Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Basic Science

Background: Oral mucositis is an inflammation of mucous membranes in the mouth which ranges from small patches and redness to severe ulceration and hemorrhage; it is a common complication of oncotherapy treatment affecting 40-80% of patients undergoing chemotherapy and almost all those undergoing radiotherapy of the head and neck. The purpose: of this study was to investigate the efficacy of gallium arsenide laser in chemotherapy induced oral Mucositis and level of tumor necrosis factor- alpha as well as interleukin-6 in cancer patients due to various malignancies. Subjects: Eighty cancer patients of both genders, smokers and non-smokers with age ranging from 40 to 65 years old were included, type of cancer was head and neck squamous cell carcinoma, lymphoma and breast cancer. They had oral mucositis of various degrees following chemotherapy treatment. They were randomly selected from the out and inpatient clinic of oncology department of Kasr Elaini hospital, and received chemotherapy in the form of Antimetabolites, Mitotic inhibitors, Anthracyclins, Alkylating agent, corticosteroids and immunotherapy from 4-8 cycles. Methods: World Health Organization assessment scale was used for mucositis assessment. Blood samples were taken from all patients for TNF-Ü and IL-6 assessment before and after treatment. All patients were treated with gallium arsenide laser (daily 6 days/week) from the start of oral mucositis. Results: There was a significant reduction in the grade of oral mucositis in almost all patients by 51.91 % with p-value = 0.001. Also there was a significant reduction in the grade of oral mucositis of non smoker patients (mean difference = 1.727) versus smoker patients (mean difference = 1.016) with p-value = 0.0001 for both status, younger patients (mean difference = 1.886) versus older patients (mean difference = 1.009) with p-value = 0.0001 for both ages, female patients (mean difference = 1.759) versus male patients (mean difference = 1.173) with p-value = 0.0001 for both genders. There was no significant changes in the mean value of TNF-Ü or IL-6 for the whole patients with p-value = 0.6965, p-value 0.0827 consequently. Conclusion: Gallium arsenide laser is effective in reducing chemotherapy induced oral mucositis in cancer patients due to various malignancies better results were obvious in younger non smoker female patients and mechanism of action does not seem to be completely linked to the changes of pro or anti-inflammatory cytokines

Issued also as CD