The incidence of severe oral mucositis and its occurrence sites in pediatric oncologic patients

Abstract

Background Childhood cancer is one of the main causes of child mortality and its treatment has debilitating effects on the oral cavity. Several oral mucositis (SOM) is one of the most common and may cause undesirable symptoms such as pain and risk of systemic infection. Material and Methods This was a longitudinal, retrospective, and observational study determining the incidence of severe oral mucositis (SOM) and its occurrence sites in pediatric oncologic patients, in João Pessoa, Brazil, between 2013 and 2018. Data from 56 patients aged 1 to 18 years were collected from their medical records and through an oral mucosa examination, from the 1st to 5th week of chemotherapy treatment (CT) using the modified Oral Assessment Guide, by previously calibrated examiners (Kappa index > 0.7). The data were analyzed by the Chi-square test, and Odds Ratios were calculated. Results Most patients were females (54.5%), aged 8.8 years (± 4.8), with hematologic tumors (73.2%), predominantly Acute Lymphoid Leukemia (50.0%). An increase in the occurrence of SOM was observed throughout the CT ( P = 0.05), ranging from 12.5% in the 1st to 35.7% in the 5th CT week. In the 1st CT week, there was a predominance of alterations in the lips (5.5%) and saliva (5.5%), while in the 5th, the jugal / palate mucosa (21.4%) remained the most affected site by SOM. Differences in the severity of SOM in the jugal / palate mucosa ( P = 0.01) and labial mucosa ( P = 0.04) were observed over time. In the 5th CT week, the likelihood of developing SOM was 13.3-fold higher (95% CI: 1.5 - 105.6) in patients with hematologic tumors. Conclusions The incidence of SOM was higher in the 5th CT week, most commonly affecting the jugal / palate mucosa, and patients with hematologic tumors were more prone to develop SOM. Key words: Mucositis, oncology, pediatric dentistry.

Manual de cuidados orales para pacientes pediátricos con cáncer

“…En casos más graves, la mucositis oral puede causar dificultad para masticar y deglutir, deterioro nutricional, dificultad para limpiar la cavidad oral y se asocia con un mayor riesgo de infección local o sistémica. Todos estos aspectos implican un aumento de los tiempos y costos del tratamiento y una disminución de la calidad de vida del paciente y sus cuidadores (33,39,(41)(42)(43)(44).…”

Unstimulated salivary flow and oral streptococci in pediatric patients with hematological tumors: A longitudinal study

“…This hospital is a reference institute for the prevention, diagnosis, and treatment of cancer, treating approximately 150 cases per month in the pediatric sector, as well as an important Brazilian research center in the oncological field. [23][24][25] This study was approved by the Research Ethics Committee of the Health Sciences Center of the Federal University of Paraíba (CAAE: 64249317.3.0000.5188) in accordance with the 1964 Declaration of Helsinki and its subsequent amendments and with Resolution no. 466 of December 12, 2012 of the Brazilian Ministry of Health.…”

Prevention and the treatment of oral mucositis: the efficacy of sodium bicarbonate vs other agents: a systematic review

“…Children and adolescents are more prone to develop severe OM, with younger children having a greater probability of an occurrence of CT-induced severe OM (90%) among children under 12 years old) [ 3 ]. Pediatric patients with hematologic tumors are more likely to develop severe OM than those with solid tumors [ 4 ].…”