Severe Oral Mucositis in Pediatric Cancer Patients: Survival Analysis and Predictive Factors
Lecidamia Cristina Leite Damascena1, Nyellisonn Nando Nóbrega de Lucena1, Isabella Lima Arrais Ribeiro2
1Departament of Statistics, Federal University of Paraíba (UFPB), João Pessoa, PB 58051-900, Brazil.
Insights
Severe oral mucositis occurs differently in pediatric cancer patients. Factors like cancer type, blood counts, and treatment influence its onset, highlighting the need for tailored care.
Area of Science:
- Oncology
- Pediatric Medicine
- Clinical Research
Background:
- Severe oral mucositis is a common and debilitating side effect of cancer treatment in children.
- Understanding the factors influencing its occurrence is crucial for improving patient care and outcomes.
Purpose of the Study:
- To investigate the incidence and associated risk factors of severe oral mucositis in pediatric patients with hematologic malignancies and solid tumors.
- To analyze the time to occurrence of severe oral mucositis based on cancer type and treatment modalities.
Main Methods:
- A longitudinal, descriptive, observational study of 142 pediatric patients (0-19 years) from 2013-2017.
- Data collection included sociodemographic, health aspects, and the modified Oral Assessment Guide (OAG).
- Survival analysis utilized the Kaplan-Meier method and Cox semiparametric model.
Main Results:
- Median time to severe oral mucositis was 35.3 days for hematologic malignancies and 77.1 days for solid tumors.
- Risk factors for hematologic malignancies included white cell/platelet changes and natural chemotherapeutic agents.
- For solid tumors, risk factors included female sex, mixed ethnicity, metastasis, abnormal creatinine, and combined/miscellaneous chemotherapy.
Conclusions:
- The timing and risk factors for severe oral mucositis in pediatric cancer patients are significantly influenced by cancer type.
- Identifying these specific factors allows for targeted interventions and improved management strategies for oral mucositis in pediatric oncology.
Abstract:
This paper investigates the occurrence of severe oral mucositis and associated factors in blood and solid cancer pediatric patients subjected to cancer treatment, using a survival analysis. A longitudinal, descriptive, observational and inductive study of 142 pediatric patients aged from 0 to 19 years was conducted from 2013 to 2017. Data were collected using a form to record the sociodemographic characteristics and health-related aspects of patients and the modified Oral Assessment Guide (OAG). Survival analysis was performed using the Kaplan-Meier method and Cox semiparametric model. The median times to occurrence of severe oral mucositis were 35.3 and 77.1 days for patients with hematologic malignancies and solid tumors, respectively. The Cox model showed that white cell changes and platelet counts as well as the use of natural chemotherapeutic agents are risk factors for the occurrence of oral mucositis among patients with hematologic malignancies. Nonetheless, among patients with solid tumors, the occurrence of oral mucositis was associated with female sex, mixed ethnicity, the presence of metastasis, abnormal creatinine levels, a combination of chemotherapy, radiotherapy, and surgery, and the administration of chemotherapeutic agents included in the miscellaneous group. The time to occurrence of severe oral mucositis and its associated factors varied according to cancer type.
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