
- •Performance status (PS) of 0 or 1 according to the Eastern Cooperative Oncology Group (ECOG)
- •Indication for radiotherapy and concurrent platinum-based chemotherapy
- •Oral mucosa intact
- •Agree to follow the protocol of oral hygiene
- •Informed consent.
Exclusion Criteria
- •Patients using medication for treatment and or prevention of mucositis
- •Patients incapable of treatment compliance or of performing the protocol of oral hygiene
Outcomes
Primary Outcomes
Incidence and / or Severity of Oral Mucositis
Time Frame: 7 weeks
The oral cavities of all patients were evaluated daily, from the first day until the last day of treatment. We used the scales of mucositis of the World Health Organization (WHO) and the Oral Mucositis Assessment Scale (OMAS) and a visual analogue scale (VAS) for pain assessment.
Secondary Outcomes
- Oral Mucositis Survival Free, Pain, Opioid Treatment, Hospitalization, Treatment Interruption, Treatment Delay, Patient Weight Loss, Nasogastric Tube or of a Gastrostomy.(7 weeks)