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Background Oral mucositis (OM) is one of the main adverse effects of the chemotherapeutic agent methotrexate (MTX). Aim To evaluate the relationship of OM with MTX metabolism time and other toxicities in childhood, cancer patients receiving high‐dose of methotrexate (HD‐MTX). Design Seventy‐seven childhood patients receiving HD‐MTX for treatment of leukaemia, osteosarcoma or lymphoma were evaluated. MTX serum level, hepatic and renal function parameters, and presence and intensity of OM were analysed. Results The patients were submitted to 255 cycles of chemotherapy. OM was diagnosed in 191 (74.9%) cycles. Of these, 119 (46.6%) presented ulcerative lesions. Lymphoma was associated with severe OM (P = .01). OM was associated with higher serum levels of aspartate aminotransferase (P = .006), alanine aminotransferase (P = .04) and creatinine (P = .008). Increase of one unit of total bilirubin and indirect bilirubin associated, respectively, with 11% and 39% higher prevalence of OM. For each increase of one unit of creatinine serum level, it was observed a 37% higher prevalence of OM in patients with lymphoma. No association was found between delayed excretion of MTX and OM development. Conclusions OM is a prevalent complication of childhood cancer patients receiving HD‐MTX. Renal and hepatic toxicity could be considered risk factors for OM, especially in patients with lymphoma.

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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.

ObjectivesThis study aimed to analyze the demographic, clinical, histopathological, diagnosis, treatment, and follow‐up data on the occurrence of oral and maxillofacial tuberculosis (OMTB).MethodsElectronic searches without publication date restrictions were undertaken in four databases. Case reports and case series describing the occurrence of OMTB were included. Critical evaluation of studies was done using the Joanna Briggs Institute – University of Adelaide tool for case reports or case series.ResultsA total of 217 studies were included in the qualitative synthesis, for a total of 301 cases of OMTB. Of these patients, 192 (63.7%) were male, with an average age of 39.6 ± 19.8 (15 months to 81 years). The tongue (n = 80/26.6%) represented the most common affected site, followed by the mandible (n = 43/14.3%). The clinical presentation consisted mainly of a painful ulcerated lesion (n = 156/56.5%). Histopathological analysis showed a granulomatous inflammation in most cases (n = 156/63.1%). The main diagnostic methods used were sputum test (n = 53/26.8%), culture (n = 49/24.7%) and purified protein derivative (PPD), or Mantoux test (n = 49/24.7%). Antituberculosis therapy was used in 244 cases (100.0%) and 5.2% of patients died.ConclusionsThis systematic review provided clinical, demographic data and information about diagnostic methods of OMTB lesions and served as an important guide to assist health professionals in the early diagnosis of these lesions.