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Braguês R, Marvão MF, Correia P, Silva RM. Oral Mucositis Management in Children under Cancer Treatment: A Systematic Review. Cancers (Basel) 2024; 16:1548. [PMID: 38672630 PMCID: PMC11048343 DOI: 10.3390/cancers16081548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Children undergoing antineoplastic treatment often present severe side effects due to the dosage and duration of treatments, with oral mucositis emerging as one of the most prevalent and painful inflammatory conditions. There is a growing body of evidence on therapeutic interventions such as cryotherapy, low-level laser therapy, and natural compounds for this condition. The aim of this systematic review was to identify and compare therapies for the management of cancer treatment-induced oral mucositis in pediatric patients. From 2655 articles obtained in initial searches, 39 articles were considered in this systematic review, after applying inclusion/exclusion criteria. Low-level laser therapy, palifermin, honey, and zinc demonstrated reductions in oral mucositis incidence, duration, severity, and pain reported by the patient. Although there are several therapies in place for the prevention and treatment of oral mucositis in children, evidence of their efficacy is still inconclusive to establish accurate clinical protocols.
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Affiliation(s)
- Ricardo Braguês
- Universidade Católica Portuguesa, Faculty of Dental Medicine, 3504-505 Viseu, Portugal; (R.B.); (M.F.M.); (P.C.)
| | - Maria Francisca Marvão
- Universidade Católica Portuguesa, Faculty of Dental Medicine, 3504-505 Viseu, Portugal; (R.B.); (M.F.M.); (P.C.)
| | - Patrícia Correia
- Universidade Católica Portuguesa, Faculty of Dental Medicine, 3504-505 Viseu, Portugal; (R.B.); (M.F.M.); (P.C.)
- Universidade Católica Portuguesa, Center for Interdisciplinary Research in Health (CIIS), 3504-505 Viseu, Portugal
| | - Raquel M. Silva
- Universidade Católica Portuguesa, Faculty of Dental Medicine, 3504-505 Viseu, Portugal; (R.B.); (M.F.M.); (P.C.)
- Universidade Católica Portuguesa, Center for Interdisciplinary Research in Health (CIIS), 3504-505 Viseu, Portugal
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Ferrández-Pujante A, Pérez-Silva A, Serna-Muñoz C, Fuster-Soler JL, Galera-Miñarro AM, Cabello I, Ortiz-Ruiz AJ. Prevention and Treatment of Oral Complications in Hematologic Childhood Cancer Patients: An Update. CHILDREN (BASEL, SWITZERLAND) 2022; 9:566. [PMID: 35455610 PMCID: PMC9029683 DOI: 10.3390/children9040566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 06/14/2023]
Abstract
Cancers have a highly negative impact on the quality of life of paediatric patients and require an individualised oral treatment program for the phases of the disease. The aim of this study was to update existing research on oral care in children diagnosed with cancer. We carried out a literature search (in English, Spanish and Portuguese) in the Pubmed, Cochrane Library, EBSCO, WOS, SciELO, Lilacs, ProQuest, and SCOPUS databases and the websites of hospitals that treat childhood cancers. We found 114 articles and two hospital protocols. After review, we describe the interventions necessary to maintain oral health in children with cancer, divided into: phase I, before initiation of cancer treatment (review of medical record and oral history, planning of preventive strategies and dental treatments); phase II, from initiation of chemo-radiotherapy to 30-45 days post-therapy (maintenance of oral hygiene, reinforcement of parent/patient education in oral care, prevention and treatment of complications derived from cancer treatment); phase III, from 1 year to lifetime (periodic check-ups, maintenance, and reinforcement of oral hygiene, dental treatments, symptomatic care of the effects of long-term cancer treatment). The use of standardised protocols can avoid or minimise oral cancer complications and the side effects of cancer therapies.
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Affiliation(s)
- Alba Ferrández-Pujante
- Department of Integral Paediatric Dentistry, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.F.-P.); (A.P.-S.); (C.S.-M.); (A.J.O.-R.)
| | - Amparo Pérez-Silva
- Department of Integral Paediatric Dentistry, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.F.-P.); (A.P.-S.); (C.S.-M.); (A.J.O.-R.)
- Institute of Biomedical Research, IMIB, 30120 Murcia, Spain; (J.L.F.-S.); (A.M.G.-M.)
| | - Clara Serna-Muñoz
- Department of Integral Paediatric Dentistry, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.F.-P.); (A.P.-S.); (C.S.-M.); (A.J.O.-R.)
- Institute of Biomedical Research, IMIB, 30120 Murcia, Spain; (J.L.F.-S.); (A.M.G.-M.)
| | - José Luis Fuster-Soler
- Institute of Biomedical Research, IMIB, 30120 Murcia, Spain; (J.L.F.-S.); (A.M.G.-M.)
- Paediatric Oncology Section, Children’s University Hospital Virgen of Arrixaca, 30120 Murcia, Spain
| | - Ana Mª Galera-Miñarro
- Institute of Biomedical Research, IMIB, 30120 Murcia, Spain; (J.L.F.-S.); (A.M.G.-M.)
- Paediatric Oncology Section, Children’s University Hospital Virgen of Arrixaca, 30120 Murcia, Spain
| | - Inmaculada Cabello
- Department of Integral Paediatric Dentistry, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.F.-P.); (A.P.-S.); (C.S.-M.); (A.J.O.-R.)
- Institute of Biomedical Research, IMIB, 30120 Murcia, Spain; (J.L.F.-S.); (A.M.G.-M.)
| | - Antonio J. Ortiz-Ruiz
- Department of Integral Paediatric Dentistry, Faculty of Medicine and Dentistry, University of Murcia, 30008 Murcia, Spain; (A.F.-P.); (A.P.-S.); (C.S.-M.); (A.J.O.-R.)
- Institute of Biomedical Research, IMIB, 30120 Murcia, Spain; (J.L.F.-S.); (A.M.G.-M.)
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Coêlho MC, Viana Filho JMC, Souza BFD, Valença AMG, Persuhn DC, Oliveira NFPD. Genetic polymorphisms of genes involved in oxidative stress and inflammatory management in oncopediatric patients with chemo-induced oral mucositis. J Appl Oral Sci 2022; 30:e20210490. [PMID: 35319668 PMCID: PMC8963388 DOI: 10.1590/1678-7757-2021-0490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/20/2022] [Indexed: 11/21/2022] Open
Abstract
Oral mucositis (OM) is a painful inflammatory oral condition that affects children who undergo chemotherapy. Oxidative stress is a known OM mediator and pro-inflammatory cytokines contribute to the amplification of the immune response.
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Affiliation(s)
- Marina Castro Coêlho
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, João Pessoa, Paraíba, Brasil
| | - José Maria Chagas Viana Filho
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, João Pessoa, Paraíba, Brasil
| | - Beatriz Fernandes de Souza
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, João Pessoa, Paraíba, Brasil
| | - Ana Maria Gondim Valença
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, João Pessoa, Paraíba, Brasil
| | - Darlene Camati Persuhn
- Universidade Federal da Paraíba - UFPB, Centro de Ciências Exatas e da Natureza, Departamento de Biologia Molecular, João Pessoa, Paraíba, Brasil
| | - Naila Francis Paulo de Oliveira
- Universidade Federal da Paraíba - UFPB, Centro de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, João Pessoa, Paraíba, Brasil.,Universidade Federal da Paraíba - UFPB, Centro de Ciências Exatas e da Natureza, Departamento de Biologia Molecular, João Pessoa, Paraíba, Brasil
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Yaffe Ornstein M, Stocki D, Levin D, Dvir R, Manisterski M, Berger-Achituv S, Rosenfeld Keidar H, Peled Y, Hazan S, Rosenberg T, Oppenheimer N, Elhasid R. Tramadol Treatment for Chemotherapy-induced Mucositis Pain in Children. J Pediatr Hematol Oncol 2022; 44:e487-e492. [PMID: 33181582 DOI: 10.1097/mph.0000000000002003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022]
Abstract
Mucositis, a painful and debilitating condition, is a common side effect of chemotherapy. The role of tramadol in the treatment of mucositis in pediatric patients has not yet been determined. In this retrospective study, we evaluate whether tramadol as single agent achieved a reduction of pain intensity among oncologic children admitted for mucositis. In total, 34 of 54 (63%) episodes were treated with tramadol alone and achieved adequate pain relief. Tramadol's side effects were mild and manageable.
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Affiliation(s)
| | - Daniel Stocki
- The Anesthesia, Intensive Care and Pain Division, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Rina Dvir
- Department of Pediatric Hemato-Oncology
| | | | | | | | | | - Shoshana Hazan
- The Anesthesia, Intensive Care and Pain Division, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Walker SM, Selers EL, Jay MA. Intravenous opioids for chemotherapy-induced severe mucositis pain in children: Systematic review and single-center case series of management with patient- or nurse-controlled analgesia (PCA/NCA). Paediatr Anaesth 2022; 32:17-34. [PMID: 34731511 DOI: 10.1111/pan.14324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chemotherapy-induced oral mucositis can result in severe pain. Intravenous (IV) opioids are recommended, but management protocols vary. We systematically reviewed studies reporting IV opioid use for pain related to chemotherapy-induced severe oral mucositis in children and conducted a large single-center case series. METHODS Ovid MEDLINE, PubMed, and Cochrane databases were searched for studies reporting IV opioid duration and/or dose requirements for severe mucositis. Secondly, our pain service database was interrogated to describe episodes of opioid administration by patient- or nurse-controlled analgesia (PCA/NCA) for children with mucositis and cancer treatment-related pain. RESULTS Seventeen studies (six randomized trials, two prospective observational, three retrospective cohort, six retrospective case series) included IV opioid in 618 patients (age 0.3-22.3 years), but reported parameters varied. Mucositis severity and chemotherapy indication influenced IV opioid requirements, with duration ranging from 3 to 68 days and variable dose trajectories (hourly morphine or equivalent 0-97 mcg/kg/h). Our 7-year series included PCA/NCA for 364 episodes of severe mucositis (302 patients; age 0.12-17.2 years). Duration ranged from 1 to 107 days and dose requirements in the first 3 days from 1 to 110 mcg/kg/h morphine. Longer PCA/NCA duration was associated with: higher initial morphine requirements (ρ = 0.46 [95% CI 0.35, 0.57]); subsequent increased pain and need for ketamine co-analgesia (118/364 episodes with opioid/ketamine 13.9 [9.8-22.2] days vs opioid alone 6.0 [3.9-10.8] days; median [IQR]); but not with age or sex. CONCLUSIONS Management of severe mucositis pain can require prolonged IV opioid therapy. Individual and treatment-related variability in analgesic requirements highlight the need for regular review, titration, and management by specialist services.
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Affiliation(s)
- Suellen M Walker
- Developmental Neurosciences Programme (Paediatric Pain Research Group), UCL GOS Institute of Child Health, London, UK.,Department of Paediatric Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Ebony L Selers
- Department of Paediatric Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trust, London, UK.,Royal Melbourne Hospital, Parkville, Vic., Australia
| | - Matthew A Jay
- Department of Paediatric Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trust, London, UK.,Population, Policy and Practice Research and Teaching Department, UCL GOS Institute of Child Health, London, UK
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- Department of Paediatric Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trust, London, UK
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Kalaycı E, Çalışkan Z. The Quality of Life and Influencing Factors in Turkish Children Receiving Cancer Treatment. J Pediatr Nurs 2021; 61:213-218. [PMID: 34126331 DOI: 10.1016/j.pedn.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 06/06/2021] [Accepted: 06/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study was conducted to determine the quality of life and the influencing factors in children aged 8-12 years who are treated for cancer in Turkey. DESIGN AND METHODS The cross-sectional and descriptive study was conducted on 300 children with cancer and their parents. The data were collected using the Questionnaire Form and the Pediatric Quality of Life Inventory PedsQL (4.0) Child and Parent Form. Descriptive statistics, the independent t-test, univariate and multiple binary logistic regression analysis were used for the evaluation. RESULTS The mean age of the children was 8.92 ± 0.98 years and the quality of life scores in all sub-dimensions and in total (36.26 ± 5.23) were found to be low. According to the univariate binary logistic regression analysis, the father being unemployed, the house being heated with a stove, and development of extravasation during the chemotherapy treatment process created a risk of decreasing the children's quality of life score (7.15 units, 41.29 units, and 44.47 units, respectively) (p < 0.05). CONCLUSIONS The father's unemployment, heating the house with a stove, and the development of extravasation during treatment were found to affect the children's quality of life negatively in the study. Inter-institutional cooperation, taking the necessary measures to decrease the frequency of extravasation development, and ensuring nurses continue family-centered care during these processes are recommended to support the families. PRACTICE IMPLICATIONS Interventions for early detection and prevention of the negative changes related to the quality of life in children with cancer need to be planned.
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Affiliation(s)
- Eda Kalaycı
- Erciyes University, Children Oncology-Hematology Clinic, Turkey
| | - Zehra Çalışkan
- Department of Pediatric Nursing, Semra and Vefa Küçük Faculty of Health Sciences, Nevşehir Hacı Bektaş Veli University, Turkey.
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Curra M, Gabriel AF, Ferreira MBC, Martins MAT, Brunetto AT, Gregianin LJ, Martins MD. Incidence and risk factors for oral mucositis in pediatric patients receiving chemotherapy. Support Care Cancer 2021; 29:6243-6251. [PMID: 33846825 DOI: 10.1007/s00520-021-06199-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 04/05/2021] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Marina Curra
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, sala 503, CEP: 90035-003 Santana, Porto Alegre, RS, Brazil
| | - Amanda F Gabriel
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, sala 503, CEP: 90035-003 Santana, Porto Alegre, RS, Brazil
| | - Maria Beatriz C Ferreira
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marco Antonio T Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, sala 503, CEP: 90035-003 Santana, Porto Alegre, RS, Brazil.,Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Lauro J Gregianin
- Department of Pediatric Oncology, Porto Alegre Clínicas Hospital (HCPA/UFRGS), Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, sala 503, CEP: 90035-003 Santana, Porto Alegre, RS, Brazil. .,Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Attinà G, Romano A, Maurizi P, D'Amuri S, Mastrangelo S, Capozza MA, Triarico S, Ruggiero A. Management of Oral Mucositis in Children With Malignant Solid Tumors. Front Oncol 2021; 11:599243. [PMID: 33859935 PMCID: PMC8042390 DOI: 10.3389/fonc.2021.599243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/16/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction In recent years, the use of intensive regimens for the treatment of pediatric cancer has led to a marked improvement in patient survival. However, these treatments are associated with an increase in toxic effects. Among these side effects, mucositis (inflammation of the oral cavity) significantly affect the success of treatment. The aim of this study was to assess the prevalence of mucositis in a pediatric population with solid tumor and undergoing chemotherapy, identify the risk factors that influence its occurrence, and verify the usefulness of pain rating scales. Methods We registered episodes of mucositis which occurred in a sample of 84 consecutive children with solid tumors between 1 January, 2012 and 30 April, 2018. The World Health Organization (WHO) oral mucositis grading scale and the modified Wong-Baker FACES Pain Rating Scale (WBS) were used to assess the severity of each episode. Moreover, data on the treatments used and blood count results were collected. Results The prevalence of mucositis in our population was 50%, without statistically significant difference according to sex and a higher prevalence observed in patients aged >10 years. The presence of neutropenia, higher number of cycles of chemotherapy, and co-existence of lymphomas and sarcomas were identified as factors favoring the occurrence of mucositis. The WBS showed results superimposed on the WHO oral mucositis grading scale in choosing the intensity and duration of mucositis treatment. Conclusion Oral mucositis is a common complication of chemotherapy against childhood malignancies. The WHO oral mucositis scale is a valuable tool for assessing its severity in pediatric patients. Furthermore, WBS can be used as an assessment tool to establish the therapy to be adopted for patients in whom direct evaluation of the oral cavity is not possible.
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Affiliation(s)
- Giorgio Attinà
- Unità di Oncologia Pediatrica, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alberto Romano
- Unità di Oncologia Pediatrica, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Palma Maurizi
- Unità di Oncologia Pediatrica, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sara D'Amuri
- Unità di Oncologia, Azienda Ospedaliera Sant'Andrea, Rome, Italy
| | - Stefano Mastrangelo
- Unità di Oncologia Pediatrica, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michele Antonio Capozza
- Unità di Oncologia Pediatrica, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Triarico
- Unità di Oncologia Pediatrica, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Ruggiero
- Unità di Oncologia Pediatrica, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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de Farias Gabriel A, Silveira FM, Curra M, Schuch LF, Wagner VP, Martins MAT, da Silveira Matte U, Siebert M, Botton MR, Brunetto AT, Gregianin LJ, Martins MD. Risk factors associated with the development of oral mucositis in pediatric oncology patients: Systematic review and meta-analysis. Oral Dis 2021; 28:1068-1084. [PMID: 33774891 DOI: 10.1111/odi.13863] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/02/2021] [Accepted: 03/25/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Oral mucositis (OM) is an acute toxicity related to cancer treatment. This systematic review aimed to identify potential risk factors associated with the development of OM in pediatric cancer patients. METHODS A search was performed in four electronic databases to identify studies that analyzed risk factors for OM in pediatric cancer patients. RESULTS Nineteen articles were included. The incidence of OM ranged from 20% to 80.4%. Chemotherapeutic agents were potential risk factors for OM in eight (42%) studies. Hematological, hepatic, and renal parameters were also considered in eight (42%) studies, while specific individual factors were reported in five (26.3%) studies. Baseline disease, oral microbiota, genetic profile, and biomarkers were reported in four (21.5%) studies each. Meta-analysis showed that groups submitted to high-risk chemotherapy for OM had a 2.79-fold increased risk of OM. CONCLUSIONS Identifying risk factors for OM is essential in order to allow individualized and early prevention treatment.
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Affiliation(s)
- Amanda de Farias Gabriel
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Martins Silveira
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Marina Curra
- Department of Oral Pathology, University of Caxias do Sul (UCS), Caxias do Sul, Porto Alegre, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Vivian Petersen Wagner
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Marco Antonio Trevizani Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Brazil
| | - Ursula da Silveira Matte
- Molecular and Protein Analysis Unit (UAMP), Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Brazil
| | - Marina Siebert
- Molecular and Protein Analysis Unit (UAMP), Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Brazil
| | - Mariana Rodrigues Botton
- Molecular and Protein Analysis Unit (UAMP), Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Brazil
| | | | - Lauro José Gregianin
- Department of Pediatric Oncology, Porto Alegre Clínicas Hospital (HCPA/UFRGS), Porto Alegre, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.,Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Brazil
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