Laser Doppler Flowmetry as a method of analysis for the evaluation of chemo - induced oral mucositis: A pilot study.
AbstractBackground: Oral mucositis (OM) is an inflammation of the oral mucosa due to cancer therapy that compromises the patient’s quality of life. Laser Doppler flowmetry (LDF) is a non-invasive method to monitor microvascular blood flow (BF) in real-time. Purpose: Develop a method to evaluate BF in the genian region cheek in patients undergoing chemotherapy by LDF and compare the degrees of OM and pain with evaluation of BF. Material and methods: Evaluation of OM was performed using the World Health Organization (WHO) and Oral Mucositis Assessment Scale (OMAS) scales and the visual analog scale for pain evaluation. For flowmetry analysis, a laser Doppler flowmeter (moorVMSTM™, 780 nm wavelength and VP3 probe), fixed by an acrylic resin support was used; VP3 probe was positioned on the genian region and the patient’s head was stabilized with a neck pillow for an accurate measurement. The Wilcoxon test was used to compare the flowmetry results at the studied times. The Pearson correlation coefficient was used to evaluate relationships between BF and the WHO, OMAS and visual analog scales. Results: Eleven patients of both sexes, aged between 30 and 78 years, with OM were included. An increase in cutaneous BF was observed at the initial times of OM, with progressive reduction during the chemotherapy cycle. There was a statistical difference (p<0.05) between time point T0 (first consultation) and time point T6 (last consultation). Conclusion: The method developed in this pilot study is effective, reliable, and reproducible, and allows the evaluation of BF dynamics in the genian region using LDF of patients undergoing chemotherapy at risk of developing OM.
2. Brown TJ, Gupta A. Management of Cancer Therapy-Associated Oral Mucositis. JCO Oncol Pract. 2020;16(3):103-9.
3. Curra MS, Soares-Junior LAV, Martins MD, Santos PSS. Protocolos quimioterápicos e incidência de mucosite bucal. Revisão integrativa. Einstein (São Paulo). 2018;16(1): eRW4007.
4. Bensadoun RJ, Nair RG. Efficacy of Low-Level Laser Therapy (LLLT) in Oral Mucositis: What Have We Learned from Randomized Studies and Meta- Analyses. Photomedicine and Laser Surgery. 2012; 30:191-2.
5. Milstein DM, te Boome LC, Cheung YW, Lindeboom JA, van den Akker HP, Biemond BJ, Ince C. Use of sidestream dark-field (SDF) imaging for assessing the effects of high-dose melphalan and autologous stem cell transplantation on oral mucosal microcirculation in myeloma patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(1):91-7.
6. Folgosi-Corrêa, MS. Caracterização das flutuações do sinal Laser Doppler do fluxo microvascular. 128f. [Tese](Doutorado em Ciências na área de Tecnologia Nuclear), Instituto de Pesquisas Energéticas e Nucleares. Universidade de São Paulo, São Paulo. 2011.
7. Leite PSA. Avaliação de dois métodos de análise da microcirculação gengival via Fluxometria Laser Doppler. 79f. [Dissertação] (Mestrado Profissional na área de Laser em Odontologia), Instituto de Pesquisas Energéticas e Nucleares. Universidade de São Paulo, São Paulo. 2007.
8. Kouadio AA, Jordana F, Koffi NJ, Le Bars P, Souedidan A. The use of laser doppler flowmetry to evaluate oral soft Tissue Blood Flow in Humans: A Review. Arch Oral Biol.2018; 86: 58-71.
9. Vongsavan N, Matthews B. Some aspects of the use of laser Doppler flow meters for recording tissue blood flow. Exp Physiol. 1993;78(1):1-14.
10. Canjau S, Miron MI, Todea CD. “Assessment of gingival microcirculation in anterior teeth using laser Doppler flowmetry”, Sixth International Conference on Lasers in Medicine, 967000C.
11. Amols HI, Goffman TE, Komaki R. Acute radiation effects on cutaneous microvasculature: Evaluation with a laser Doppler perfusion monitor. Radiology. 1988; 169: 557-60.
12. Svalestad J, Hellem S, Thorsen E, Johannessen AC. Effect of hyperbaric oxygen treatment on irradiated oral mucosa: microvessel density. Int J Oral Maxillofac Surg. 2015;44(3):301-7.
13. Berardesca E, Leveque JL, Masson P. EEMCO guidance for the measurement of skin microcirculation. Skin pharm appl skin physiol. 2002; 15(6): 442-456.
14. Ariyawardana A, Cheng KKF, Kandwal A, Tilly V, Al-Azri AR, Galiti D, Chiang K, Vaddi A, Ranna V, Nicolatou-Galitis O, Lalla RV, Bossi P, Elad S; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO). Systematic review of anti-inflammatory agents for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer. 2019;27(10):3985-95.
15. Helmers R, Straat NF, Navran A, Nai Chung Tong TAP, Teguh DN, van Hulst RA, de Lange J, Milstein DMJ. Patient-Side Appraisal of Late Radiation-Induced Oral Microvascular Changes. Int J Radiat Oncol Biol Phys. 2018. 15;102(4):1299-1307.
16. Scardina GA, Cacioppo A, Messina P. Changes of Oral Microcirculation in Chemotherapy Patients: A Possible Correlation with Mucositis? Clin.Anat. Palermo. 2014; 27:417–22.
17. Wilder-Smith P, Hammer-Wilson MJ, Zhang J, Wang Q, Osann K, Chen Z, Wigdor H, Schwartz J, Epstein J. In vivo imaging of oral mucositis in an animal model using optical coherence tomography and optical Doppler tomography. Clin Cancer Res. 2007. 15;13(8):2449-54.
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