Radiation-induced Oral Mucositis in Brazilian Patients: Prevalence and Associated Factors

Abstract

Aim: To determine the prevalence of radiationinduced oral mucositis (OM) and associated factors. Patients and Methods: A cross-sectional retrospective study was performed at a reference dental care center. The medical records of patients submitted to radiotherapy for the treatment of head and neck cancer were used to collect clinical and demographic variables. The data were submitted to descriptive analysis and multivariate Poisson regression with robust variance [p<0.05; 95% confidence intervaI (CI)]. Results: Four hundred and thirteen patients were analyzed. The mean age was 55±14 years. The prevalence of OM in the overall sample was 41.9% and was higher among males (78.2%). The following variables were significantly associated with the outcome: radiation dose [prevalence ratio (PR)= 1.04; 95% CI=1.02-1.06]; concomitant chemotherapy (PR=1.48, 95% CI=1.05-2.08); oral candidiasis (PR=1.97, 95% CI=1.44-2.68); and osteoradionecrosis (PR=1.51, 95% CI=1.10-2.06). Conclusion: Radiation-induced OM was associated with radiation dose, concomitant chemotherapy, oral candidiasis and osteoradionecrosis. The rate of OM underscores the importance of adequate oral care prior to treatment for head and neck cancer.Oral mucositis (OM) is one of the most significant and common complications of radio/chemotherapy for the treatment of head and neck cancer (1-3). The pathogenesis of OM is complex and related to xerostomia, which is a consequence of the impairment of the salivary glands caused by radiation. OM may occur during or after treatment, the debilitating adverse effects of which include severe pain as well as difficulties in eating and performing oral hygiene, thereby compromising quality of life and potentially leading to suspension of cancer treatment, which increases the risk of death (4, 5).Data on the prevalence of radiation-induced OM in patients submitted to treatment for head and neck cancer are scarce in the literature and reveal considerable variation (6, 7). Recent studies have focused more on the different methods of cancer treatment rather than the causes of OM and associated factors (8,9).The oral regions most affected by OM are the floor of the mouth, lateral edge of the tongue, buccal mucosa and soft palate (10). Erythema is the initial manifestation, followed by the development of desquamative white plaques, which ulcerate, causing considerable pain. Poor oral hygiene and an absence of clinical follow-up before and during radiotherapy may aggravate the problem (8).An in-depth investigation of OM would provide information for better clinical management of this complication, contributing to its prevention and improving the quality of life of patients (9, 10). Thus, the aim of the present study was to investigate the prevalence of radiationinduced OM and report its associated factors.

Mucosite oral relacionada à quimioterapia em pacientes com câncer de mama: uma breve revisão

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Protective effect of titanium tetrafluoride and silver diamine fluoride on radiation-induced dentin caries in vitro

“…However, normal cells are also affected by head and neck radiotherapy, which can cause salivary gland dysfunction and, consequently, hyposalivation that dramatically increases the risk for dental caries. Furthermore, radiotherapy also causes some damage to the dental hard tissue, increasing its susceptibility to demineralization 3 , 4 .…”

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