Risk factors for oral mucositis in pediatric oncology patients undergoing chemotherapy: a prospective cohort

Abstract

Objective: To verify the risk factors for incidence and severity of oral mucositis (OM) in children and adolescents during anticancer treatment. Methods: A prospective cohort was carried out with 105 patients under 19 years, followed for ten consecutive weeks and submitted to chemotherapy (CT) with or without another treatment modality. Sociodemographic variables were collected using a specific form, with CT regimens obtained from medical records and the oral cavity evaluated by Oral Modified Assessment Guide (OAG). Bivariate comparison tests were used to summarize data and test within- and between-group differences. The longitudinal changes in the participants’ condition were modeled by mixed-model regression, using generalized estimating equations. Results: The incidence of mild/moderate and severe OM (SOM) ranged from 43.8% to 64.8% and 16.2% to 31.4%, respectively. The sex, age, type of tumor, treatment modality did not statistically influence the severity of OM. The longer the time since the chemotherapy session, the lower the risk of presenting OM and SOM. However, the chances of OM or SOM not occurring at longer intervals between chemotherapy sessions were very low. In most patients who developed OM, the mild/moderate condition persisted for ten weeks and the severe form for three weeks. Conclusion: Children and adolescents with cancer showed oscillations in the severity of OM during antineoplastic treatment and only the time since the last chemotherapy was statistically significant for severity of OM and OAG score.