Head and Neck Oncology Group

Rio de Janeiro, Brazil

Head and Neck Oncology Group

Rio de Janeiro, Brazil
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Antunes H.S.,Instituto Nacional Of Cancer Inca | Wajnberg G.,Instituto Nacional Of Cancer Inca | Wajnberg G.,Head and Neck Oncology Group | Wajnberg G.,Federal University of Fluminense | And 20 more authors.
Lasers in Medical Science | Year: 2017

Oral mucositis is an acute toxicity that occurs in patients submitted to chemoradiotherapy to treat head and neck squamous cell carcinoma. In this study, we evaluated differences in gene expression in the keratinocytes of the oral mucosa of patients treated with photobiomodulation therapy and tried to associate the molecular mechanisms with clinical findings. From June 2009 to December 2010, 27 patients were included in a randomized double-blind pilot study. Buccal smears from 13 patients were obtained at days 1 and 10 of chemoradiotherapy, and overall gene expression of samples from both dates were analyzed by complementary DNA (cDNA) microarray. In addition, samples from other 14 patients were also collected at D1 and D10 of chemoradiotherapy for subsequent validation of cDNA microarray findings by qPCR. The expression array analysis identified 105 upregulated and 60 downregulated genes in our post-treatment samples when compared with controls. Among the upregulated genes with the highest fold change, it was interesting to observe the presence of genes related to keratinocyte differentiation. Among downregulated genes were observed genes related to cytotoxicity and immune response. The results indicate that genes known to be induced during differentiation of human epidermal keratinocytes were upregulated while genes associated with cytotoxicity and immune response were downregulated in the laser group. These results support previous clinical findings indicating that the lower incidence of oral mucositis associated with photobiomodulation therapy might be correlated to the activation of genes involved in keratinocyte differentiation. © 2017 Springer-Verlag London Ltd.


Antunes H.S.,Instituto Nacional Of Cancer Inca | Herchenhorn D.,Head and Neck Oncology Group | Small I.A.,Instituto Nacional Of Cancer Inca | Araujo C.M.M.,Instituto Nacional Of Cancer Inca | And 4 more authors.
Oral Oncology | Year: 2017

Background The impact of low-level laser therapy (LLLT) to prevent oral mucositis in patients treated with exclusive chemoradiation therapy remains unknown. This study evaluated the overall, disease-free and progression-free survival of these patients. Methods: Overall, disease-free and progression-free survival of 94 patients diagnosed with oropharynx, nasopharynx, and hypopharynx cancer, who participated on a phase III study, was evaluated from 2007 to 2015. The patients were subjected to conventional radiotherapy plus cisplatin every 3 weeks. LLLT was applied with an InGaAlP diode (660 nm–100 mW–1 J–4 J/cm2). Results With a median follow-up of 41.3 months (range 0.7–101.9), patients receiving LLLT had a statistically significant better complete response to treatment than those in the placebo group (LG = 89.1%; PG = 67.4%; p = 0.013). Patients subjected to LLLT also displayed increase in progression-free survival than those in the placebo group (61.7% vs. 40.4%; p = 0.030; HR:1:93; CI 95%: 1.07–3.5) and had a tendency for better overall survival (57.4% vs. 40.4%; p = 0.90; HR:1.64; CI 95%: 0.92–2.91). Conclusion This is the first study to suggest that LLLT may improve survival of head and neck cancer patients treated with chemoradiotherapy. Further studies, with a larger sample, are necessary to confirm our findings. © 2017 Elsevier Ltd

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