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Master's Dissertation
DOI
https://doi.org/10.11606/D.25.2020.tde-01102021-155300
Document
Author
Full name
Raquel D'Aquino Garcia Caminha
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2020
Supervisor
Committee
Santos, Paulo Sergio da Silva (President)
Barberio, Gabriel Salles
Bombonatti, Juliana Fraga Soares
Coracin, Fábio Luiz
Title in Portuguese
Avaliação da microcirculação da mucosa oral por meio da fluxometria laser doppler em pacientes que recebem  quimioterapia e radioterapia 
Keywords in Portuguese
Fluxometria laser doppler
Microcirculação
Mucosite oral
Abstract in Portuguese
O objetivo deste estudo foi identificar as alterações presentes na microcirculação da mucosa oral por meio da Fluxometria Laser Doppler (FLD) em pacientes que recebem quimioterapia (QT) e/ou radioterapia (RT) com alto risco de desenvolver a mucosite oral (MO) e relacionar o fluxo sanguíneo com a graduação da MO e o fluxo sanguíneo com a graduação de dor. A amostra foi composta por indivíduos sob quimioterapia com alto risco de desenvolver MO (GQ); indivíduos sob RT acima de 20Gy em região de cabeça e pescoço - concomitante ou não a QT (GR) e indivíduos sem doença oncológica (GC). Foi realizada a mensuração do fluxo sanguíneo na região geniana através da FLD, sendo que no GQ foram realizadas 7 avaliações, no GR foram 8 avaliações e no GC apenas 1 avaliação; a dor em mucosa oral foi avaliada através da Escala Visual Analógica (EVA) e a MO através das escalas da Organização Mundial de Saúde (MO-OMS) e da Oral Mucositis Assessment Scale (MO-OMAS). O GQ foi composto por 7 indivíduos, o GR por 10 indivíduos e o GC por 12 indivíduos. Observamos que no GQ ao compararmos a evolução da MO-OMS ao longo do tempo com o momento inicial (T0) as manifestações são piores nos momentos T2, T3, T4. No GR também observamos a piora da manifestação da MO-OMS nos momentos T3, T4, T5, T6 com recebimento de dose de radiação entre 22 à 60Gy. Na MO-OMAS observamos que no GQ as piores manifestações ocorreram nos momentos T2, T3, T4, quando comparadas ao momento inicial (T0). No GR as piores manifestações da MO-OMAS foram coincidentes com a da MO-OMS no GR nos momentos T3, T4, T5, T6 e em dose de radiação entre 22 à 60Gy. Em relação ao fluxo sanguíneo observamos que no GQ houve aumento do fluxo sanguíneo ao longo do tempo, nos momentos T1, T2, T4, T5 quando comparamos ao momento inicial (T0), com exceção do momento T3 onde observou-se diminuição no fluxo sanguíneo. No GR também houve aumento do fluxo sanguíneo nos momentos T1, T2, T3, T5, T6 quando comparamos com o momento inicial (T0), com exceção do T4 (dose de radiação entre 32 a 40Gy), onde observou-se diminuição no fluxo sanguíneo. Concluímos que as alterações no fluxo sanguíneo da região geniana de indivíduos submetidos a QR e RT foram identificadas pela FLD e permitiu avaliar que as piores manifestações de MOOMS, MO-OMAS e pior intensidade da dor estão relacionadas com menor fluxo sanguíneo.
Title in English
Evaluation of microcirculation of the oral mucosa using laser doppler flowmetry in patients receiving chemotherapy and radiotherapy
Keywords in English
Laser doppler flowmetry
Microcirculation
Oral mucositis
Abstract in English
The aim of this study was to identify the changes present in the microcirculation of the oral mucosa through Laser Doppler Flowmetry (LDF) in patients receiving chemotherapy (CT) and / or radiotherapy (RT) with a high risk of developing oral mucositis (OM) and relating blood flow with the grading of OM and blood flow with grading of pain. The sample consisted of individuals undergoing chemotherapy with a high risk of developing OM (CTG); individuals under RT above 20Gy in the head and neck region - concomitant or not with CT (RG) and individuals without oncological disease (CG). Blood flow was measured in the genial region through LDF, and 7 evaluations were performed in the CTG, 8 evaluations were performed in the RG and 1 evaluation was performed in the CG; oral mucosa pain was assessed using the Visual Analogue Scale (VAS) and OM using the World Health Organization (OM-WHO) and Oral Mucositis Assessment Scale (OM-OMAS) scales. The CTG consisted of 7 individuals, the RG for 10 individuals and the CG for 12 individuals. We observed that in CTG when comparing the evolution of OM-WHO over time with the initial moment (T0), the manifestations are worse in moments T2, T3, T4. In RG, we also observed a worsening of the manifestation of OM-WHO at moments T3, T4, T5, T6 and when receiving a radiation dose between 22 to 60Gy. At OM-OMAS we observed that in CTG the worst manifestations occurred at moments T2, T3, T4, when compared to the initial moment (T0). In RG, the worst manifestations of OM-OMAS were coincident with that of OM-WHO in RG in moments T3, T4, T5, T6 and in radiation dose between 22 to 60Gy. Regarding blood flow, we observed that in the CTG there was an increase in blood flow over time, at T1, T2, T4, T5 when compared to the initial moment (T0), except for the T3 moment where a decrease in blood flow was observed. In RG there was also an increase in blood flow at T1, T2, T3, T5, T6 when compared to the initial moment (T0), with the exception of T4 (radiation dose between 32 to 40Gy), where a decrease in blood flow was observed. We conclude that changes in blood flow in the genital region of individuals undergoing CT and RT were identified by the LDF and allowed us to assess that the worst manifestations of OM-WHO, OM-OMAS and worse pain intensity are related to lower blood flow.
 
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Release Date
2023-10-01
Publishing Date
2021-10-01
 
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