Factors Contributing to the Duration of Chemotherapy-Induced Severe Oral Mucositis in Oncopediatric Patients

Lecidamia Cristina Leite Damascena, Nyellisonn Nando Nóbrega de Lucena, Isabella Lima Arrais Ribeiro, Tarciana Liberal Pereira de Araujo, Ricardo Dias de Castro, Paulo Rogério Ferreti Bonan, Eufrásio de Andrade Lima Neto, Luiz Medeiros de Araújo Filho, Ana Maria Gondim Valença, Lecidamia Cristina Leite Damascena, Nyellisonn Nando Nóbrega de Lucena, Isabella Lima Arrais Ribeiro, Tarciana Liberal Pereira de Araujo, Ricardo Dias de Castro, Paulo Rogério Ferreti Bonan, Eufrásio de Andrade Lima Neto, Luiz Medeiros de Araújo Filho, Ana Maria Gondim Valença

Abstract

This study analyzes the factors contributing to the duration of severe oral mucositis in oncopediatric patients. A longitudinal study was conducted in the pediatric department of a cancer referral hospital between 2013 and 2017. Seventy-three patients diagnosed with cancer undergoing chemotherapy protocols were analyzed. Oral evaluations were performed using the Modified Oral Assessment Guide criteria, and the data were collected from the patients' records. The Kaplan-Meier method was used to estimate survival curves. Most patients were males (52.1%), of mixed race ("pardo") (49.3%), with a mean age of 7.56 years (±5.34). There was a predominance of patients diagnosed with solid tumors (52.1%), with no metastasis (86.3%), using natural product chemotherapeutics (56.2%), who had not undergone a bone marrow transplant (97.3%); amputation was observed in 35.6% of patients, while death rates were as high as 8.2%. The survival analysis estimated a mean time of 30.6 days until complete remission of severe oral mucositis. The regression analysis showed that patients over 10 years old had a median mucositis duration 1.4 times greater than those at the age of 10 years or younger. Patients without metastasis had a median mucositis duration 1.7 times greater than those with metastasis (p-value ≤ 0.10). Increasing age and the absence of metastasis were conditions that prolonged the duration of severe oral mucositis.

Keywords: cancer; child; mucositis.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier analysis stratified for the metastasis variable of oncopediatric patients with severe oral mucositis in Napoleão Laureano Hospital. João Pessoa, Paraíba State, Brazil (2013–2017).
Figure 2
Figure 2
Standardized êi* residuals evaluating the overall final model fit.
Figure 3
Figure 3
Cox-Snell residuals evaluating the overall final model fit.

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