Impact of a protocol for the prevention and care of oral mucositis in pediatric patients diagnosed with cancer

Abstract

Introduction: Oral mucositis (OM) is a common complication associated with cancer treatment, and it can range from mild to severe degree. Up to 80% of children undergoing chemotherapy will experience some degree of OM, which can get to increase mortality by up to 40% in severe cases. Although OM incidence differs according to cancer type and treatment regimen, children with hematological malignancies experience higher incidence and prevalence than children diagnosed with solid tumors. According to the above, OM is likely to represent a major cause for common protocol-indicated dose reduction and, hence, for treatment delay. Therefore, this work analyzes approaches that been used to impact on OM prevention and opportune treatment, in addition to contributing to yet-unpublished national statistics. Material and Methods: This was a retrospective, descriptive study of 157 cancer-diagnosed pediatric patients attended to during the period from September 2014 to June 2016 and who were at risk for experiencing an OM event during their treatment stage. Results: OM occurrence was 21.6% and annual prevalence was 2.6% out of a total of 1731 assessments. Conclusions: Our results are promising, and expanding the sample size, as well the perspective of collaboration with other institutions is suggested in order to promote a standardized oral care protocol for children diagnosed with cancer. (creativecommons.org/licenses/by-nc-nd/4.0/). KEYWORDSOral mucositis; Pediatric cancer; Oral care protocol Protocol for the prevention and care of oral mucositis in pediatric patients diagnosed with cancer 97

Severity of Oral Mucositis in Children following Chemotherapy and Radiotherapy and Its Implications at a Single Oncology Centre in Durango State, Mexico

“…It is therefore important to implement preventive and therapeutic guidelines to maintain excellent oral health and reduce the risk of developing oral mucositis. Ávila-Sánchez et al [19] observed a lower prevalence of oral mucositis than that reported in the global literature after implementing a dental health protocol; the severity of oral mucositis was reduced within 7 days of implementing this protocol. Therefore, we also plan to introduce an oral health protocol at our institute to reduce the risk of oral mucositis.…”

“…Oral health remains a public health concern in Mexico, including in Durango state where 50% of children have dental problems (especially caries); hence, it is possible that the development of oral mucositis is related to poor oral hygiene [19]. It is therefore important to implement preventive and therapeutic guidelines to maintain excellent oral health and reduce the risk of developing oral mucositis.…”

Photobiomodulation for Chemotherapy-Induced Oral Mucositis in Pediatric Patients

“…The impaired function of the epithelial barrier may lead to secondary and systemic infections, which result in higher demands for wide-spectrum antibiotics [ 1 , 4 , 5 , 6 ]. Besides that, OM is often associated with cancer therapy interruptions or dose reductions, resulting in worsened clinical and economic outcomes and higher patient mortality [ 5 , 6 , 7 ].…”

“…Due to rapidly dividing cells, oral mucosa is highly sensitive to the damaging effects of cytotoxic drugs or radiotherapy (RT) to the head and neck region. Children and young adults are thus predisposed to develop this condition because they have a higher epithelial mitotic rate [ 5 , 7 , 8 ]. Age, as well as the type of malignancy and treatment regime, are some factors that influence the incidence of chemotherapy-induced OM.…”

“…In children, OM occurs in approximately 52 to 80% of cancer patients receiving treatment, although there are some variations in the literature. The estimated incidence is higher in patients with hematological malignancies compared to solid tumors [ 6 , 7 , 9 , 10 , 11 , 12 ]. Furthermore, some drugs used in different chemotherapy (CT) protocols display a higher cytotoxic potential than others, one example being methotrexate (MTX) alone or in combination with other agents.…”