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Tam OCH, Ho RSL, Chan S, Li KKW, Lam TL, Cheung ETY, Cheung OY, Ho WWS, Cheng KKF, Shing MMK, Ku DTL, Chung BHY, Yang W, Chan GCF, Ng HK, Liu APY. Genome-Wide DNA Methylation Profiling as Frontline Diagnostics for Central Nervous System Embryonal Tumors in Hong Kong. Cancers (Basel) 2023; 15:4880. [PMID: 37835574 PMCID: PMC10571663 DOI: 10.3390/cancers15194880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
This paper examines the link between CNS tumor biology and heterogeneity and the use of genome-wide DNA methylation profiling as a clinical diagnostic platform. CNS tumors are the most common solid tumors in children, and their prognosis remains poor. This study retrospectively analyzed pediatric patients with CNS embryonal tumors in Hong Kong between 1999 and 2017, using data from the territory-wide registry and available formalin-fixed paraffin-embedded tumor tissue. After processing archival tumor tissue via DNA extraction, quantification, and methylation profiling, the data were analyzed by using the web-based DKFZ classifier (Molecular Neuropathology (MNP) 2.0 v11b4) and t-SNE analysis. Methylation profiles were deemed informative in 85 samples. Epigenetic data allowed molecular subgrouping and confirmed diagnosis in 65 samples, verified histologic diagnosis in 8, and suggested an alternative diagnosis in 12. This study demonstrates the potential of DNA methylation profiling in characterizing pediatric CNS embryonal tumors in a large cohort from Hong Kong, which should enable regional and international collaboration in future pediatric neuro-oncology research.
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Affiliation(s)
- Otto C. H. Tam
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong; (O.C.H.T.)
| | - Ronnie S. L. Ho
- Department of Pathology, Gleneagles Hospital, Wong Chuk Hang, Hong Kong
| | - Shing Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong; (O.C.H.T.)
| | - Kay K. W. Li
- Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Tit-Leung Lam
- Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | | | - Oi-Yee Cheung
- Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Wilson W. S. Ho
- Department of Neurosurgery, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- Department of Neurosurgery, Hong Kong Children’s Hospital, Kowloon, Hong Kong
| | - Kevin K. F. Cheng
- Department of Neurosurgery, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- Department of Neurosurgery, Hong Kong Children’s Hospital, Kowloon, Hong Kong
| | - Matthew M. K. Shing
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Kowloon, Hong Kong
| | - Dennis T. L. Ku
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Kowloon, Hong Kong
| | - Brian H. Y. Chung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong; (O.C.H.T.)
| | - Wanling Yang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong; (O.C.H.T.)
| | - Godfrey C. F. Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong; (O.C.H.T.)
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Kowloon, Hong Kong
| | - Ho-Keung Ng
- Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Anthony P. Y. Liu
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong; (O.C.H.T.)
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Kowloon, Hong Kong
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Woo PYM, Au D, Ko NMW, Wu O, Chan EKY, Cheng KKF, Wong AKS, Kirollos RW, Ribas G, Chan KY. Gods and monsters: Greek mythology and Christian references in the neurosurgical lexicon. Surg Neurol Int 2022; 13:67. [PMID: 35242433 PMCID: PMC8888308 DOI: 10.25259/sni_70_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 01/24/2022] [Indexed: 11/14/2022] Open
Abstract
Background: Myths and religion are belief systems centered around supernatural entities that attempt to explain the observed world and are of high importance to certain communities. The former is a collection of stories that belong to a cultural tradition and the latter are organized faiths that determine codes of ethics, rituals and philosophy. Deities or monstrous creatures in particular act as archetypes instructing an individual’s conduct. References to them in Greek mythology and Christianity are frequently manifested in the modern neurosurgical vernacular. Methods: A review of the medical literature was performed using the PubMed and MEDLINE bibliographic databases. Publications from 1875 to 2021 related to neurosurgery or neuroanatomy with the medical subject headings (MeSH) terms mythology, religion, Christianity and Catholicism were reviewed. References pertaining to supernatural beings were classified to either a deity or a monstrosity according to their conventional cultural context. Results: Twelve narratives associated with neurosurgery were identified, nine relating to Greek mythology and three associated with the Christian-Catholic faith. Eight accounts concerned deities and the remaining with monstrous creatures. Conclusion: This article explores the etymology of commonly utilized terms in daily neurosurgical practice in the context of mythology and religion. They reveal the ingenuity and creativity of early pioneers who strived to understand the brain.
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Affiliation(s)
| | - Danise Au
- Department of Neurosurgery, Kwong Wah Hospital, Hong Kong,
| | | | - Oscar Wu
- Department of Neurosurgery, Kwong Wah Hospital, Hong Kong,
| | - Emily K. Y. Chan
- Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Hong Kong,
| | - Kevin K. F. Cheng
- Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, Hong Kong,
| | | | | | - Guilherme Ribas
- Department of Neurosurgery, Albert Einstein Hospital, Sao Paulo, Brazil
| | - Kwong-Yau Chan
- Department of Neurosurgery, Kwong Wah Hospital, Hong Kong,
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Liu APY, Liu Q, Shing MMK, Ku DTL, Fu E, Luk CW, Ling SC, Cheng KKF, Kwong DLW, Ho WWS, Ng HK, Gajjar A, Yasui Y, Chan GCF, Armstrong GT. Incidence and Outcomes of CNS Tumors in Chinese Children: Comparative Analysis With the Surveillance, Epidemiology, and End Results Program. JCO Glob Oncol 2021; 6:704-721. [PMID: 32392090 PMCID: PMC7268901 DOI: 10.1200/jgo.19.00378] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Despite being the most common pediatric solid tumors, incidence and outcome of CNS tumors in Chinese children have not been systematically reported. We addressed this knowledge gap by comparing the epidemiology of pediatric CNS tumors in Hong Kong and the United States. PATIENTS AND METHODS Data between 1999 and 2016 from a population-based cancer registry in Hong Kong, China, on patients < 18 years old with CNS tumors (Hong Kong cohort) and from the US SEER Program (Asian/Pacific Islander and all ethnicities) were compared. Incidence and overall survival (OS) by histology were evaluated. RESULTS During the study period, 526 children were newly diagnosed with CNS tumors in Hong Kong (crude incidence rate, 2.47 per 100,000; 95% CI, 2.26 to 2.69). Adjusted incidences were significantly lower in the Hong Kong (2.51; 95% CI, 2.30 to 2.74) than in the SEER (Asian/Pacific Islander: 3.26; 95% CI, 2.97 to 3.57; P < .001; all ethnicities: 4.10 per 100,000; 95% CI, 3.99 to 4.22; P < .001) cohorts. Incidences of germ cell tumors (0.57 v 0.24; P < .001) were significantly higher, but those of glial and neuronal tumors (0.94 v 2.61; P < .001), ependymomas (0.18 v 0.31; P = .005), and choroid plexus tumors (0.08 v 0.16; P = .045) were significantly lower in Hong Kong compared with SEER (all ethnicities) cohorts. Compared with the SEER (Asian/Pacific Islander) cohort, histology-specific incidences were similar except for a lower incidence of glial and neuronal tumors in Hong Kong (0.94 v 1.74; P < .001). Among cohorts, OS differed only for patients with glial and neuronal tumors (5-year OS: Hong Kong, 52.5%; SEER [Asian/Pacific Islander], 73.6%; SEER [all ethnicities], 79.9%; P < .001). CONCLUSION We identified important ethnic differences in the epidemiology of CNS tumors in Chinese children. These results will inform the development of pediatric neuro-oncology services in China and aid further etiologic studies.
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Affiliation(s)
- Anthony P Y Liu
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN.,Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Qi Liu
- Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew M K Shing
- Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Dennis T L Ku
- Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Eric Fu
- Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Chung-Wing Luk
- Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Siu-Cheung Ling
- Department of Pediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong SAR, China
| | - Kevin K F Cheng
- Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, Hong Kong SAR, China.,Division of Neurosurgery, Department of Surgery, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Dora L W Kwong
- Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - Wilson W S Ho
- Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, Hong Kong SAR, China.,Division of Neurosurgery, Department of Surgery, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Ho-Keung Ng
- Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Amar Gajjar
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Godfrey C F Chan
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
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Chan DYC, Tsang ACO, Ho WWS, Cheng KKF, Li LF, Tsang FCP, Taw BBT, Pu JKS, Leung GKK, Lui MWM. Emergency endoscopic third ventriculostomy for blocked shunts? Univariate and multivariate analysis of independent predictors for failure. J Neurosurg 2018; 131:1-7. [PMID: 30497141 DOI: 10.3171/2018.6.jns1865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/12/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVEHydrocephalus with a blocked ventriculoperitoneal (VP) shunt is a life-threatening condition. Emergency endoscopic third ventriculostomy (ETV) is a potential treatment option. The aim of the study was to identify independent risk factors associated with failure of ETV in treating patients with blocked shunts.METHODSThe authors retrospectively reviewed data from consecutive patients admitted for blocked shunt treated by ETV during the study period from 2000 to 2016. Univariate and multivariate analyses were performed to identify independent factors associated with failed ETV for blocked shunts, such as age, sex, history of CNS infection, number of previous shunt revisions, operations performed as an emergency or elective, number of specialists, and other factors.RESULTSIn total, 121 patients underwent ETV during the study period. Of these, 31 patients (25.6%) had ETV for treatment of a blocked shunt. In 25 (80.6%) of 31 ETV was performed as an emergency procedure. There was no significant difference in the success rate of ETV depending on whether it was performed as an emergency procedure (64% [16/25]) or an elective procedure (66.7% [4/6]; OR 0.062, 95% CI 0.001-2.708; p = 0.149). Univariate and multivariate analyses identified that history of a CNS infection was an independent risk factor for failure of ETV in treating patients with a blocked shunt (OR 0.030, 95% CI 0.001-0.888; p = 0.043).CONCLUSIONSEmergency ETV had a comparable success rate as elective ETV. A history of CNS infection is an independent predictor of ETV failure in treating patients with blocked shunts.
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Cheng KKF, Cheng HL, Wong WH, Koh C. A mixed-methods study to explore the supportive care needs of breast cancer survivors. Psychooncology 2017; 27:265-271. [PMID: 28727224 DOI: 10.1002/pon.4503] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 07/12/2017] [Accepted: 07/17/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Needs assessment is the essence of quality cancer survivorship care. The aim of this study was to explore the supportive care needs of breast cancer survivors (BCS) in the first 5 years post treatment. METHODS A mixed-methods approach was employed. A quantitative study included a Supportive Care Needs Survey, which was completed by 250 BCS to identify the level of their needs for help. The quantitative data informed semistructured qualitative interviews undertaken with 60 BCS to explore in detail their posttreatment needs and experiences. RESULTS 32.4% and 16.8% reported 1 to 5 and greater than or equal to 6 needs for help, respectively. The regression analyses revealed that women within 2 years posttreatment and with higher educational level had higher levels of Psychological and Health Care System/Information needs. The qualitative data revealed "continuity of care" and "lifestyle advice and self-management" as prominent survivorship concerns. It was shown that determination to continue normal life, social support, and feeling overwhelmed by information were all experienced as important influences on survivors' need for help. CONCLUSIONS Posttreatment needs vary with BCS characteristics and to the domains concerned. The approach to posttreatment care needs to be personalized and viable.
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Affiliation(s)
- K K F Cheng
- National University of Singapore, Kent Ridge Road, Singapore
| | - H L Cheng
- Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - W H Wong
- National University Hospital, Kent Ridge Road, Singapore
| | - C Koh
- National University Hospital, Kent Ridge Road, Singapore
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Ip WY, Epstein JB, Lee V, Yuen HL, Li R, Thompson DR, Goggins WB, Cheng KKF. Oral mucositis in paediatric patients after chemotherapy for cancer. Hong Kong Med J 2014; 20 Suppl 7:4-8. [PMID: 25647816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- W Y Ip
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
| | - J B Epstein
- Oral Medicine, Division of Otolaryngology, Head and Neck Surgery, City of Hope National Medical Center, Duarte, CA, USA & Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - V Lee
- Children's Cancer Centre, Department of Paediatrics, Prince of Wales Hospital
| | - H L Yuen
- Department of Paediatrics, Queen Elizabeth Hospital
| | - R Li
- Department of Paediatrics, Tuen Mun Hospital
| | - D R Thompson
- Department of Health Sciences & Department of Cardiovascular Sciences, University of Leicester, United Kingdom
| | - W B Goggins
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
| | - K K F Cheng
- Alice Centre for Nursing Studies, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Chan CWH, Cheng KKF, Lam LW, Li CK, Chik KW, Cheung JSS. Psycho-educational intervention for chemotherapy-associated nausea and vomiting in paediatric oncology patients: a pilot study. Hong Kong Med J 2008; 14:32-35. [PMID: 18941272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- C W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
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Cheng KKF. Children's acceptance and tolerance of chlorhexidine and benzydamine oral rinses in the treatment of chemotherapy-induced oropharyngeal mucositis. Eur J Oncol Nurs 2004; 8:341-9. [PMID: 15550364 DOI: 10.1016/j.ejon.2004.04.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Oral care is of great importance in the prevention of chemotherapy-induced oropharyngeal mucositis. Although considerable attention has been given in improving oral care practices, patients' acceptance and tolerance of oral rinses is a continuing problem in oral care. A randomized crossover design was used to determine the relative acceptability and tolerability of chlorhexidine and benzydamine oral rinse agents in children receiving chemotherapy. At the end of the study, each subject was asked to compare these two agents in relation to stinging and taste, as well as his/her perception in reducing mucositis. Thirty-four children aged 6-17 years completed two courses of chemotherapy during which they alternately practiced oral care using chlorhexidine then benzydamine or benzydamine then chlorhexidine. All of the children tolerated the agents well and continued with rinsing throughout the study. Only a few children had to resort to diluting the agents with normal saline or water. Fifty-nine percent of children reported that the stinging associated with benzydamine was more accepted than chlorhexidine. The taste of both these agents was accepted by 50% of children. Approximately 60% of children reported that chlorhexidine was more helpful than benzydamine in reducing mucositis. About 47% and 50% of them preferred chlorhexidine and benzydamine in their subsequent chemotherapy, respectively. In conclusion, chlorhexidine and benzydamine are acceptable and well-tolerated by children over the age 6 years old.
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Affiliation(s)
- K K F Cheng
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 804A, Esther Lee Building, Shatin, New Territories, Hong Kong.
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Cheng KKF, Chang AM, Yuen MP. Prevention of oral mucositis in paediatric patients treated with chemotherapy. Eur J Cancer 2004; 40:1208-16. [PMID: 15110885 DOI: 10.1016/j.ejca.2003.10.023] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2002] [Revised: 07/24/2003] [Accepted: 10/21/2003] [Indexed: 11/18/2022]
Abstract
This study compared the efficacy of two protocols for oral care using either chlorhexidine or benzydamine as oral rinses to alleviate mucositis in children undergoing chemotherapy. Eligible participants were randomised to receive either protocol for 3 weeks in a two-period crossover design. The occurrence of ulcerative lesions and severity of mucositis were measured at baseline and twice weekly, using the modified Oral Assessment Guide (OAG). Data were continuously analysed by plotting them directly on predefined sequential charts. According to this sequential analysis, the study could be terminated at the 34th within subject comparison, with a statistically significant reduction in ulcerative lesions (P<0.05) and severity of mucositis (P<0.05) in children on the chlorhexidine protocol. These findings suggest that chlorhexidine together with oral care might be helpful in alleviating mucositis when given prophylactically to children on chemotherapy, but the therapeutic benefit needs to be confirmed in a larger trial.
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Affiliation(s)
- K K F Cheng
- Nethersole School of Nursing, Faculty of Medicine, Room 804A, Esther Lee Building, Chung Chi College, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
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Abstract
This prospective randomized 2-period crossover study aimed at comparing the efficacy of 2 oral care protocols differing in the type of mouthwashes: chlorhexidine versus benzydamine in alleviating oral mucositis symptoms for children undergoing chemotherapy. Forty subjects were randomly allocated to receive either chlorhexidine first then benzydamine protocols or benzydamine first then chlorhexidine protocols. Each protocol was started on the first day of chemotherapy and continued for 21 days. Subjects were evaluated in intervals of 3 to 4 days using the World Health Organization (WHO) grading for mucositis and 10-cm visual analogue scale for oral symptoms evaluations. Among 34 evaluable subjects, 26% and 48% of them using chlorhexidine and benzydamine had WHO grade II mucositis, respectively (P < .05). The results revealed a significant difference in mean area under the curve (AUC) of mouth pain (1.35 +/- 2.26 versus 3.09 +/- 3.21) (P = .05), and a trend of a lessening of mean AUC of difficulty in eating/chewing (2.49 +/- 3.74 versus 2.71 +/- 4.1) (P = .82) and swallowing (1.34 +/- 3.31 versus 1.91 +/- 4.03) (P = .53) for subjects receiving chlorhexidine compared to those receiving benzydamine. In conclusion, chlorhexidine may be helpful in palliating mucositis symptoms for children in chemotherapy. The beneficial effect, however, is small and needs to be confirmed in a larger trial.
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Affiliation(s)
- K K F Cheng
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
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Cheng KKF, Molassiotis A, Chang AM. An oral care protocol intervention to prevent chemotherapy-induced oral mucositis in paediatric cancer patients: a pilot study. Eur J Oncol Nurs 2002; 6:66-73. [PMID: 12849596 DOI: 10.1054/ejon.2001.0161] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The likelihood of paediatric cancer patients experiencing oral mucositis has increased significantly as high-dose and multiple chemotherapy agents are used in the treatment of childhood cancer in recent years. The resulting oral ulcerative lesions can cause significant pain, dysphagia, alteration in nutritional status and increased risk for localized infections that could disseminate systemically. The purpose of this pilot study was to determine the clinical benefits of an oral care protocol intervention on the prevention and reduction of the severity of oral mucositis in paediatric patients receiving chemotherapy. Fourteen children were enrolled in the study; there were seven children in the control and seven in the experimental group. In the experimental group, children received a preventive oral care protocol consisting of tooth brushing, normal saline rinse and 0.2% chlorhexidine mouth rinse. Children in the control group received usual care according to the study's clinical setting. Data were collected at baseline, then twice a week for 3 weeks. The incidence of ulcerative lesions, severity of oral mucositis and the related pain intensity were used as the main outcome variables. The experimental group exhibited fewer and less painful oral mucositis lesions. The results of this study support the preventive use of oral care protocols in paediatric patients undergoing chemotherapy for cancer treatment.
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Affiliation(s)
- K K F Cheng
- Department of Nursing Studies, University of Hong Kong.
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