Incidence and risk factors for oral mucositis in pediatric patients receiving chemotherapy

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.

Automated summary

The study investigated the incidence and risk factors for oral mucositis in pediatric cancer patients undergoing chemotherapy. It found that chemotherapy protocols using high-dose methotrexate, methotrexate combined with cyclophosphamide/doxorubicin, and methotrexate combined with cyclophosphamide have a higher incidence of severe grades of oral mucositis. Patients with severe oral mucositis also exhibited lower levels of leukocytes, hemoglobin, platelets, and higher levels of total bilirubin, alanine aminotransferase (ALT), and creatinine.