Occurrence and Severity of Oral Mucositis in Brazilian Pediatric Cancer Patients

Pires, Hévila de Figueiredo; Bezerra, Paula Maria Maracajá; Silva, Victor Borges da; Ribeiro, Isabella Lima Arrais; Serpa, Eliane Batista Medeiros; Sousa, Simone Alves de; Valença, Ana Maria Gondim

doi:10.1590/pboci.2020.085

Hévila de Figueiredo Pires

Private Practice, João Pessoa, PB, Brazil.

http://orcid.org/0000-0002-6622-511X

Paula Maria Maracajá Bezerra

Postgraduate Program in Dentistry, School of Dentistry, Federal University of Paraíba, João Pessoa, PB, Brazil.

http://orcid.org/0000-0002-9705-8959

Victor Borges da Silva

Department of Statistics, Federal University of Paraíba, João Pessoa, PB, Brazil.

http://orcid.org/0000-0001-9960-6616

Isabella Lima Arrais Ribeiro

Post-Doctoral Fellow, São Paulo University, Ribeirão Preto, SP, Brazil.

http://orcid.org/0000-0001-6538-6811

Eliane Batista Medeiros Serpa

Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, PB, Brazil.

http://orcid.org/0000-0002-9119-4079

Simone Alves de Sousa

Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, PB, Brazil.

http://orcid.org/0000-0002-3254-9036

Ana Maria Gondim Valença Author to whom correspondence should be addressed: Ana Maria Gondim Valença, Rua Miguel Satyro, 350, apt. 2301, Cabo Branco, João Pessoa, PB, Brazil. 58045-110. Phone: +55 83 999864397. E-mail: anamvalenca@gmail.com.

Department of Statistics, Federal University of Paraíba, João Pessoa, PB, Brazil.

http://orcid.org/0000-0001-8460-3981

Author to whom correspondence should be addressed: Ana Maria Gondim Valença, Rua Miguel Satyro, 350, apt. 2301, Cabo Branco, João Pessoa, PB, Brazil. 58045-110. Phone: +55 83 999864397. E-mail: anamvalenca@gmail.com.

Academic Editors: Alessandro Leite Cavalcanti and Wilton Wilney Nascimento Padilha

Conflict of Interest

The authors declare no conflicts of interest.

Authors’ Contributions

HFP Methodology, Investigation, Formal Analysis and Writing - Review and Editing.

PMMB Methodology, Investigation, Formal Analysis and Writing - Review and Editing.

VBS Investigation, Formal Analysis and Writing - Review and Editing.

ILAR Conceptualization, Methodology, Formal Analysis and Writing - Review and Editing.

EBMS Methodology, Supervision and Writing - Review and Editing.

SAS Methodology, Supervision and Writing - Review and Editing.

AMGV Conceptualization, Methodology, Investigation, Formal Analysis and Writing - Review and Editing.

All authors declare that they contributed to critical review of intellectual content and approval of the final version to be published.

Variables	N	%
Sex
Female	42	49.4
Male	43	50.6
Age (9.5 ± 5.4 Years)
< 10 Years	44	51.8
≥ 10 Years	41	48.2
Self-Reported Skin Color
Mixed Race	44	51.8
White	35	41.2
Black	3	3.5
Indigenous	2	2.3
Not Stated	1	1.2
City of Residence
João Pessoa	18	21.2
Other Cities in the State of Paraíba	64	72.9
Cities in Other States	3	5.9

Type of Tumor / Underlying Disease	N	%
Hematological Tumor
Acute Lymphoblastic Leukemia	30	35.3
Acute Myeloid Leukemia	11	13.0
Non-Hodgkin's Lymphoma	9	10.6
Hodgkin's Lymphoma	7	8.2
Total	57	67.1
Solid Tumor
Osteosarcoma	8	9.4
Wilms Tumor	4	4.7
Rhabdomyosarcoma	4	4.7
Neuroblastoma	3	3.5
Testicular Tumor	3	3.5
Central Nervous System Tumor	2	2.3
Breast Cancer	1	1.2
Melanoma	1	1.2
Ovarian Tumor	1	1.2
Ewing's Sarcoma	1	1.2
Total	28	32.9
Antineoplastic Therapy
Exclusive Chemotherapy	67	79.8
Chemotherapy and Surgery	11	13.1
Chemotherapy and Radiotherapy	7	7.1
Class of Chemotherapeutic Drug Administered in the 1^st Week of Treatment^* * Patients were administered chemotherapeutic drugs of more than one class.
Natural Products	79	94.8
Antimetabolites	27	32.4
Alkylants	15	17.7
Miscellaneous	9	10.8

Variables	Presence		Absence		Total
	N	%	N	%	N	%
Oral Mucositis
2nd Week	41	60.0	27	40.0	68	100.0
5th Week	20	40.9	29	59.1	49	100.0
10th Week	16	43.2	21	56.8	37	100.0
Severe Oral Mucositis
2nd Week	22	32.3	46	67.7	68	100.0
5th Week	17	34.7	32	65.3	49	100.0
10th Week	11	29.7	26	70.3	37	100.0

	Occurrence of Severe Oral Mucositis Per Week of Treatment
Variables	2nd Week				5th Week				10th Week
	Present		Absent		Present		Absent		Present		Absent
	N	%	N	%	N	%	N	%	N	%	N	%
Age
< 10 Years	9	27.3	24	72.7	6	31.6	13	68.4	6	42.9	8	57.1
≥ 10 Years	13	37.1	22	62.9	11	36.7	19	63.3	5	21.8	18	78.2
p-value	0.385				0.715				0.173
Hematological Tumor
Yes	16	31.4	35	68.6	14	37.9	23	62.1	9	32.2	19	67.8
No	6	35.3	11	64.7	3	25.0	9	75.0	2	22.3	7	77.7
p-value	0.765				0.417				0.571
Use of Antimetabolites^(a) (a) Loss of information in the 2nd week (13 patients), 5th week (7 patients) and 10th week (3 patients);
Yes	6	27.3	16	72.7	6	31.6	13	68.4	4	43.5	13	56.5
No	11	33.3	22	66.7	6	26.1	17	73.9	6	37.5	10	62.5
p-value	0.581				0.695				0.383
Use of Methotrexate^(a) (a) Loss of information in the 2nd week (13 patients), 5th week (7 patients) and 10th week (3 patients);
Yes	3	17.7	14	82.3	3	25.0	9	75.0	2	18.2	9	81.8
No	14	36.9	24	63.1	9	30.0	21	70.0	8	36.4	14	63.6
p-value	0.155				0.746				0.284
Leukocyte Count^(b) (b) Loss of information in the 2nd week (6 patients), 5th week (5 patients) and 10th week (2 patients);
< 3,400 / mm³	10	32.3	21	67.7	4	25.0	12	75.0	7	43.8	9	56.2
3,400 - 9,500 / mm³	6	33.3	12	66.7	8	44.4	10	55.6	2	13.3	13	86.7
> 9,500 / mm³	2	15.4	11	84.6	3	25.0	9	75.0	1	25.0	3	75.0
p-value	0.474				0.390				0.171
Platelet Count^(c) (c) Loss of information in the 2nd week (6 patients), 5th week (4 patients) and 10th week (2 patients);
< 150,000 / mm³	7	30.4	16	69.6	3	27.3	08	72.7	6	50.0	6	50.0
150,000 - 450,000 / mm³	10	30.3	23	69.7	9	32.1	19	67.9	4	21.1	15	78.9
> 450.000 / mm³	1	16.7	5	83.3	2	33.3	4	66.7	0	0.0	4	100.0
p-value	0.781				0.950				0.090
Blood Creatinine Level^(d) (d) Loss of information in the 2nd week (9 patients), 5th week (5 patients) and 10th week (4 patients).
< 0.4 mg / dl	7	41.2	10	58.8	5	38.5	8	61.5	4	44.4	5	55.6
0.4 - 1.3 mg / dl	10	23.9	32	76.2	9	31.0	20	69.0	5	20.8	19	79.2
> 1.3 mg / dl	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
p-value	0.182				0.637				0.175

[1] Author to whom correspondence should be addressed: Ana Maria Gondim Valença, Rua Miguel Satyro, 350, apt. 2301, Cabo Branco, João Pessoa, PB, Brazil. 58045-110. Phone: +55 83 999864397. E-mail: anamvalenca@gmail.com.

Brasil

Brasil

Occurrence and Severity of Oral Mucositis in Brazilian Pediatric Cancer Patients

Abstract

Objective:

Material and Methods:

Results:

Conclusion: