Prevention and Treatment of Oral Complications in Hematologic Childhood Cancer Patients: An Update

The Study Progress and Analysis of Preventive Measures of Nursing Care for Chemotherapy-Induced Oral Mucositis in Pediatric Patients with Hematologic Malignancies: A Retrospective Study

Objective

To analyze the preventive and therapeutic effects of comprehensive nursing interventions on chemotherapy-induced oral mucositis in pediatric patients with hematologic malignancies.

Methods

A retrospective analysis was conducted, and 80 pediatric patients with hematologic malignancies who underwent chemotherapy in our hospital from January 2020 to December 2023 were selected as the research subjects. According to different nursing intervention methods, the patients were divided into an experimental group (45 cases) and a control group (35 cases). The experimental group received comprehensive nursing interventions, including oral care, dietary guidance, and psychological support; the control group received routine care. The observation indicators included the incidence of oral mucositis, Oral Mucositis Daily Questionnaire (OMDQ) scores, pain index (Visual Analog Scale), and levels of inflammatory markers (IL-6 and CRP) in saliva.

Results

In the first, second, and fourth weeks of chemotherapy, the incidence of oral mucositis in the experimental group was significantly lower than in the control group (P < 0.05), with a total incidence of 51.11% compared to 77.14% (P = 0.017). Before chemotherapy, no significant difference was observed in OMDQ or VAS scores between the groups (p>0.05). However, in the first, second, and fourth weeks, OMDQ and VAS scores in the experimental group were significantly lower than those in the control group (P < 0.001). Similarly, levels of IL-6 and CRP showed no baseline difference between groups but were significantly reduced in the experimental group during these weeks (P < 0.001).

Conclusion

Comprehensive nursing interventions significantly reduce the incidence and severity of chemotherapy-induced oral mucositis in pediatric patients with hematologic malignancies, alleviate oral pain in pediatric patients, and effectively reduce the levels of inflammatory markers in saliva. The application of comprehensive nursing interventions in clinical nursing practice can improve the quality of care for pediatric patients with hematologic malignancies.

Knowledge, attitude, and practice toward family-based treatment among parents of children with leukemia

Background

To investigate the KAP toward family-based treatment among parents of children with leukemia.

Methods

This cross-sectional study was conducted between December, 2022 and July, 2023 in the Pediatric hematologic oncology department of West China Second University Hospital, Sichuan University. The study population consisted of parents of children diagnosed with leukemia. Their demographic characteristics and KAP toward family-based treatment for leukemia were collected by self-administered questionnaires.

Results

A total of 482 parents participated, including 379 (78.63%) females, with an average age of 35.83 ± 6.40 years. The mean scores for KAP were 7.28 ± 1.13 (possible range: 0-10), 37.82 ± 4.38 (possible range: 9-45), and 40.09 ± 4.17 (possible range: 9-45), respectively. Multivariate logistic regression analysis indicated that the knowledge score (OR = 1.48, 95% CI: [1.08-2.05], P = 0.016), attitude score (OR = 1.31, 95% CI: [1.18-1.46], P < 0.001), education of junior college and above (OR = 11.28, 95% CI: [1.94-65.65], P = 0.007), and monthly income of 5,000-10,000 Yuan (OR = 10.88, 95% CI: [1.15-102.98], P = 0.037) were independently associated with a proactive practice. Structural equation modeling (SEM) results highlighted the significant direct impact of knowledge on attitude (β = 0.72, P = 0.002), attitude on practice (β = 0.57, P < 0.001), and knowledge on practice (β = 0.81, P < 0.001).

Conclusion

Parents of children with leukemia demonstrated inadequate knowledge, but positive attitudes and proactive practices toward family-based treatment for leukemia. Future interventions should not only prioritize augmenting parental knowledge through educational initiatives but also focus on fostering positive attitudes and providing support for both knowledge and practical parenting skills to facilitate proactive involvement.

Oral Complications and Management Strategies for Cancer Patients: Principles of Supportive Oncology in Dentistry

PURPOSE OF REVIEW

It is recognized that patients undergoing cancer treatment experience different adverse effects depending on the type of therapy they received. The objective of this work is to provide a scientific evidence-based protocol for oral care in cancer patients. Cancer resection surgery, chemotherapy, and radiotherapy can cause important complications that impact patients' quality of life.

RECENT FINDINGS

Cancer patients, from the moment of diagnosis to the end of treatment and subsequent follow-up, have diverse care needs, both from a systemic and local point of view. The implementation of oral care protocols before, during, and after cancer therapy is essential because it helps to identify risk factors for the development of predictable oral complications. It is essential to establish that all cancer patients, before starting treatment, undergo a systematic dental check-up to avoid limitations during treatment and also alter their quality of life. Regular professional oral care maintenance and follow-up programs are essential to maintaining a patient's long-term oral health.

Oral Manifestations: A Warning-Sign in Children with Hematological Disease Acute Lymphocytic Leukemia

Acute lymphocytic leukemia (ALL) is the most frequent form of all childhood leukemias, mostly affecting children between 2 and 4 years old. Oral symptoms, such as mouth ulcers, mucositis, xerostomia, Herpes or Candidiasis, gingival enlargement and bleeding, petechiae, erythema, mucosal pallor and atrophic glossitis, are very common symptoms of ALL and can be early signs of the disease. Secondary and tertiary complications, a direct effect of chemo and radiotherapy, are associated with more severe bleeding, higher susceptibility to infections, ulcerations, inflammation of the mucous membranes, osteoradionecrosis, xerostomia, taste alterations, trismus, carious lesions and dental abnormalities. Immunotherapy, though less toxic, causes oral dysesthesia and pain. Overall, the effects in the oral cavity are transient but there are long-term consequences like caries, periodontal disease and tooth loss that impair endodontic and orthodontic treatments. Also, dental abnormalities resulting from disturbed odontogenesis are known to affect a child's quality of life. The medical dentist should identify these complications and perform appropriate oral care in tandem with other health professionals. Thus, poor oral hygiene can lead to systemic ALL complications. The aim of this review is to describe the oral complications in children with ALL who are undergoing chemo, radio or immunotherapy.