Determinants of severe oral mucositis in paediatric cancer patients: a prospective study
Naïma Otmani1, Raouf Alami, Laïla Hessissen
1Pediatric Hemato-Oncology Unit, Children Hospital, Rabat, Morocco. onaima2000@yahoo.fr
Insights
Severe oral mucositis (OM) affects over half of young cancer patients receiving chemotherapy, with specific cancers and treatments increasing risk. Identifying these risk factors is crucial for better patient care and prevention strategies.
Area of Science:
- Pediatric Oncology
- Cancer Therapeutics
- Oral Medicine
Background:
- Oral mucositis (OM) is a common and debilitating side effect of cancer chemotherapy in children.
- Understanding the incidence and risk factors for severe OM is essential for developing effective management strategies.
Purpose of the Study:
- To determine the incidence of severe oral mucositis (OM) in pediatric cancer patients undergoing standard chemotherapy.
- To identify the key determinants and risk factors associated with the development of severe OM in this population.
Main Methods:
- A retrospective study was conducted at a Pediatric Hemato-Oncology unit.
- Data were collected from 970 patients under 16 years old treated with chemotherapy between 2001 and 2006.
- Incidence, time to onset, duration, and risk factors for severe OM were analyzed.
Main Results:
- Oral mucositis occurred in 55.6% of patients, with 17.9% experiencing severe grades.
- Severe OM was significantly associated with specific diagnoses: undifferentiated carcinoma of nasopharyngeal type (RR=2.6), non-Hodgkin lymphoma (RR=2.1), and acute leukemia (RR=1.7).
- Methotrexate-based chemotherapy regimens increased the risk of severe OM (RR=1.7).
Conclusions:
- The type of underlying malignancy and specific chemotherapy regimens are primary risk factors for OM development in pediatric cancer patients.
- This study provides a model for identifying high-risk patients, enabling targeted preventive and therapeutic interventions.
- Further research into optimizing chemotherapy protocols and supportive care can mitigate severe OM incidence.
Objective:
To analyse the incidence and the determinants of severe oral mucositis (OM) in young cancer patients treated by standard chemotherapy.
Methods:
The study was carried out at the Pediatric Hemato-Oncology unit of Children's Hospital of Rabat. Patients under 16 years of age with malignant disease treated by chemotherapy between January 2001 and December 2006 were recorded.
Results:
Consecutive patients (n = 970) with malignant disease were studied. The age ranges from 2 months to 16 years (mean, 6.8 ± 4.1 years). OM occurred in 540 (55.6%) patients, and 17.9% of them encountered severe grades. Mean time to onset of the lesions was 10.5 ± 6.8 (range, 1-22 days) and mean duration was 6.8 ± 3.1 (range, 2-23 days). All chemotherapeutic protocols were associated with OM development (range, 20-100%). Patients with severe OM were more likely to have undifferentiated carcinoma of nasopharyngeal type (RR = 2.6, 95% IC 1.1-6.1), non-Hodgkin lymphoma (RR = 2.1, 95% CI 1.2-2.4) and acute leukaemia (RR = 1.7, 95% CI 1.5-3.6). Methotrexate-based therapies were also associated with the worsening of OM (RR = 1.7, 95% IC 1.2-2.6).
Conclusion:
Underlying disease and chemotherapy regimens are the principal risk factors of OM development. This model can help in the identification of patients at risk for adequate preventive and therapeutic measures.
