Incidence and Risk Factors for Oral Mucositis in Pediatric Patients Receiving Chemotherapy

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2021 Apr 13

PMID 33846825

Citations 11

Authors

Marina Curra

Amanda F Gabriel

Maria Beatriz C Ferreira

Marco Antonio T Martins

Andre T Brunetto

Lauro J Gregianin

Manoela Domingues Martins

Affiliations

Soon will be listed here.

Abstract

Purpose: To investigate the incidence and risk factors for oral mucositis (OM) in patients with childhood cancer undergoing chemotherapy.

Methods: Eight hundred and twenty-nine cycles of chemotherapy were evaluated in 112 patients with childhood cancer undergoing chemotherapy. Chemotherapy protocol, hematological, hepatic, and renal function parameters were collected and compared to presence and severity of OM, as graded by the World Health Organization (WHO) scale. Patients received counseling on oral hygiene and those who presented with OM (grade ≥1) received photobiomodulation therapy (PBMT).

Results: Age ranged from 0 to 17 years (mean/SD, 8.58 ± 5.05) and fifty-one patients (45.54%) were females. The most common baseline diseases were leukemia (51%) followed by sarcomas (23%) and lymphomas (18%). Eight hundred and twenty-nine cycles of chemotherapy were evaluated, and OM was diagnosed in 527 cycles (63.57%). Higher incidence and severity of OM was observed in protocols using high-dose methotrexate (MTX-HD), MTX-HD cyclophosphamide/doxorubicin combination, and MTX-HD combined with cyclophosphamide (p <0.001). Patients with severe OM had lower levels of leukocytes (p = 0.003), hemoglobin (p = 0.005), platelets (p = 0.034), and higher levels of total bilirubin (p = 0.027), alanine aminotransferase (ALT) (p = 0.001), and creatinine (p = 0.007).

Conclusion: The study contributes to the elucidation of the risk factors for OM in pediatric cancer patients. Chemotherapy protocols using MTX-HD, MTX-HD associated with doxorubicin and cyclophosphamide, and MTX-HD and cyclophosphamide a have higher incidence of severe grades of OM. Other toxicities such as hematological, hepatic, and renal also developed in patients with OM.

Citing Articles

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Enhancing Standardized Practices for Oral Mucositis Prevention in Pediatric Hematopoietic Stem Cell Transplantation: A Best Practice Implementation Project.

Zhang L, Luo Y, Long J, Yin Y, Fu Q, Wang L Risk Manag Healthc Policy. 2024; 17:1909-1920.

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Chemotherapy-induced oral mucositis: hierarchical analysis of recurrence factors.

de Macedo T, de Melo M, Ferreira A, da Silva-Selva E, Godoy G, Caldas Junior A Eur Arch Paediatr Dent. 2024; 25(4):589-596.

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TNF-α promoter hypomethylation is frequent in oncopediatric patients who recovered from mucositis.

Filho J, de Castro Coelho M, Queiroz Neto J, de Souza B, Valenca A, de Oliveira N Braz Oral Res. 2024; 38:e042.

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Identifying central symptom clusters and correlates in children with acute leukemia undergoing chemotherapy: a network analysis.

Fang J, Wong C, Liu C, Huang H, Qi Y, Xu L Front Oncol. 2023; 13:1236129.

PMID: 37671049 PMC: 10475730. DOI: 10.3389/fonc.2023.1236129.

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