International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 12 , ISSUE 4 ( July-August, 2019 ) > List of Articles

Original Article

Chemotherapy in Pediatric Oncology Patients and the Occurrence of Oral Mucositis

Isabella LA Ribeiro, Eufrásio de Andrade Lima Neto, Ana MG Valença

Keywords : Chemotherapy, Dentistry, Oncology, Pediatric, Severe oral mucositis

Citation Information : Ribeiro IL, Neto ED, Valença AM. Chemotherapy in Pediatric Oncology Patients and the Occurrence of Oral Mucositis. Int J Clin Pediatr Dent 2019; 12 (4):261-267.

DOI: 10.5005/jp-journals-10005-1633

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Background: It is known that chemotherapeutic agents are not equally stomatotoxic and oral cavity lesions are the most frequent complications encountered in antineoplastic chemotherapy. Aims: The objective of this study was to evaluate the occurrence of severe oral mucositis during a chemotherapy treatment and to identify its relationship with the chemotherapeutic class used. Materials and methods: This is a longitudinal, prospective, and observational study that used an intensive direct observation technique for assessing the oral clinical conditions and the chemotherapy treatment administered to 105 patients (both children and adolescents). Results: Severe oral mucositis occurred in all the 10 weeks of evaluation (ranging from 16.2 to 31.4%) and the association between the type of chemotherapy and the occurrence of severe oral mucositis is recorded only in the 6th week, with the chance to develop severe oral mucositis being 3.07 (3.85–2.29) times higher in patients underwent chemotherapy with antimetabolites than in those who have not used chemotherapy (p = 0.012). Conclusion: It was concluded that the chemotherapeutic agents most related to severe oral mucositis and to the interruption in chemotherapy are those of the class of antimetabolites, especially the methotrexate and the Ara C.


PDF Share
  1. Couto AC, Ferreira JD, et al. Trends in childhood leukemia mortality over a 25-year period. J Pediatr 2010;86(5):405–410. DOI: 10.2223/JPED.2027.
  2. Meeske KA, Ji L, et al. Comparative Toxicity by Sex Among Children Treated for Acute Lymphoblastic Leukemia: A Report From the Children's Oncology Group. Pediatr Blood Cancer 2015;62(12): 2140–2149. DOI: 10.1002/pbc.25628.
  3. Moizan H. L’évaluation de la qualité de vie em cancérologie dês voies aérodigestives supérieures passe és aucrible dês odontologistes hospitaliers français. Éthiqueet santé 2010;7(4):184–190. DOI: 10.1016/j.etiqe.2008.08.002.
  4. Santos TFR, Coradini CDB, et al. Knowledge and practice of oral health in child patients with cancer. Arquivos em Odontologia 2010;46(1):5–10.
  5. Albarran LG. Reactivates Adverse reactions to oncological medications in Pediatrics. Mexico: Faculty of Chemists Farmacobiologia. Universidad Michoacana From San Nicolas de Hidalgo; 2012.
  6. Cheng KKF, Lee V, et al. Oral mucositis in pediatric and adolescent patients undergoing chemotherapy: the impact of symptoms on quality of life. Support Care Cancer 2012;20(1):2335–2342. DOI: 10.1007/s00520-011-1343-1.
  7. Cheng KKF, Chang AM, et al. Prevention of oral mucositis in paediatric patients treated with chemotherapy: a randomised crossover trial comparing two protocols of oral care. Eur J Cancer 2004;40(8): 1208–1216. DOI: 10.1016/j.ejca.2003.10.023.
  8. Cheng KKF, Lee V, et al. Incidence and risk factors of oral mucositis in paediatric and adolescent patients undergoing chemotherapy. Oral Oncology 2011;47(3):153–162. DOI: 10.1016/j.oraloncology.2010. 11.019.
  9. Rímulo AL, Ferreira MC, et al. Chemotherapy-induced oral mucositis in a patient with acute lymphoblastic leukaemia. European Archives of Paediatric Dentistry 2011;12(2):124–127. DOI: 10.1007/BF03262792.
  10. Dhillon J, Kalra GK, et al. Oral health in children with Leucemia. Indian J Palliat Care 2012;18(1):12–18. DOI: 10.4103/0973-1075.97343.
  11. Makin G. Principles of chemotherapy. Paediatr Child Health 2014;24(4):161–165. DOI: 10.1016/j.paed.2013.09.002.
  12. Mills D, Maloney AM. Oral Mouth Care and Mucositis. Supportive Care in Pediatric Oncology. Springer Berlin Heidelberg; 2015. pp. 177–189.
  13. Caze MO, Bueno D, et al. Referential study of a chemotherapy protocol for leukemia LinfocAutomatic Acute infantile. Rev Hcpa 2010;30(1):5–12.
  14. Eilers J, Berger AM, et al. Development, testing, and application of the oral assessment. Oncol Nurs Forum 1998;15(3):325–330.
  15. 15. Brasil. Agência National surveillance Sanitária. Drugs used in neoplasms. 2013. Available at: Http://www.anvisa.gov.br/divulga/public/livro_eletronico/neoplasiA.html. Access on: 19.02.2017.
  16. Brazil. National Cancer Institute. Estimate 2014: Incidence of cancer in Brazil. National Institute of Cancer José Alencar Gomes da Silva, coordination of prevention and vigilance. Rio de Janeiro, 2014.
  17. Boissel N, Aurlec M-F, et al. Should adolescents with acute lymphoblastic leukemia be treated as old children or young adults? Comparison of the FrenchFRALLE-93 and LALA-94 Trials. J Clin Oncol 2003;21(5):774–780. DOI: 10.1200/JCO.2003.02.053.
  18. Cheng KKF, Goggins WB, et al. Risk factors for oral mucositis in children undergoing chemotherapy: A matched case-control study. Oral Oncol 2008;44(11):1019–1025. DOI: 10.1016/j.oraloncology.2008.01.003.
  19. Mouchrek Júnior JCE, Trovão MMA. Assessment of the plaque and gingival indices of children with neoplastic submitted to antineoplastic treatment. Rev Bras Odontol 2010;67(1):101–105.
  20. Kung AYH, Zhang S, et al. Oral Health Status of Chinese Paediatric and Adolescent Oncology Patients with Chemotherapy in Hong Kong: a Pilot Study. The Open Dentistry. Journal 2015;9(1):21–30. DOI: 10.2174/1874210601509010021.
  21. Camargo B, Santos MO, et al. Cancer incidence among children and adolescents in Brazil: First report of 14 population-based cancer registries. Int J Cancer 2010;126(3):715–720. DOI: 10.1002/ijc.24799.
  22. Ip WY, Epstein JB, et al. Oral mucositis in paediatric patients after chemotherapy for cancer. Hong Kong Med J 2014;20(6):S4–S8.
  23. Mendonça MA, Araújo MD, et al. Oral Mucositis in Pediatric Acute Lymphoblastic Leukemia Patients: Evaluation of Microbiological and Hematological Factors. Pediatr Hematol Oncol 2015;32(5):322–330. DOI: 10.3109/08880018.2015.1034819.
  24. White MC, Hommers C, et al. Pain management in 100 episodes of severe mucositis in children. Ped Anesthesia 2011;21(4):411–416. DOI: 10.1111/j.1460-9592.2010.03515.x.
  25. Scully C, Epstein J, et al. Oral mucositis: a challenging complication of radiotherapy, chemotherapy, and radiochemotherapy: part 1, pathogenesis and prophylaxis of mucositis. Head Neck 2003;25(12):1057–1070. DOI: 10.1002/hed.10318.
  26. Cheng KKF, Leung SF, et al. Severe oral mucositis associated with cancer therapy: impact on oral functional status and quality of life. Support Care Cancer 2010;18(11):1477–1485. DOI: 10.1007/s00520-009-0771-7.
  27. Santos TRA, Souza SR. As intervenções de enfermagem à criança e ao adolescente com câncer durante o tratamento quimioterápico. Rev Pesqui Cuid Fundam 2015;7(3):2853–2864.
  28. Nesemeier R, Dunlap N, et al. Evidence-Based Support for Nutrition Therapy in Head and Neck Cancer. Curr Surg Rep 2017;5(8):18. DOI: 10.1007/s40137-017-0179-0.
  29. Orgel E, Sposto R, et al. Impact on Survival and Toxicity by Duration of Weight Extremes During Treatment for Pediatric Acute Lymphoblastic Leukemia: A Report From the Children's Oncology Group. J Clin Oncol 2014;31(1):1–9. DOI: 10.1200/JCO.2013.52.6962.
  30. Lima AG, Antequera R, et al. Efficacy of Low-Level Laser Therapy and Aluminum Hydroxide in Patients with Chemotherapy and Radiotherapy-Induced Oral Mucositis. Braz Dent J 2010;21(3):186–192. DOI: 10.1590/S0103-64402010000300002.
  31. Ribeiro ILA, Valença AMG, et al. Oral monitoring of a pediatric patient during chemotherapy treatment. Revista Cubana de Estomatologia 2015;52(2):196–201.
  32. Figueiredo ALP, Lins L, et al. Laser therapy in control of the Mucositis Oral: A Study of Meta analysis. Rev Assoc Med Bras 2013;59(5):467–474. DOI: 10.1016/j.ramb.2013.08.003.
  33. Luo F, Gu J, et al. Systems pharmacology strategies for anticancer drug discovery based on natural products. Mol Biosyst 2014;10(7): 1912–1917. DOI: 10.1039/c4mb00105b.
  34. Eid SY, El-Readi MZ, et al. Natural Products Modulate the Multifactorial Multidrug Resistance of Cancer. Pharmacol Pharm 2015;6(3):146–176.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.